護理人員維護病人安全之影響因素探討

The Causal Model Analysis of Nurses' Patient Safety Perception

張孟玲(Meng-Ling Chang) ； 邱國琄(Kuo-Chuan Chiu) ； 高木榮(Mu-Jung Kao) ； 劉祥得(Hsiang-Te Liu)

《北市醫學雜誌》 13卷3期 (2016/09) Pp. 123-136

https://doi.org/10.6200/TCMJ.2016.13.3.13

摘要

目的：研究影響護理人員自我效能感、人力配置、團隊合作是否影響其病人安全認知。本研究亦探討標準化流程對於自我效能和病人安全認知的調節效果(moderating effect)。方法：以北區某聯合醫院手術室、加護病房與急診室為調查單位，共獲得有效樣本343份。利用LISREL軟體，以驗證式因素分析(confirmatory factor analysis, CFA)檢測構面及題項的信度與效度，同時以階層迴歸分析(hierarchical regression analysis)、結構化模式分析，檢測所設立的研究假設。結果：本研究證實，當護理人員自我效能感高時，病人安全認知也會高；人力配置、團隊合作認知高時，病人安全認知也會提高。此外，標準化流程會調節自我效能和病人安全認知間的關係。結論：護理管理上應該強化護理人員自我效能感；進行人力配置合理化；以及強化團隊合作觀念，必能提升其病人安全認知。此外，護理人員在低度標準化流程認知時，特別需要塑造其較高的自我效能認知，才能提高病人安全認知。

關鍵字

自我效能 ； 人力配置 ； 團隊合作 ； 標準化流程 ； 病人安全認知

並列摘要

Objective: This study explored whether self-efficacy, recognition of manpower allocation and team cooperation among nursing staff affect their patient safety perception. We also explored the moderating effect of standard operation procedures (SOPs) on self-efficacy and patient safety perception. Methods: This study collected 343 valid samples from the Taipei City Hospital. Cnfirmatory factor analysis (CFA), hierarchical regression and structural equation modeling were used to justify the hypotheses using the LISREL software. Results: The result showed that patient safety perception among nurses was positively influenced by their self-efficacy, recognition on manpower allocation and team cooperation. Besides, SOPs moderated the relationshipship between self-efficacy and patient safety perception. Conclusion: To strengthen nurses' perception on patient safety, it is essential to increase their self-efficacy, allocate manpower reasonably, and strengthen the concept of team cooperation. When nursing staff have weak perception on SOPs, molding of a higher self-efficacy is especially important for elevating their perception on patient safety.

並列關鍵字

Self-efficacy ； manpower allocation ； team cooperation ； standard operation procedures ； patient safety perception