急診護理人員與緊急醫療救護人員交班完整性及其相關因素之探討

背景：急診護理人員與緊急醫療救護技術員是兩個獨立、性質類似但有不同專業觀點且需頻繁交班的團隊，常因內外在不同因素的影響，導致雙方在交班認知有所不同，而無法有效交班，期望藉由本研究探討瞭解影響雙方交班因素，達到交班共識，提升病人安全品質。方法：採橫斷式研究設計，自編結構式調查問卷線上進行資料收集，便利取樣方式，取得雙北市急診護理人員共101位研究對象。並以單因子變異數、皮爾森積分相關、多元迴歸模式進行統計分析。結果：（1）以ISBAR內容重要性之認知為交班完整性依據，非常重要項目佔所有比例36%。（2）社會人口學與交班系統與相關訓練、病人及病情狀況、交班完整性無顯著差異。（3）交班系統與相關訓練與交班完整性呈正相關，（r＝.708, p＜.01）、病人及病情狀況與交班完整性呈正相關，（r=.452, p＜.01）。（4）交班系統與相關訓練對交班完整性為主要重要預測因子，可解釋總變異量的51.8%。結論：交班系統與相關訓練為主要預測因子，建議可共同辦理相關在職教育及技術訓練課程、同步改變交班方式及作業系統、制定交班格式口訣，找到雙方交班共識，期待提升病人安全品質。

關鍵字

急診護理人員；交班完整性；交班系統與相關訓練；病人及病情狀況

並列摘要

Background: They are two independent teams with similar system between the nurses who work in emergency room and the emergency medical technicians (EMTs). They need to frequently do the patient handover but due to the influence of internal or external factors and two partied have the different professional viewpoint, it causes the different perceptions of patient handover and cannot be effective. Through this study to explore and comprehend the factors then reach a consensus to both, therefore, improve the quality of patient safety. Methods: A cross-sectional study design was adopted, A total of 101 subjects of emergency nursing staff in basic level first aid duty hospitals of Taipei City and New Taipei City as samples were selected by using self-compiled structured questionnaires. Statistical analysis was performed by one-way analysis of variance, Pear-son correlation coefficient and multiple regression model. Results: (1) 36% of the total think the completeness of patient handover which is based on the ISBAR format is very important. (2) There is no significant difference in the Social Demography, Handover system & Related Training, Patient & Disease Status, and Handover Integrity of the research subjects. (3) There is a significant correlation between the Handover system & Related Training and Patient & Disease Status of the research subjects. (r=.708, p＜.01), Indicating that fully functional Handover system & Related Training, the higher patient participation, and the more complex and serious disease conditions affect the integrity of patient handover. (r=.452, p＜.01) (4) The handover system & related training are the main predictors of the handover integrity, which can explain 51.8% of the total Measures of Variation. Conclusion: Handover system & Related Training is the main predictors. According the research result, providing the relevant education and technical training courses, simultaneously change the handover method and operating system, formulate handover format, identify problems and propose solutions were suggested to improve the quality of patient safety.

並列關鍵字

Triage nurse ； handover integrity ； handover system ； patient condition

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