急診護理人員檢傷分級能力現況及其影響因素探討

The Current Status quo of Triage Nurses Competency and Related Factors in the Emergency Department

陳淑新(Shu-shin Chen)

指導教授 ： 張文英

臺北醫學大學/護理學院/護理學研究所/碩士(2007年)

https://doi.org/10.6831/TMU.2007.00088

摘要

因各醫院急診病患檢傷分級均由護理人員來執行，所以其分級的正確與否，不僅影響病患的等候時間，更攸關急診病患的照護品質。本研究目的旨在：一、瞭解急診護理人員之檢傷分級能力現況；二、瞭解與比較不同護理人員之基本屬性、醫院屬性及檢傷教育訓練，其護理人員檢傷分級能力得分之差異情形；三、預測影響急診護理人員檢傷分級能力之因子。
本研究設計為描述性比較研究，以橫斷式問卷調查30%新竹以北評鑑合格之14家醫院的急診檢傷護理人員。本研究工具為研究者自擬之急診檢傷分級因素調查表及檢傷分級能力評估表。此兩種工具均採專家內容效度檢定，但僅有檢傷分級能力評估表再採內在一致性（internal reliability）及再測信度（test -retest）檢定，其KR-20值為0.83。資料統計方法包括百分率、平均值、獨立t檢定、單因子變異數分析及複回歸分析。
本研究共收案279位護理人員，結果發現急診部（科）檢傷護理人員之年齡、護理年資、急診年資、檢傷年資、專業證照種類及護理能力進階級數，均與護理人員檢傷分級能力有統計上之顯著差異（p＜.01），而教育程度及性別則無統計上之顯著差異。急診護理人員檢傷分級能力得分以醫學中心較佳；檢傷教育訓練之授課時數、授課方式及授課內容與護理人員檢傷分級能力得分有統計上顯著差異（p＜.05）。而在迴歸模式中，急診護理人員之急診年資、專業證照種類、醫院評鑑等級、檢傷輔助設備、檢傷教育訓練之授課時數等5變項均為影響檢傷分級能力之因子（p < .05），解釋力為41.6％。
本研究結果可作為急診部（科）人力配置及安排護理人員在職教育課程的參考依據，並提供政府訂定相關規定與資源分配時之實證參考，以制定更符合民眾就醫需求的醫療政策。

關鍵字

急診 ； 檢傷護理人員 ； 能力

並列摘要

Beasuse the triage is usually perfomed by nurses in the emergency department; therefore, the accuracy of triage level assignment is important because it is not only affected the patient waiting time, but also associated with the quality of patient care. The aims of this study were 1) to understand the status quo of the triage nurses competency, 2) to understand and compare the differences between demographics of nurses, level of hospitals, and triage education training, and nurses’ triage scores, 3) to predict the impact factors related to nurses’ competency scores.
The design was descriptive comparison study using cross-sectional questionnaire to survey nurses from 30% of hospitals in northern of Taiwan. Two instruments were used in this study, including self-developed emergency triage questionnaire and triage competency assessment tool. The validity of these two instruments was assessed by content analysis. Only the triage competency assessment tool was also assessed by internal reliability test and test-retest. The result KR-20 was 0.83. Data were analyzed by percentage, mean, independent t-test, one-way ANOVA, and regression analysis.
A total of 279 nurses participated in this study. The results were indicated that nurses triage competency was influenced by nurses’ age, working experience, years of working experience in the emergency department, type of certifications, level of clinical ladder. However, a significant difference was not found (p<.01) from above variables. Moreover, a significant difference was not found between level of education and gender and nurses triage competency. Nurses who work in the medical center have higher scores of triage than those of non-medical centers. A significant difference was also found between the hours of education training and type of continuing nursing education, and the contents of education and nurses’ triage competency (p<.05). For the regression analysis, factors related to the nurses working experience in the emergency department, types of certifications, level of hospital accreditation, triage assistants, hours of education training were found related to nurses’ triage competency. The variance of explanation was 41.6%.
The findings not only provide information to nursing resource management and continuing nursing education, but also to assist government to set health policy and to resource allocation to meet the needs of public.

並列關鍵字

emergency department ； triage nurse ； competency

參考文獻

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