醫院病人安全文化、組織學習對異常事件發生之影響

The Impact of Hospital Patient Safety Culture and Organizational Learning on Occur of Medical Adverse Event

廖佩倫(Pei-Lun Liao)

指導教授 ： 蔡雅芳

中山醫學大學/健康管理學院/醫療產業科技管理學系/碩士(2019年)

https://doi.org/10.6834/CSMU201900162

摘要

研究目的：隨著醫療科技日新月異，在醫療照護的體系中病人安全文化始終是一項重要的議題，透過培養組織學習的能力，使組織學習正確的方法以及在錯誤發生前預測風險，提高醫院對病人安全文化的認知，以降低異常事件發生。本研究以個案醫院為研究對象，探討個案醫院員工對病人安全文化的認知、組織學習的態度以及異常事件發生的相關性。
研究方法及資料：本研究採用橫斷面研究設計與問卷調查法，使用結構式問卷進行調查，收案時間為108年3月18日至4月18日，共發放415份問卷，回收407份，其中18份判定為無效問卷，有效問卷為389份，有效率為95%，經SPSS 22.0 版統計套裝軟體進行問卷信效度分析、描述性分析、獨立樣本t檢定、單因子變異數分析、簡單線性迴歸以及皮爾森相關分析。
研究結果：在人口特質中性別、職務類別、臨床工作單位、專業服務時間不同，以及是否為管理階層人員對於病人安全文化認知有達到統計上顯著差異；性別、職務類別、專業上服務時間不同及是否為管理階層人員對於組織學習態度有達到統計上顯著差異；職務類別及臨床工作單位對於異常事件發生有達到統計上顯著差異。病人安全文化認知會影響組織學習態度且呈現正相關(r=0.618, P=0.000)；而病人安全文化(r=-0.177,P=0.000)與組織學習(r=-0.105,P=0.040)會反向影響異常事件發生，即呈現負相關。
結論與建議：研究結果發現，員工對醫院病人安全文化認知會正向影響員工組織學習態度，且病人安全文化認知與組織學習態度皆會反向影響異常事件發生；換言之，當員工對病人安全文化與組織學習認知態度越高，發生異常事件的機會較低。建議醫院管理者可以藉塑造強的病人安全文化，培養員工組織學習的正向態度，加強員工對病人安全的重視，進而減少異常事件的發生。

關鍵字

病人安全文化 ； 組織學習 ； 異常事件發生

並列摘要

Purpose：With the gradual improvement of medical technology, patient safety is an important issue in healthcare industry. By cultivating the ability of organizational learning, the organization can learn the correct method and predict the risk before the error occurs, and improve the awareness of the hospital patient safety culture to reduce the medical adverse event. This study takes case hospital staff’s as the research subject, understands the patient safety culture awareness and organizational learning attitude and the occur of medical adverse event of hospital staff’s, and explore the impact of patient safety culture and organizational learning on the occur of medical adverse event.
Method：This study used a cross-sectional study and structured questionnaire survey. The data collection was from March 18 to April 18, 2019, and distributed 415 questionnaires, 407 questionnaires (including 18 invalid questionnaires) were recovered. The effective recovery rate was 95%. The reliability and validity analysis, descriptive analysis, T-test, ANOVA, linear regression analysis and Pearson correlation analysis were used by SPSS version 22.0 statistical analysis software.
Result：The results of this study found that gender, occupational categories, clinical work unit, professional service time and whether to serve as supervisor with patient in staff's data characteristics will affect staff's patient safety culture awareness; gender, occupational categories, professional service time and whether to serve as supervisor will affect staff's organizational learning attitude; occupational categories and clinical work unit affect staff's occur of medical adverse event. The staff's awareness of patient safety culture affect the attitude of organizational learning and is positively correlated (r=0.618, P=0.000); patient safety culture (r=-0.177, P=0.000) and organizational learning (r=-0.105, P=0.040) affect the occur of medical adverse event, which presents a negative correlation.
Conclusion and Suggestion：The results of this study found that patient safety culture awareness was positively affect organizational learning attitudes, and patient safety culture and organizational learning will negatively affect the happened of medical adverse event. In other words, hospital staff's improve awareness of patient safety culture and attitude of organizational learning will reduce the happened of medical adverse event. Suggest the hospital administrators can strengthen the hospital staff's positive attitude of organizational learning, improve patient safety culture awareness, and thus create a strong patient safety culture.

並列關鍵字

patient safety culture ； organizational learning ； occur of medical adverse event.

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