降低精神科日間病房病人上呼吸道感染發生率

Reduction of the Rate of Upper Respiratory Tract Infection in a Psychiatric Day Care Center

10.6847/TJPMHN.202106_16(1).05

李馨儀(Shin-Yi Li)；侯虹伶(Hung-Ling Hou)；鄭惠文(Hui-Wen Cheng)；李宜柔(Yi-Jou Li)

精神科日間病房 ； 上呼吸道感染 ； 感染管制 ； psychiatric day ward ； upper respiratory tract infection ； infection control

精神衛生護理雜誌

16卷1期（2021 / 06 / 01）

35 - 46

繁體中文

醫院屬人口高密集的場所，病人出現上呼吸道感染症狀，若未落實感染管制措施，易造成群聚發生。本病房於2017年7月至8月期間出席率由95.8%下降至85.4%，43.8%因上呼吸道感染請假，引發改善動機。經調查發現護理師未評估病人感染症狀，且未主動採取防範措施、未整合感染病人資料；病人方面，對上呼吸道感染認知不足、未落實手部衛生、流感疫苗施打率低；設備環境方面，病房清潔標準不符合規定、手部衛生設備不足、有上呼吸道症狀者缺乏安置空間。本專案旨落實感染管制措施，降低上呼吸道感染發生率。於2017年10月15日至2018年4月30日介入改善策略，護理師方面訂定病房照顧常規；病人方面，制定防疫標語、辦理衛教課程、施打流感疫苗、推動手部衛生活動；設備環境方面，修訂日間病房上呼吸道感染管制作業及增設洗手設備。專案介入後上呼吸道感染發生率由43.8%降至25.0%，透過醫療團隊合作，落實感染管制措施，確實能有效避免院內群聚感染發生，提供安全的就醫環境。

Hospitals are densely populated places. Cluster infection occurs easily if patients have symptoms of upper respiratory tract infection (URTI) and control measures are not implemented appropriately. In July and August 2017, 43.8% of patients at our day care center took sick leave because of URTI, and the overall attendance rate decreased from 95.8% to 85.4%. A survey revealed that, on the part of caregivers, nurses did not assess the patients’ symptoms of infection; nor did they take active preventive measures or compile the data on infected patients. Awareness of URTI was insufficient among patients, hand hygiene was lacking, and influenza vaccination rates were low. Regarding the equipment and the environment, ward cleaning standards did not met the requirements, hand hygiene equipment was inadequate, and a specific space for isolated people with URTI symptoms was lacking. The purpose of this project was to implement infection control measures in order to reduce URTI incidence. The mitigation strategies were undertaken from October 15, 2017, to April 30, 2018. Healthcare professionals established a ward care routine for the nurses, formulated epidemic prevention slogans, conducted health education courses, administered influenza vaccines, and promoted hand hygiene activities for the patients. They also revised the URTI control protocol for day care cards and set up hand washing equipment. The URTI incidence rate decreased from 43.8% to 25.0% after these interventions were enforced. Through the cooperation of medical teams and the implementation of infection control measures, cluster infections in hospitals can be effectively prevented and a safe medical environment can be provided.

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