Reduce the Incidence Rate of Post—ERCP Cholangitis: Take An Example of A Northern Hospital

• Main Authors: Hsiu-Ying Wu, 吳秀英
• Other Authors: Chien-Te Ho
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/fb37m9

碩士 === 元智大學 === 管理碩士在職專班 === 107 === ERCP(Endoscopic Retrograde cholangio-Pancreatoaphy）：the important management for biliary duct and the biliary duct infection is one of the most commmon complication. How to reduce the occurance of ERCP-related biliary duct complication needs the effective method for quility control. The main purpose of research aimed that the post-ERCP cholangitis incidence rate increased from 2% to 4.5%. This research data, collected from 2018/4/22 to 2018/5/18, of OPD patient under ERCP survey showed the following problems: 1.There was no consistency about the pre-ERCP, post-ERCP management for the high-risk patient because of the doctors clinical experience.2.The incompletely disinfection for the equipment for the increased of patient’s number. 3.The insufficient of equipment for the increased of patient’s number 4. The protocol of equipment disinfection, protective equipment was taught by mouth and the members easily forgot. 5.There was no specification for before and after the ERCP and there was no inner regularly audit at examination room. 6.The new members was taught by apprenticeship for variation analysis.Strategy group(1): ERCP combined boundle stragegy: 1.in-service education for different position 2. Case discussion every month 3. Arrange protocal record sheet of the before and after ERCP 4.arrange the new audit for infection control 5.modified the checklist for endoscopic infection control 6.Make the flow chart for ERCP equipment disinfection, protective equipment and the checklist for before, mid, and after the ERCP. 7.Training the ERCP seeding teachers for specialty education 8.Arrange twice education for 3 new members(0-3 months) 9.Arrange the test of congnity, practice after education 10.Modified the guideline of endoscopic infection control at examination room by nursing department, infection controller, medical department. Strategy group(2): ERCP-related equipment perfect strategy:1.training specialty education of seeding teachers at examination room 2.Regularly and randomly audit 3. Post flow chart of equipment disinfection protocol 4.Post flow chart of protective equipment exmination protocol at prepare room 5.Post “Endoscopic infection control checklist”,“ERCP examination checklist”on ERCP preparation working car.The reduction the incidence of the post-ERCP cholangitis rate from 4.5% to 2% by above effective suggestion could be the local ERCP bundle predecessor and provide the basement of policy for ERCP-related infeciton control prevention at internal hospitals.