病人和醫務人員對於病患安全認知之差異分析－以某醫學中心為例

研究目的：病患安全是一個全世界共同注意的議題也是台灣在邁入醫療大國的過程中不可避免的醫務管理和醫療政策的一環。從2002年起台灣接連爆發幾起重大醫療疏失案例，以及SARS風暴，都讓國人震驚。但是到底病人對於病人安全議題的重視觀點和醫務人員是否相同？或是醫務人員認為自己的努力是否為病人所認同？都是值得深入研究的。研究方法：本研究採用自編結構式問卷隨機抽樣調查台北市某醫學中心病患及醫務人員兩大族群對於「病人安全」相關議題之重要性和達成程度之認知差異，然後再以paired-t tests進行統計分析。研究結果：共計有505份有效問卷。結果顯示「病人身份辨識」和「用藥安全」二構面的「重要性」上，醫務人員顯著的高過病人，而「與醫師的互動」、「感染管制」、「醫學檢測」和「病人安全通報」等構面上則是病人高於醫務人員。另在「用藥安全」和「病人身份辨識」二個構面上醫務人員認為「達成程度」顯著的高過病人外，在其他幾個構面上兩者之問對達成程度上的認知是沒有統計上顯著的差異。在「重要性」與「達成程度」的差異上，對醫務人員而言「用藥安全」差異最大，但是「跌倒預防」則差異最小；對病人而言「感染管制」差異最大，而「跌倒預防」則差異最少。結論與建議：從本研究結果推論病人與醫務人員對「病人安全」議題在「重要性」和「達成程度」的認知上是存在著差異，另於「病人安全」議題「重要性」和「達成程度」之問的差異的認知雙方亦存在顯著差異。因此從本研究結果可以證明醫療院所可能對於民眾心目中對於各病患安全的議題的重要性不是很瞭解，以致於努力做卻搞錯了順序。另醫療機構或醫務人員做了努力但是卻無法透過適當的方法傳遞給病患，以致無法引起病患的共嗚，此則暴露出醫療院所宣傳方法不足無法改善病患心目中的認知。前者和品質管理的策略規劃關係密切，但是後者卻是不則不扣的醫療行銷的不足，有待更進一步的找出有效的宣傳方法來改善。

關鍵字

病人安全； paired-t tests ；策略

並列摘要

Purpose: Patient safety is an important issue all over the world, and it is an evitable issue of hospital administration and health policy for Taiwan which eagerly wants to become a medically well-developed nation. However, since 2002, a series of incidents, including SARS, raised the issue about poor patient safety in Taiwan. Since then, both the governments and health care institutions have spent so much effort on improving patient safety. But many literature still indicate that there are gaps between patients' and medical staff's perception about patient safety. How different is the perception about patient safety between patients and medical staff? This study aims at examining the difference. Method: A structured questionnaire about patient safety issues were developed and used to survey patients and medical staffs of a medical center locating in Taipei metro area. Paired t tests were conducted to analyze difference in importance and achievement of patient safety. Results: 505 valid questionnaires were returned. Results indicate that medical staff regarded that ”patient identification” and ”prescription safety” more important than that of patients'. However, patients valued ”interaction with doctors”, ”infection control”, ”medical examination” and ”patient safety promulgation” more important than that of medical staff There are significant differences between importance and achievement in ”preventing falling down” and ”prescription safety” among medical staff and ”infection control” and ”preventing falling down” for patients. Conclusions: Useful information for making strategic priorities for hospital administrators and health policy makers in determining their strategic actions in promoting patient safety. Patient education skills or proper marketing actions should be used to improve existing methods in patient safety education.