提升手術團隊執行腹腔溫熱化療防護安全正確率

Improve the Safety and Accuracy Rate of the Operating Personnel in During Hyperthermic Intra Peritoneal Chemotherapy

10.6880/TJON.202306_23(1).04

巫祈明(Chi-Ming Wu)；黃明月(Ming-Yue Huang)；許云菁(Yun-Ching Hsu)；李心瑜(Shine-Yu Lee)；吳素蘭(Su-Lan Wu)；王琦(Chi Wang)

腹腔溫熱化學治療 ； 風險評估 ； 病人安全 ； hyperthermic intraperitoneal chemoperfusion, or HIPEC, IPHC ； riskevaluation ； patient safety

腫瘤護理雜誌

23卷1期（2023 / 06 / 01）

37 - 51

繁體中文;英文

於手術室執行開放式腹腔溫熱化療帶來風險甚大，若危害因素未控制，可能會發生骨髓抑制、免疫力降低、畸胎等情形。而手術團隊在無足夠安全防護下暴露於化學藥物中安全防護成為重要議題，故引發改善動機。進一步調查發現，手術室團隊防護安全正確率：護理師42.9%、環管人員74.3%；認知正確率：護理師64.5%、環管人員99%。為改善團隊執行腹腔溫熱化療防護安全，專案小組經建構知能及實務行動學習庫、規劃多功能化學藥物專屬領用車、增購活動式基因毒性專用垃圾桶、增列腹腔溫熱化療手術防護措施、增修腹腔溫熱化療手術作業標準。執行後，手術室團隊防護安全正確率：護理師由42.9%提升至96.4%、環管人員由74.3%提升至100%；認知正確率：護理師由64.5%提升至98.5%、環管人員由99%提升至100%。經由此專案期望可促進手術團隊之安全並提升癌症病人之照護品質。

Performing the HIPEC treatment in the surgical room bears a great risk of marrow suppression, immunity decrease, and teratogenesis if the risk factors are not properly controlled. Meanwhile, the surgical team that perform the HIPEC treatment are exposed to the toxic chemicals if there is not adequate safety protocol in place. Thus, safety protection becomes a very important agenda, which is the drive behind this study. The researchers of this study conducted a survey about the protection safety accuracy in the surgical team. The result shows that the accuracy rate of the nurses is 42.9%, the environment management personnel 74.3%, and the awareness accuracy of the nurses is 64.5%, and the environment management personnel 99%. In order to improve the protection safety of the HIPEC treatment performing personnel, the researchers proposed a series of strategies which are listed as follows. First, constructing an awareness-and-practice mobile learning database. Second, completion of the multi-functional thermo-therapy- oriented medicine collecting cart. Third, purchasing trash bins dedicated for genotoxicity materials. Fourth, posting the HIPEC surgery protecting procedures. Fifth, solidifying the HIPEC surgery operating standards. After applying the strategies, the researchers found that the protection safety accuracy of the surgical related personnel increased from 42.9% to 96.4% in nurses, increased from 74.5% to 100% in the environment management personnel, whereas the awareness accuracy increased from 64.5% to 98.5% in nurses, increased from 99% to 100% in the environment management personnel. The aim of this study is to help ensure the safety of the surgical personnel and improve the quality of care for cancer patients.

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