Pub Date : 2024-03-01DOI: 10.53106/199457952024031802011
王志中 王志中
在全人照護中我們還能做些什麼？在盤點現行的醫療作為後，可以歸納為以下三點：1.病人在健康生活型態的建立方面應給予指導，加速病人的康復及預防疾病的復發。2.病人在疾病的治療及預防上應採取主動，有積極的態度及作為，使疾病的治療更為有效。3.病人的家屬或其照護者對於病人疾病的治療或其生活上的照護，應給予指導，以提升病人照護的品質。基於以上資訊，在此提出兩點建議：1.提升病人主動照護自己。2.指導病人之家屬或其照護者，協助病人的照護。適時告知及指導病人及其照護者，強化全人照護品質。 What else can be done in holistic health care? By compiling existing medical practices, this study summarized its findings into the following three points: First, patients should be guided to establish a healthy lifestyle, thereby accelerating their recovery and preventing disease recurrences. Second, patients should take initiative in their disease treatment and prevention. Their proactive attitude and conduct will enhance the treatment outcomes. Third, guidance should be provided to patients’ family or their caregivers regarding disease treatment or routine care, thereby improving the quality of care received by the patient. Based on the aforementioned findings, we propose two suggestions. First, patients should adopt a more active attitude toward self-care. Second, patients’ family or caregivers should be guided to assist them in caring for the patients. The aforesaid suggestions may be included in shared decision-making pamphlets for the timely notification of patient conditions, provision of relevant guidance to patients and their caregivers, and reinforce the quality of the holistic health care received by patients.
{"title":"在全人照護中我們還能做些什麼？","authors":"王志中 王志中","doi":"10.53106/199457952024031802011","DOIUrl":"https://doi.org/10.53106/199457952024031802011","url":null,"abstract":"\u0000 在全人照護中我們還能做些什麼？在盤點現行的醫療作為後，可以歸納為以下三點：1.病人在健康生活型態的建立方面應給予指導，加速病人的康復及預防疾病的復發。2.病人在疾病的治療及預防上應採取主動，有積極的態度及作為，使疾病的治療更為有效。3.病人的家屬或其照護者對於病人疾病的治療或其生活上的照護，應給予指導，以提升病人照護的品質。基於以上資訊，在此提出兩點建議：1.提升病人主動照護自己。2.指導病人之家屬或其照護者，協助病人的照護。適時告知及指導病人及其照護者，強化全人照護品質。\u0000 What else can be done in holistic health care? By compiling existing medical practices, this study summarized its findings into the following three points: First, patients should be guided to establish a healthy lifestyle, thereby accelerating their recovery and preventing disease recurrences. Second, patients should take initiative in their disease treatment and prevention. Their proactive attitude and conduct will enhance the treatment outcomes. Third, guidance should be provided to patients’ family or their caregivers regarding disease treatment or routine care, thereby improving the quality of care received by the patient. Based on the aforementioned findings, we propose two suggestions. First, patients should adopt a more active attitude toward self-care. Second, patients’ family or caregivers should be guided to assist them in caring for the patients. The aforesaid suggestions may be included in shared decision-making pamphlets for the timely notification of patient conditions, provision of relevant guidance to patients and their caregivers, and reinforce the quality of the holistic health care received by patients.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"520 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802005
劉紫娟 劉紫娟, 陳詩典 陳詩典, 池宜蓉 池宜蓉, 陳建州 陳建州, 莊仁賓 莊仁賓
近年國內多起醫療機構火災事件導致人員傷亡，顯示醫療機構環境安全之重要性。民眾對於醫療環境安全愈加重視，醫院應更加重視防火安全，並從病人安全及消防安全著手。嘉義醫院為建構安全的醫療環境品質，特參加2023年醫療機構環境安全諮詢計畫「防火安全模組」輔導計畫，獲取外部專家意見，建構更安全的醫療就醫環境。本次透過全員參與，全面性、系統性的盤點各項硬體設備與緊急應變計畫，瞭解自身的風險脆弱點，提升火災發生時緊急應變處理能力。借助國內外專家學者經驗，現場審視與指導，依照醫院特性或高潛在風險因子，在有限資源下，討論改善的優先順序與相關替代方案。希望藉由本文分享參加輔導計畫之過程與經驗，提供醫療機構共參考，共同提升醫院環境安全。 In recent years, numerous fires in healthcare institutions in Taiwan have resulted in casualties, highlighting the importance of environmental safety in medical facilities. With growing public concern over the safety of healthcare environments, hospitals must prioritize fire safety, focusing on both patient and fire safety measures. Chiayi Hospital staff participated in the 2023 Fire Safety Module counseling project of the Safe Healthcare Environment Advisory Program to establish a safe medical environment. This program incorporated guidance from external patient safety and fire safety experts to construct safe treatment environments. A thorough inventory of equipment and emergency response plans was conducted, involving the collaborative participation of all staff members to identify institutional vulnerabilities and enhance emergency response capabilities in the event of a fire. On-site inspections and guidance leveraged the counsel of domestic and international experts and scholars to address risk factors unique to the hospital, discussing solutions and areas of improvement to prioritize in accordance with the hospital’s limited resources at hand. This paper outlines Chiayi Hospital’s experiences in the Safe Healthcare Environment Advisory Program to benefit other hospitals and enhance hospital environmental safety throughout Taiwan.
{"title":"嘉義大病院 守護嘉義兩甲子－衛生福利部嘉義醫院參與「醫療機構環境安全諮詢計畫(SHEAP)」經驗分享","authors":"劉紫娟 劉紫娟, 陳詩典 陳詩典, 池宜蓉 池宜蓉, 陳建州 陳建州, 莊仁賓 莊仁賓","doi":"10.53106/199457952024031802005","DOIUrl":"https://doi.org/10.53106/199457952024031802005","url":null,"abstract":"\u0000 近年國內多起醫療機構火災事件導致人員傷亡，顯示醫療機構環境安全之重要性。民眾對於醫療環境安全愈加重視，醫院應更加重視防火安全，並從病人安全及消防安全著手。嘉義醫院為建構安全的醫療環境品質，特參加2023年醫療機構環境安全諮詢計畫「防火安全模組」輔導計畫，獲取外部專家意見，建構更安全的醫療就醫環境。本次透過全員參與，全面性、系統性的盤點各項硬體設備與緊急應變計畫，瞭解自身的風險脆弱點，提升火災發生時緊急應變處理能力。借助國內外專家學者經驗，現場審視與指導，依照醫院特性或高潛在風險因子，在有限資源下，討論改善的優先順序與相關替代方案。希望藉由本文分享參加輔導計畫之過程與經驗，提供醫療機構共參考，共同提升醫院環境安全。\u0000 In recent years, numerous fires in healthcare institutions in Taiwan have resulted in casualties, highlighting the importance of environmental safety in medical facilities. With growing public concern over the safety of healthcare environments, hospitals must prioritize fire safety, focusing on both patient and fire safety measures. Chiayi Hospital staff participated in the 2023 Fire Safety Module counseling project of the Safe Healthcare Environment Advisory Program to establish a safe medical environment. This program incorporated guidance from external patient safety and fire safety experts to construct safe treatment environments. A thorough inventory of equipment and emergency response plans was conducted, involving the collaborative participation of all staff members to identify institutional vulnerabilities and enhance emergency response capabilities in the event of a fire. On-site inspections and guidance leveraged the counsel of domestic and international experts and scholars to address risk factors unique to the hospital, discussing solutions and areas of improvement to prioritize in accordance with the hospital’s limited resources at hand. This paper outlines Chiayi Hospital’s experiences in the Safe Healthcare Environment Advisory Program to benefit other hospitals and enhance hospital environmental safety throughout Taiwan.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"20 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802001
林品蒨 林品蒨, 羅文婕 羅文婕, 江靜楓 江靜楓
臺灣的醫療不斷地發展前進，但與此同時，各醫療機構也面臨著建築物、設施設備逐漸老舊的挑戰，有鑑於此，財團法人醫院評鑑暨醫療品質策進會（簡稱醫策會）自2018年起著手研議醫療機構環境安全諮詢計畫，並透過與澳洲ACHSI共同合作，帶入更多元的國際視野，終於在2023年Covid 19疫情暫緩後正式推出本計畫內容。本文將詳細介紹醫療機構環境安全諮詢計畫的內涵，期待能鼓勵更多醫療院所參與，共同努力營造機構的環境安全。 As Taiwan’s healthcare continues to develop and progress, medical institutions are facing the challenge of aging buildings and facilities. In light of this, the Joint Commission of Taiwan began to develop the Safe Healthcare Environment Advisory Program(SHEAP)in 2018. Through collaboration with the Australian Council on Healthcare Standards International, which introduced a more diverse international perspective, the program was officially launched in 2023 after the COVID-19 pandemic had subsided. This article details the contents of the program, hoping to encourage more medical institutions to participate and jointly strive to create a safe environment.
{"title":"建立醫院安全場域—醫療機構環境安全諮詢計畫(SHEAP)介紹","authors":"林品蒨 林品蒨, 羅文婕 羅文婕, 江靜楓 江靜楓","doi":"10.53106/199457952024031802001","DOIUrl":"https://doi.org/10.53106/199457952024031802001","url":null,"abstract":"\u0000 臺灣的醫療不斷地發展前進，但與此同時，各醫療機構也面臨著建築物、設施設備逐漸老舊的挑戰，有鑑於此，財團法人醫院評鑑暨醫療品質策進會（簡稱醫策會）自2018年起著手研議醫療機構環境安全諮詢計畫，並透過與澳洲ACHSI共同合作，帶入更多元的國際視野，終於在2023年Covid 19疫情暫緩後正式推出本計畫內容。本文將詳細介紹醫療機構環境安全諮詢計畫的內涵，期待能鼓勵更多醫療院所參與，共同努力營造機構的環境安全。\u0000 As Taiwan’s healthcare continues to develop and progress, medical institutions are facing the challenge of aging buildings and facilities. In light of this, the Joint Commission of Taiwan began to develop the Safe Healthcare Environment Advisory Program(SHEAP)in 2018. Through collaboration with the Australian Council on Healthcare Standards International, which introduced a more diverse international perspective, the program was officially launched in 2023 after the COVID-19 pandemic had subsided. This article details the contents of the program, hoping to encourage more medical institutions to participate and jointly strive to create a safe environment.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"201 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140283231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
目的：透過雙相型陽壓呼吸器(BiPAP)通報資料庫分析，探討減壓墊於BiPAP相關壓傷之預防成效。方法：方便取樣南部某區域教學醫院成人內科加護病房之BiPAP通報資料庫，次級資料分析減壓墊於BiPAP相關壓傷之預防成效。結果：減壓墊組的壓傷發生率為6.06%，無減壓墊組為7.78%，兩組無統計顯著差異(p =.5863)。壓傷個案相關變項比較，減壓墊組比無減壓墊組平均延緩21.18小時產生壓傷(p =.8660)，平均減少0.12個壓傷(p =.5501)、減少1.96 cm2的壓傷表面積(p =.7334)，較低的重度壓傷發生風險(risk ratio = 0.44, p =.1666)，然礙於臨床發生壓傷的個案數偏少，故成效比較尚未達顯著差異。結論：兩組比較雖未達顯著差異，但次級資料庫的真實世界數據顯示減壓墊組具有較佳的預防壓傷臨床效益，建議臨床仍可善用減壓墊於預防BiPAP相關壓傷。 "Purpose: To compare the effectiveness of pressure relief pads in preventing bi-level positive airway pressure-related injuries by analyzing data from a medical reporting database. Methods: The authors took a convenience sample of records from the medical reporting database of the adult medical intensive care unit of a regional teaching hospital in southern Taiwan. Secondary database analysis was employed to examine the effectiveness of pressure relief pads in preventing pressure injuries. Results: The incidence of pressure-related injuries in the pressure relief pads group was 6.06%, whereas the incidence in the no relief pads group was 7.78% (p = .5863). Pressure relief pads delayed the occurrence of pressure injuries by 21.18 hours (p = .8660), reduced the number of pressure injury lesions by 0.12 (p = .5501), reduced the surface area of pressure injuries by 1.96 cm2 (p = .7334), and reduced the risk of severe pressure injury (risk ratio = 0.44, p = .1666). Due to the small number of clinical incident pressure injuries reported, the comparison of effectiveness did not reach statistical significance. Conclusion: Although no significant difference was observed between the two groups, real-world data from the secondary database revealed that the pressure relief pads effectively and safely prevented pressure injuries.
{"title":"減壓墊於BiPAP壓傷之預防成效：次級資料庫分析","authors":"吳玲瑩 吳玲瑩, 馮宥訢 馮宥訢, 范栩瑄 范栩瑄, 陳榆蓉 陳榆蓉, 李春綢 李春綢, 曾瑞慧 Chun-Chou Lee, 朱淑媛 Jui Hui Tseng, 郭嘉琪 郭嘉琪","doi":"10.53106/199457952024031802007","DOIUrl":"https://doi.org/10.53106/199457952024031802007","url":null,"abstract":"\u0000 目的：透過雙相型陽壓呼吸器(BiPAP)通報資料庫分析，探討減壓墊於BiPAP相關壓傷之預防成效。方法：方便取樣南部某區域教學醫院成人內科加護病房之BiPAP通報資料庫，次級資料分析減壓墊於BiPAP相關壓傷之預防成效。結果：減壓墊組的壓傷發生率為6.06%，無減壓墊組為7.78%，兩組無統計顯著差異(p =.5863)。壓傷個案相關變項比較，減壓墊組比無減壓墊組平均延緩21.18小時產生壓傷(p =.8660)，平均減少0.12個壓傷(p =.5501)、減少1.96 cm2的壓傷表面積(p =.7334)，較低的重度壓傷發生風險(risk ratio = 0.44, p =.1666)，然礙於臨床發生壓傷的個案數偏少，故成效比較尚未達顯著差異。結論：兩組比較雖未達顯著差異，但次級資料庫的真實世界數據顯示減壓墊組具有較佳的預防壓傷臨床效益，建議臨床仍可善用減壓墊於預防BiPAP相關壓傷。\u0000 \"Purpose: To compare the effectiveness of pressure relief pads in preventing bi-level positive airway pressure-related injuries by analyzing data from a medical reporting database. Methods: The authors took a convenience sample of records from the medical reporting database of the adult medical intensive care unit of a regional teaching hospital in southern Taiwan. Secondary database analysis was employed to examine the effectiveness of pressure relief pads in preventing pressure injuries. Results: The incidence of pressure-related injuries in the pressure relief pads group was 6.06%, whereas the incidence in the no relief pads group was 7.78% (p = .5863). Pressure relief pads delayed the occurrence of pressure injuries by 21.18 hours (p = .8660), reduced the number of pressure injury lesions by 0.12 (p = .5501), reduced the surface area of pressure injuries by 1.96 cm2 (p = .7334), and reduced the risk of severe pressure injury (risk ratio = 0.44, p = .1666). Due to the small number of clinical incident pressure injuries reported, the comparison of effectiveness did not reach statistical significance. Conclusion: Although no significant difference was observed between the two groups, real-world data from the secondary database revealed that the pressure relief pads effectively and safely prevented pressure injuries.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"30 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802003
葉清益 葉清益
文以醫療機構環境與基礎建設各系統現場訪視，採系統追蹤方式，從受訪2家醫療院所環境風險管理與火災風險辨識著手，以消防安全設施設備管理；各樓棟防火區劃完整度檢視；避難逃生路徑規劃與逃生方向指引；醫用氣體使用安全；危險物質儲存、使用、洩漏管理；用電與各機房環境安全及緊急災害應變措施機制等面向，重點檢視受輔導醫療機構設施設備與環境安全現況及安全脆弱點，提供醫療機構管理階層，提升病人就醫環境整體安全之參考。 This paper describes a systematic tracking approach for conducting on-site inspections at two medical facilities and assessing their institutional environments and infrastructure. The assessment centers on the management of environmental and fire risks, including overseeing fire safety facilities and equipment. The comprehensiveness of the fire zoning of individual buildings and the planning of and guidance to evacuation routes are evaluated. Also assessed are the safe use of medical gases, the management (including storage, use, and leakage) of hazardous substances, electrical safety, environmental safety in rooms with heavy machinery, disaster response, and emergency management. The primary objective is to scrutinize the safety vulnerabilities of the facilities and to critically evaluate the general environmental conditions at the two medical institutions, providing management teams with insights to enhance the safety of the health-care environment.
{"title":"醫療機構環境安全諮詢計畫(SHEAP)輔導經驗分享","authors":"葉清益 葉清益","doi":"10.53106/199457952024031802003","DOIUrl":"https://doi.org/10.53106/199457952024031802003","url":null,"abstract":"\u0000 文以醫療機構環境與基礎建設各系統現場訪視，採系統追蹤方式，從受訪2家醫療院所環境風險管理與火災風險辨識著手，以消防安全設施設備管理；各樓棟防火區劃完整度檢視；避難逃生路徑規劃與逃生方向指引；醫用氣體使用安全；危險物質儲存、使用、洩漏管理；用電與各機房環境安全及緊急災害應變措施機制等面向，重點檢視受輔導醫療機構設施設備與環境安全現況及安全脆弱點，提供醫療機構管理階層，提升病人就醫環境整體安全之參考。\u0000 This paper describes a systematic tracking approach for conducting on-site inspections at two medical facilities and assessing their institutional environments and infrastructure. The assessment centers on the management of environmental and fire risks, including overseeing fire safety facilities and equipment. The comprehensiveness of the fire zoning of individual buildings and the planning of and guidance to evacuation routes are evaluated. Also assessed are the safe use of medical gases, the management (including storage, use, and leakage) of hazardous substances, electrical safety, environmental safety in rooms with heavy machinery, disaster response, and emergency management. The primary objective is to scrutinize the safety vulnerabilities of the facilities and to critically evaluate the general environmental conditions at the two medical institutions, providing management teams with insights to enhance the safety of the health-care environment.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"233 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140270668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802009
趙雪嵐 趙雪嵐
產後護理之家服務對象，包括產後未滿二個月產婦及出生未滿二個月嬰兒。又嬰兒出生後來自母親的抗體逐漸消退，且免疫力尚未達到成熟階段，感染疾病風險高及可能嚴重併發症，因此對於服務對象入住機構內健康管理、包括疾病監測、疑似感染及適當隔離等，防範於未然及有效感染控制措施至為重要，各項感染管制訂定如：陪住家屬及訪客管理，遵守政府規範防疫政策；服務對象之配膳、飲食衛生、哺餵、哺育器材清消，飲用水衛生安全、供水設施等措施並落實執行，維護產婦、嬰兒及工作人員等之健康，建構優質安全環境，提升照護品質。機構管理者及工作人員應瞭解基本的感染預防及管制策略，確實執行應用，避免機構內感染及群聚事件，且配合衛生主管機關評鑑及感染管制查核督導，強化各項感染管制措施，共築完善防疫網。 Postpartum care homes provide services to mothers and infants in the first 2 months after birth. During this time, antibodies from the mother gradually diminish in infants, whose immunity is insufficiently mature, placing them at high risk of contracting diseases and developing serious complications. Therefore, adhering to and implementing strict infection control measures is crucial. For service recipients of health management in postpartum homes, infectious disease monitoring, isolation precautions, rules for managing family members and visitors, disease control regulations, meal preparation and feeding hygiene, access to cleaning and disinfection equipment, and regular cleaning and disinfection of water supplies are all critical measures for improving service quality and creating a high-quality and safe care environment. Institutional managers and staff must understand basic infection prevention and control strategies and carefully implement them to avoid infections and cluster incidents in postpartum homes. They must also cooperate with health authorities for institution accreditation, infection control inspection, and supervision to strengthen infection control measures and create comprehensive epidemic prevention strategies.
{"title":"產後護理之家服務對象感染預防措施","authors":"趙雪嵐 趙雪嵐","doi":"10.53106/199457952024031802009","DOIUrl":"https://doi.org/10.53106/199457952024031802009","url":null,"abstract":"\u0000 產後護理之家服務對象，包括產後未滿二個月產婦及出生未滿二個月嬰兒。又嬰兒出生後來自母親的抗體逐漸消退，且免疫力尚未達到成熟階段，感染疾病風險高及可能嚴重併發症，因此對於服務對象入住機構內健康管理、包括疾病監測、疑似感染及適當隔離等，防範於未然及有效感染控制措施至為重要，各項感染管制訂定如：陪住家屬及訪客管理，遵守政府規範防疫政策；服務對象之配膳、飲食衛生、哺餵、哺育器材清消，飲用水衛生安全、供水設施等措施並落實執行，維護產婦、嬰兒及工作人員等之健康，建構優質安全環境，提升照護品質。機構管理者及工作人員應瞭解基本的感染預防及管制策略，確實執行應用，避免機構內感染及群聚事件，且配合衛生主管機關評鑑及感染管制查核督導，強化各項感染管制措施，共築完善防疫網。\u0000 Postpartum care homes provide services to mothers and infants in the first 2 months after birth. During this time, antibodies from the mother gradually diminish in infants, whose immunity is insufficiently mature, placing them at high risk of contracting diseases and developing serious complications. Therefore, adhering to and implementing strict infection control measures is crucial. For service recipients of health management in postpartum homes, infectious disease monitoring, isolation precautions, rules for managing family members and visitors, disease control regulations, meal preparation and feeding hygiene, access to cleaning and disinfection equipment, and regular cleaning and disinfection of water supplies are all critical measures for improving service quality and creating a high-quality and safe care environment. Institutional managers and staff must understand basic infection prevention and control strategies and carefully implement them to avoid infections and cluster incidents in postpartum homes. They must also cooperate with health authorities for institution accreditation, infection control inspection, and supervision to strengthen infection control measures and create comprehensive epidemic prevention strategies.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"244 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802002
徐永年 徐永年
本文以輔導委員的角度從SHEAP環境安全諮詢計畫輔導的架構及內容重點切入，分別介紹「緊急應變計畫」、「演練與訓練」、「建築與設備」及「管理機制」四大面向之輔導重點，並統整輔導過程中發現機構常見的問題。最後與讀者分享從國外專家委員身上學習到的寶貴經驗，期待能鼓勵更多醫院重視環境安全與火災風險管理，並透過本計畫給予醫院更適切的改善策略。 This article examines the framework and key content of the Safe Healthcare Environment Advisory Program (SHEAP) from the perspective of a consultant by highlighting the focal points of consultation in four major aspects, namely emergency response planning, drills and training, construction and equipment, and management mechanisms. It also organizes common issues identified in institutions during the consultation process. Finally, the article shares valuable experience provided by international experts and consultants, hoping to encourage more hospitals to stress environmental safety and fire risk management. Through SHEAP, this article provides strategies for hospitals to improve their healthcare services.
{"title":"初探實地輔導及剖析輔導面向－以SHEAP委員的角度","authors":"徐永年 徐永年","doi":"10.53106/199457952024031802002","DOIUrl":"https://doi.org/10.53106/199457952024031802002","url":null,"abstract":"\u0000 本文以輔導委員的角度從SHEAP環境安全諮詢計畫輔導的架構及內容重點切入，分別介紹「緊急應變計畫」、「演練與訓練」、「建築與設備」及「管理機制」四大面向之輔導重點，並統整輔導過程中發現機構常見的問題。最後與讀者分享從國外專家委員身上學習到的寶貴經驗，期待能鼓勵更多醫院重視環境安全與火災風險管理，並透過本計畫給予醫院更適切的改善策略。\u0000 This article examines the framework and key content of the Safe Healthcare Environment Advisory Program (SHEAP) from the perspective of a consultant by highlighting the focal points of consultation in four major aspects, namely emergency response planning, drills and training, construction and equipment, and management mechanisms. It also organizes common issues identified in institutions during the consultation process. Finally, the article shares valuable experience provided by international experts and consultants, hoping to encourage more hospitals to stress environmental safety and fire risk management. Through SHEAP, this article provides strategies for hospitals to improve their healthcare services.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"89 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802004
張慧璿 張慧璿, 賴慧貞 賴慧貞
公安意識的抬頭，消防法規近期幾乎每年修正以符合民眾對於安全要求，在醫院提供以病人為中心的醫療服務之時，醫院如何提供病人不僅只是就醫環境的美觀整潔，而是需要更安全、更安心的診療空間。醫院評鑑基準及評量項目自2019年起將條文1.7.4列入試評重點條文「醫院應指定專責人員研擬火災之減災、預防與準備措施」，各醫院必須從管理機制與應變機制、建築設計與設施設備、環境空間與動線標示、教育訓練與機構運作各方面進行整備以符合法規。藉著醫策會提供以「人」（病人與員工）安全為核心的輔導計畫，實地訪查委員能因地制宜提供許多細膩及明確的寶貴建議，成為醫院提升消防及緊急應變量能的目標，期待能有更多醫療機構參與，共同打造以病人為中心的安心就醫環境。 Fire safety regulations are vital to safe, clean, patient-centered hospital environments. Per standard hospital evaluation criteria, hospitals must designate staff to develop fire mitigation, prevention, and strain mechanisms that meet fire safety codes by preparing fireproof management mechanisms with clear instructions on fire safety equipment, fire alarms, fire escapes, and safety exits. The Safe Healthcare Environment Advisory Program (SHEAP) is a mentoring program that teaches safety strategies to healthcare staff, providing on-site professionals and detailed safety training to improve emergency response capabilities. By collaborating to implement the SHEAP, hospital staff can create safe and patient-centered work environments.
公安意識的抬頭，消防法規近期幾乎每年修正以符合民眾對於安全要求，在醫院提供以病人為中心的醫療服務之時，醫院如何提供病人不僅只是就醫環境的美觀整潔，而是需要更安全、更安心的診療空間。醫院評鑑基準及評量項目自2019年起將條文1.7.4列入試評重點條文「醫院應指定專責人員研擬火災之減災、預防與準備措施」，各醫院必須從管理機制與應變機制、建築設計與設施設備、環境空間與動線標示、教育訓練與機構運作各方面進行整備以符合法規。藉著醫策會提供以「人」（病人與員工）安全為核心的輔導計畫，實地訪查委員能因地制宜提供許多細膩及明確的寶貴建議，成為醫院提升消防及緊急應變量能的目標，期待能有更多醫療機構參與，共同打造以病人為中心的安心就醫環境。 Fire safety regulations are vital to safe, clean, patient-centered hospital environments. Per standard hospital evaluation criteria, hospitals mustdesignate staff to develop fire mitigation, prevention, and strain mechanisms that meet fire safety codes by preparing fireproof managementmechanisms with clear instructions on fire safety equipment, fire alarms, fire escapes, and safety exits. The Safe Healthcare Environment AdvisoryProgram (SHEAP) is a mentoring program that teaches safety strategies to healthcare staff, providing on-site professionals and detailed safetytraining to improve emergency response capabilities. By collaborating to implement the SHEAP, hospital staff can create safe and patient-centeredwork environments.
{"title":"打造以病人為中心的安心醫療環境—衛生福利部豐原醫院參與「醫療機構環境安全諮詢計畫(SHEAP)」經驗分享","authors":"張慧璿 張慧璿, 賴慧貞 賴慧貞","doi":"10.53106/199457952024031802004","DOIUrl":"https://doi.org/10.53106/199457952024031802004","url":null,"abstract":"\u0000 公安意識的抬頭，消防法規近期幾乎每年修正以符合民眾對於安全要求，在醫院提供以病人為中心的醫療服務之時，醫院如何提供病人不僅只是就醫環境的美觀整潔，而是需要更安全、更安心的診療空間。醫院評鑑基準及評量項目自2019年起將條文1.7.4列入試評重點條文「醫院應指定專責人員研擬火災之減災、預防與準備措施」，各醫院必須從管理機制與應變機制、建築設計與設施設備、環境空間與動線標示、教育訓練與機構運作各方面進行整備以符合法規。藉著醫策會提供以「人」（病人與員工）安全為核心的輔導計畫，實地訪查委員能因地制宜提供許多細膩及明確的寶貴建議，成為醫院提升消防及緊急應變量能的目標，期待能有更多醫療機構參與，共同打造以病人為中心的安心就醫環境。\u0000 Fire safety regulations are vital to safe, clean, patient-centered hospital environments. Per standard hospital evaluation criteria, hospitals must designate staff to develop fire mitigation, prevention, and strain mechanisms that meet fire safety codes by preparing fireproof management mechanisms with clear instructions on fire safety equipment, fire alarms, fire escapes, and safety exits. The Safe Healthcare Environment Advisory Program (SHEAP) is a mentoring program that teaches safety strategies to healthcare staff, providing on-site professionals and detailed safety training to improve emergency response capabilities. By collaborating to implement the SHEAP, hospital staff can create safe and patient-centered work environments.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"237 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01DOI: 10.53106/199457952024031802010
于政民 于政民
隨著同性婚姻合法化，社會對性少數議題關注增加，但跨性別相關議題仍未受到足夠重視。本文從不強調生理性別、不隨意幫人出櫃、以及適當的稱讚方式等方面，提出對跨性別者的互動需注意的要點。在臨床和日常生活中，尊重性別認同、避免刻板印象，有助於建立更友善、尊重的溝通氛圍。 Since the legalization of same-sex marriage in Taiwan in May 2019, Taiwanese citizens have become increasingly aware of the concerns of sexual minorities. One subgroup of sexual minorities that continues to be underappreciated is transgender individuals. This article offers several recommendations for sensitively interacting with transgender individuals, such as not emphasizing their biological sex, refraining from outing individuals against their wishes, and avoiding inappropriate words of praise. In both clinical and daily settings, respecting gender identity and avoiding stereotypes helps establish a friendly and respectful atmosphere.
{"title":"跨越性別框架，深化對跨性別者的理解","authors":"于政民 于政民","doi":"10.53106/199457952024031802010","DOIUrl":"https://doi.org/10.53106/199457952024031802010","url":null,"abstract":"\u0000 隨著同性婚姻合法化，社會對性少數議題關注增加，但跨性別相關議題仍未受到足夠重視。本文從不強調生理性別、不隨意幫人出櫃、以及適當的稱讚方式等方面，提出對跨性別者的互動需注意的要點。在臨床和日常生活中，尊重性別認同、避免刻板印象，有助於建立更友善、尊重的溝通氛圍。\u0000 Since the legalization of same-sex marriage in Taiwan in May 2019, Taiwanese citizens have become increasingly aware of the concerns of sexual minorities. One subgroup of sexual minorities that continues to be underappreciated is transgender individuals. This article offers several recommendations for sensitively interacting with transgender individuals, such as not emphasizing their biological sex, refraining from outing individuals against their wishes, and avoiding inappropriate words of praise. In both clinical and daily settings, respecting gender identity and avoiding stereotypes helps establish a friendly and respectful atmosphere.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"123 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140278472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
"目的：運用品管圈手法降低頭頸部癌病人在放射治療之擺位誤差。材料與方法：影響擺位誤差要素分為:身體僵硬或病因性原因無法配合、病人太緊張而導致定位誤差、定位記號線不見了，和不明原因無法與定位時的位置一致，根據三現原則和真因驗證，擬定4個對策群組共10項改進對策。結果：對策實施後X、Y 和 Z 三軸平移擺位誤差平均值和標準差，分別1.67±0.93mm降至1.49±0.58mm(p =0.141) 、1.43±0.66mm降至1.08±0.45mm (p <0.001)和4.05±1.8mm降至1.16±0.55mm (p <0.001)；3D向量方向從5.00±1.67mm 降至2.54±0.65mm (p <0.001)。Y軸(roll)旋轉方向從0.76±0.37°³降至0.51±0.24°(p <0.001)，而其在3D向量方向>3mm由90%，降低至48%、>5mm則由43%降低至0。結論：有顯著的降低擺位誤差，未來持續提升治療品質與成效。 Purpose: To reduce setup errors in the treatment of head and neck cancer patients during radiotherapy by applying quality control circle techniques. Materials and Methods: The following factors contributed to setup errors: bodily stiffness or medical conditions preventing patient movement, patient anxiety leading to localization errors, the disappearance of localization markers, and discrepancies between the positioning and reference locations for unknown reasons. Based on the principles of the Three occurrence and verifying true causes, 4 groups consisting of a total of 10 improvement strategies groups were created. Results: Following the implementation of these strategies, the means and standard deviations of setup errors in the X, Y, and Z axes improved from 1.67 ± 0.93 mm to 1.49 ± 0.58 mm (p =0.141), from 1.43 ± 0.66 mm to 1.08 ± 0.45mm (p < 0.001), and from 4.05 ± 1.8 mm to 1.16 ± 0.55 mm (p < 0.001), respectively. Additionally, 3D vector directional setup errors decreased from 5.00 ± 1.67 mm to 2.54 ± 0.65 mm (p < 0.001), and the Y-axis (roll) rotation error decreased from 0.76 ± 0.37° to 0.51 ± 0.24° (p < 0.001). For 3D vector directional errors >3 mm, errors decreased from 90% to 48%; for vector directional errors >5 mm, errors decreased from 43% to 0%. Conclusion: Setup errors were substantially reduced by the adopted strategies.
{"title":"降低頭頸部癌病人在放射治療中擺位誤差","authors":"何聖佑 何聖佑, 謝禮存 Sheng-Yow Ho, 陳佳群 陳佳群, 李淞維 Chia-Chun Chen, 楊淑琴 楊淑琴","doi":"10.53106/199457952024031802008","DOIUrl":"https://doi.org/10.53106/199457952024031802008","url":null,"abstract":"\u0000 \"目的：運用品管圈手法降低頭頸部癌病人在放射治療之擺位誤差。材料與方法：影響擺位誤差要素分為:身體僵硬或病因性原因無法配合、病人太緊張而導致定位誤差、定位記號線不見了，和不明原因無法與定位時的位置一致，根據三現原則和真因驗證，擬定4個對策群組共10項改進對策。結果：對策實施後X、Y 和 Z 三軸平移擺位誤差平均值和標準差，分別1.67±0.93mm降至1.49±0.58mm(p =0.141) 、1.43±0.66mm降至1.08±0.45mm (p <0.001)和4.05±1.8mm降至1.16±0.55mm (p <0.001)；3D向量方向從5.00±1.67mm 降至2.54±0.65mm (p <0.001)。Y軸(roll)旋轉方向從0.76±0.37°³降至0.51±0.24°(p <0.001)，而其在3D向量方向>3mm由90%，降低至48%、>5mm則由43%降低至0。結論：有顯著的降低擺位誤差，未來持續提升治療品質與成效。\u0000 Purpose: To reduce setup errors in the treatment of head and neck cancer patients during radiotherapy by applying quality control circle techniques. Materials and Methods: The following factors contributed to setup errors: bodily stiffness or medical conditions preventing patient movement, patient anxiety leading to localization errors, the disappearance of localization markers, and discrepancies between the positioning and reference locations for unknown reasons. Based on the principles of the Three occurrence and verifying true causes, 4 groups consisting of a total of 10 improvement strategies groups were created. Results: Following the implementation of these strategies, the means and standard deviations of setup errors in the X, Y, and Z axes improved from 1.67 ± 0.93 mm to 1.49 ± 0.58 mm (p =0.141), from 1.43 ± 0.66 mm to 1.08 ± 0.45mm (p < 0.001), and from 4.05 ± 1.8 mm to 1.16 ± 0.55 mm (p < 0.001), respectively. Additionally, 3D vector directional setup errors decreased from 5.00 ± 1.67 mm to 2.54 ± 0.65 mm (p < 0.001), and the Y-axis (roll) rotation error decreased from 0.76 ± 0.37° to 0.51 ± 0.24° (p < 0.001). For 3D vector directional errors >3 mm, errors decreased from 90% to 48%; for vector directional errors >5 mm, errors decreased from 43% to 0%. Conclusion: Setup errors were substantially reduced by the adopted strategies.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"104 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140279801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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