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  • 學位論文

照護流程標準化以急救流程為例

Standardization and Digitization of Patient Care Procedures Taking Emergency Department as an Example

指導教授 : 陳錦杏

摘要


急診部門的醫護人員都必須了解每一個急救項目的操作流程,當病患被送達急診部門時,醫護人員依檢傷分類、掛號、檢驗、看診等急診處置流程,在緊急的時間內完成急救項目,妥善照護病患,避免傷亡。本研究主要探討病人安全與數位學習的實施現況,了解數位學習對於增進急診臨床學習與教育訓練的成效。系統成效評估以Davis 所提出的科技接受模式(TAM)為基礎,探討數位學習接受度與使用者背景之間的關係。研究目的如下: (一)瞭解受測者對於數位學習的使用現況。 (二)利用科技接受模式(TAM),探討教材內容之易用性、有用性、使用意願等因素。 (三)分析有用性、易用性對數位學習系統使用意願的預測情形。 研究方法採用橫斷式(cross-sectional)問卷調查法,針對醫護相關學校的學生及國內中部地區醫院的醫護人員,進行自填式問卷調查,以SPSS 12.0進行t檢定、單因子變異數分析、皮爾遜(Pearson)積差相關及多元迴歸分析等統計分析,另外利用結構方程模式(AMOS軟體)分析本研究假設架構的相關性。 研究結果如下: (一)全民CPR課程,研究者共發放253份調查問卷,其回收196份問卷,有效問卷為177份,有效問卷回收率達69.96%。填答者的性別,女性佔95.5%,男性佔4.5%。對於數位學習的認知:有聽過的達65.5%,有用過的達36.7%,聽過者比使過用者多。有參與數位學習課程的學生對科技接受模式的參與使用意願高。 (二) 醫護人員,研究者發放250份調查問卷,其回收195份問卷,有效問卷為193份,有效問卷回收率達 77.2%,其中以女性居多,佔92.2%、男性為7.8%;若以專業別分類,醫師佔17.6%、護士82.4%(一般護士59.1%、急診護士11.9%,ICU護士10.9%)。對於數位學習的認知,有聽過的達97.44%,有用過的達87.18%。利用Amos分析易用性、有用性及使用態度之結果顯示,三個構面的重要性依序為使用態度、有用性、易用性。 本研究所提出之“急救流程數位學習系統”,提供不受空間影響及時間限制的學習方式,有效減少學習者必需集合上課或練習的時間與精力,不但降低社會成本也提高學習的便利性。以視訊為基礎之數位學習系統可以提供有效的訓練學習方式,提昇醫療照護人員之專業技能,增進照護的品質。

關鍵字

急診 數位學習 病人安全 TAM AMOS

並列摘要


Proficiency in patient care procedures for healthcare professionals of the emergency department is very crucial in saving patients’ lives. These include administrative and clinical procedures, such as patient examination, disease classification, registration, pathological testing, physician-patient encounter, etc. In addition, emergent life-saving procedure must be conducted as soon as possible after patients have arrived the hospital to prevent serious harm and death. The objective of this study is to investigate the motivation and effectiveness of learning emergent procedures using video-based e-learning contents for the students studying in a medical university and healthcare professionals working at the emergency department of a hospital. Davis’ technology acceptance model (TAM) was applied to evaluate the perceived usefulness, perceived ease of use, and behavioral intention of the video-based e-learning contents. The objectives of this investigation are summarized as follows: 1. To understand the current status in using e-learning contents for nursing students and healthcare professionals. 2. To evaluate perceived usefulness, perceived ease of use, and behavioral intention based on TAM for students and healthcare professionals using video-based e-learning materials. 3. To analyze the impact of the perceived usefulness and perceived ease of use on behavioral intention. Cross-sectional questionnaire was adopted in this investigation. Students and healthcare professionals recruited from a medical university and a district hospital located at central Taiwan area were asked to fill the questionnaires. Inferential analyses, such as t-test, one way ANOVA, Pearson''s product-moment correlation, and multiple regressions, were conducted using SPSS (version 12.0) statistic software package. Additionally, structural equation pattern was also analyzed using AMOS software. An online video-based course with video clips used to demonstrate step-by-step procedures was produced and applied for CPR training. A total of 253 questionnaires were dispensed to the nursing students and 196 copies were received. By eliminating 19 incomplete or invalid questionnaires with missing data, 177 (70%) copies were used for further analysis. The results show that 95.5% and 4.5% of the received valid questionnaires were filled by female and male, respectively. Among these participants, 65.5% had heard e-learning and 36.7% had experiences in using e-learning courses. Regarding the healthcare professionals, 195 of the 250 dispensed questionnaires responded, in which 193 responses were treated as valid. Among the collected valid questionnaires, 195 (92.2%) of the participants were female and only 7.8% were male. Among them, 17.7% were physicians and 82.4% were nurses (general ward: 59.1%, ER: 11.9%, and ICU: 10.9%). 97.44% of them had ever heard of e-learning and 87.18% hade the experiences in using e-learning courses. After analyzing the perceived usefulness, perceived ease of use, and behavior intention with Amos software, behavior intention was ranked as the most important factor followed by perceived usefulness and perceived ease of use. In this thesis, we investigated the application of video-based emergency procedure e-learning course which enables the students and healthcare professionals to learn the skill without time and location limitation. It highly increases the learning efficiency and significantly decreases costs induced by equipment and space investments of a traditional classroom. It is expected to be able to increase learning efficiency and elevate healthcare quality.

並列關鍵字

Healthcare Quality E-Learning Emergency Patient Safety TAM AMOS

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