醫院員工屬性與病人安全文化之相關性研究

The Relationship between Hospital Employee Attributes and Patient Safety Culture

林淑美(Shu-Mei Lin) ； 邱逸淳(Yi-Chun Chiu) ； 詹尚易(Shang-Yih Chan) ； 陳柏頴(Po-Ying Chen) ； 何清幼(Chin-Yu Ho) ； 邱家祈(Chia-Chi Chiu) ； 翁林仲(Lin-Chung Woung) ； 黃勝堅(Sheng-Jean Huang) ； 萬同軒(Tung-Hsuan Wan)

《北市醫學雜誌》 17卷1期 (2020/03) Pp. 87-105

https://doi.org/10.6200/TCMJ.202003_17(1).0008

摘要

目的：探討醫院員工屬性與病人安全文化之相關性，提供管理者持續營造安全文化之基礎及策略方向，亦做為未來持續追蹤的基礎資料。方法：本研究以8個不同院區，共計4,925名員工為研究對象。採橫斷式調查法，使用醫策會（2009）病人安全文化八個構面的結構性量表，透過病人安全文化調查系統收集調查資料。以描述統計、T檢定、單因子變異數及填答平均百分比分析，員工屬性與病人安全文化的關係。結果：本研究分析3,697份問卷結果顯示，病人安全文化與員工基本屬性（p＜0.001）、專業職務（p＜0.001）、單位（p＜0.001）及院區（p＜0.001）皆有顯著相關。對病人安全文化達正向感受之員工屬性為主管（66.30%）、專業職務屬性為醫師（67.44%）、醫技（65.57%）及藥劑人員（63.34%）；單位屬性為手術室（61.42%）、藥局（70.38%）、檢驗（61.80%）、放射（61.47%）、外科及兒科病房（73.04%及68.66%）。惟於復原力構面皆未達顯著正向感受。結論：本研究得知醫院員工在專業類別、單位別及院區別與病人安全文化感受皆有顯著相關，且醫師及主管顯著較為正向。員工對於安全文化的感受是影響不良事件的上游因素，建議醫院應重視員工整體職業倦怠感，差異化營造員工屬性之正向病人安全文化，且建置制度以鼓勵醫師擔任主管，成為營造正向病人安全文化的指標角色，並定期調查持續驗證推動成效。

關鍵字

病人安全 ； 文化 ； 復原力 ； 屬性

並列摘要

Objectives: To explore the relationship between hospital employee attributes and patient safety culture and provide the basis and strategic direction of safety culture continuously for the administrators as well as the baseline for future follow-up. Methods: In this study, 4,925 employees from eight branches of a city hospital were included as research subjects. A cross-sectional survey using the Eight Dimensions for Patient Safety Culture Structural Scale was conducted through the Taiwan Patient Safety Culture System. Descriptive statistics, t-tests, analysis of variance, and percentage were used to evaluate the relationship between hospital employee attributes and patient safety culture. Results: A total of 3,697 employees were recruited in this study. Employee attributes (p＜0.001), professional field (p＜0.001), branch (p＜0.001), and department (p＜0.001) were all significantly associated with the patient safety culture. The employee attributes which were positively related to patient safety culture included supervisors (66.30%), physician (67.44%), paramedical (65.57%), and pharmacy (63.34%). The unit attributes which were positively related to patient safety culture included operating room (61.42%), pharmacy (70.38%), laboratory (61.80%), radiology (61.47%), surgery, and pediatrics wards (73.04% & 68.66%). All attributes of the resilience dimension were not related patient safety culture. Conclusion: Employee attributes were significantly associated with patient safety culture. Employees' perception of safety culture is the cause to affecting adverse events. We suggest that studied hospitals to pay attention on the feeling of job burnout among employees, promote positive patient safety culture according to their different attributes, build systems to encourage physicians to become leaders, and routinely inspect and audit the effectiveness of implementations.

並列關鍵字

patient safety ； culture ； resilience ； attributes