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緊急救護技術員在急診交班之完整性及其相關因素之研究

Study on the patient handover completeness and related factors between emergency medical technicians and triage nurses at emergency department

摘要


背景:本研究透過問卷分析方式調查目前救護技術員與急診護理師交班現況,並以國際上醫療救護人員統一交班格式IMIST-AMBO作為基準對照目前台灣救護技術員交班內容,以了解目前台灣救護技術員交班內容與國際救護人員交班內容之差異。此外,問卷中亦調查台灣救護技術員對於交班系統與相關訓練、病人條件因素等是否認為會影響交班完整性。方法:本研究為橫斷式調查,並以立意取樣方式針對新北市政府消防局第一線救護技術員進行問卷調查,共收到有效樣本197人。結果:研究發現台灣緊急救護技術員資料發現交班完整性以IMIST-AMBO標準來看,交班內容符合標準之項目平均分數為58.81分。對於交班系統與相關訓練研究發現,救護技術員在系統層面、教育層面、交班流程層面對交班完整性認知程度影響皆有一致性的高度的認同。在病人條件因素研究中發現緊急救護技術員對於讓病人及家屬共同參與交班過程,進而會提升交班完整性的認同程度相對的低分及不認同。高級救護技術員對於「交班系統與相關訓練因素會影響交班完整性」認同程度比中級救護技術員高。受測者自認交班完整性越高對於「不同病人條件會影響交班完整性的認同程度」也越高。結論:藉由本研究的結果,建議台灣應擬定院前與院端都能統一交班格式,以確保病人資訊能夠正確且完整的被傳遞。緊急救護技術員認為要與急診檢傷人員共同參與交班的訓練,也認同是一個有助於提升交班完整性的方式。讓彼此有共同的交班格式及語言,在過程中可以了解熟悉彼此的工作內容與工作習慣,以提升台灣救護技術員的完整交班能力。

並列摘要


Background: This study aimed to investigate current situation of patient handover between emergency medical technicians and emergency room triage nurses. In this questionnaire study, it included the comparison of Taiwan emergency medical technician handover items and IMIST-AMBO format, the degree of agreement in handover system, training, and patient conditions to affect the completeness of handover. Methods: This was a cross-sectional study that was conducted to investigate emergency medical technicians from New Taipei City Fire Department. There were 197 participants completed this questionnaire. Results: The key findings and suggestions were the completeness score of handovers in Taiwan emergency medical technicians was 58; participants agreed that system, education, and handover workflow can affect completeness of handover; participants were not welling to involve patients and their family into handover; paramedics agreed that handover system and educational factors can influence completeness of handover than EMT2. Conclusion: In conclusion, it is necessary to develop a unique handover format for both prehospital and emergency department personnel. Handover training should involve both EMTs and ED nurses to improve interprofessional communication accuracy. Future study may compare the effect of handover training intervention.

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