全膝關節置換術為器材數量較多，工具組裝過程繁雜的複雜性手術法，手術室護理人員在手術過程中正確及完整的傳遞器械是影響手術病患安全重要流程之一。現況發現手術室護理人員雖已完成全膝關節置換術在職教育，但對手術步驟之相關知識、器械工具組裝傳遞技能仍產生混淆情形，課後在職教育學習成效僅達55.0%。而有成效的在職教育可增進護理人員的專業知識技能，本專案小組人員藉由：修訂在職教育辦法、舉辦技能工作坊、製作膝關節手術操作手冊、提供模型練習的專案措施實行後，使得學習成效由55.0%提升至90.0%，達到專案目的，顯示本專案對提升手術室護理人員全膝關節置換術在職教育成效具有正面意義。

Total knee replacement (TKR) is an extremely complex surgical operation that requires numerous implements assembling procedures and multiple instrumentation. It is imperative that perioperative nurses should be thoroughly familiar with these techniques and pass instruments quickly and accurately for the sake of patients’ safety. Despite the fact that all current nursing staff have completed the training course in total knee replacement, many nurses still remain confused about surgical procedures and instrument used methods during the operation. The effectiveness of this course is estimated to be 55.0% only. An efficient training course ought to increase professional knowledge, skills and attitude of nursing personnel. Our panel applied revising the in-service training with regards to methods, creating a TKR procedure manual, and providing a model for practice and thus pushing the effectiveness result from 55.0% to 90.0 %, which was the expected standard outcome of this course. This project revealed that the in-service education is effective in improving perioperative nurses’ learning of total knee replacement.