背景和目的：本研究旨在建立手術室器械計數流程標準化管理模式，並評估其施行成效，祈藉由標準化減少人為疏忽、提升病人安全與降低醫院器械成本。方法：研究自民國95 年2 月開始計劃並建立器械計數標準作業程序，制訂多項器械管理規劃方案，執行三個月後開始進行評估與分析器械計數完成率、遺失率，並以卡方檢定、ANOVA檢定比較改善前後之差異性。結果：結果顯示每台刀四次計數點之器械計數完成率顯著提升至81%~95% (p < 0.05) ；器械遺失率由0.69 件/百台刀下降至0.32 件/百台刀；每月平均損失金額並未顯著改變(p > 0.05) ，此可能因本研究追蹤期間不夠長，因此成效並無顯著統計意義。結論：持續執行器械計數標準流程管理並定期監督與評值，相信未來一定能使器械遺失率趨近於零，進而降低醫院購置器械的成本，增加器械管理效能，提昇手術室的服務品質。

Background and Objectives: With the aims of reducing human errors, improving patientsafety, and containing hospital instrument costs, the objectives of this study were to standardizeoperation room instrument management protocols and to evaluate their performance. Methods:By establishing standard operation procedures for instrument counting, multiple instrumentmanagement protocols were implemented in February 2006. The completion rates of instrumentcounting and instrument loss rates were evaluated before and 3 months after initiation of theprotocols. Chi-squared test and ANOVA were used investigate the efficacy of the qualityimprovement intervention. Results: The completion rates of instrument counting at 4checkpoints for single surgeries improved from 81% to 95% (p < 0.05). The instrument loss rateswere reduced from 0.69 to 0.32/surgery. The average cost incurred from instrument lossesremained unchanged (p > 0.05), due to a limited follow-up duration. Conclusions:Standardization of operation procedures with regular audits is critical to the success of operatingroom instrument management. Continuous quality improvement efforts are being implementedwith the aim of reducing instrument loss to zero; we believe this can further contain hospitalinstrument costs, enhance management competency, and improve operating room service qualityand safety.