社會資本、知識分享與病人安全文化關係之研究

近年來各醫療機構紛紛應用醫療團隊資源管理(Team Resource Management，TRM) 提升組織或單位之病人安全文化，其醫療團隊之組成就如乙社會網絡，成員之間藉由互助合作、有效溝通、相互分享其資訊或知識，以達到降低錯誤、提升病人安全文化之目的。本研究對象主要為護理人員，因為護理人員所處的組織網絡的連結十分密切，常與不同的專業團隊一起工作，有更多的機會可以交流自己的想法。然而，社會資本的結構構面強調的就是網絡與社會互動，藉由與其他同事的頻繁互動和交流，進而促進知識分享。目的：本研究主要以社會資本相關理論為基礎，進一步探討組織內部擁有知識的個別成員，所處的社會網絡關係，是否對知識分享、病人安全文化有所影響? 方法：本研究以南台灣某區域醫院414位護理人員為研究對象，利用問卷調查法進行資料的蒐集，獲得有效問383份問卷，有效回收率92.5％。結果：一、社會資本與知識分享之間(p＜0.01,r=.582)具有顯著正向關係二、社會資本與病人安全文化之間(p＜0.01,r=.169)有具有顯著的正向關係三、知識分享與病人安全文化之間(p＜0.01,r=.581)有具有顯著的正向關係四、知識分享在社會資本與病人安全文化之間具有部份中介效果結論：護理人員的社會資本愈高，愈會影響組織成員的知識分享，而知識分享與病人安全文化亦呈顯著正相關。因此，本研究提出建議，醫院管理者應該營造一個開放、友善、信任的環境，讓員工願意分享彼此的知識。

關鍵字

社會資本；知識分享；病人安全文化

並列摘要

In recent years, various medical institutions have applied the medical team resource management (Team Resource Management, TRM) to enhance culture of patient safety for a single unit or the whole institution. Set up like a social network service, members of the medical team cooperate seamlessly, communicate effectively and share their information or knowledge generously to minimize errors in order to optimize patient safety. The subjects of this study are registered nurses. Put in a well- organized and close network, registered nurses often work with diverse professional teams and offer their plan to serve patient with care and discipline. Nevertheless, the main dimensions of social capital are network and communication. Maintaining and enhancing social capital depends critically on the ability of the nurses to communicate among each other, work effectively and fulfill their roles. Objectives：Based on social capital theory, this study aims to explore the impact of disciplined nurses and their network on sharing of knowledge and optimization of patient safety culture. Methods：The study population comprises 414 registered nurses of a regional hospital in southern Taiwan. Using questionnaires to collect data, we obtained 383 valid questionnaires, the effective rate being 92.5%. Results：First, there is a significant and positive association between social capital and knowledge sharing(p＜0.01,r=.582). Second, there is a significant and positive association between social capital and patient safety culture(p＜0.01,r=.169).Third, knowledge sharing is significantly and positively associated with patient safety culture(p＜0.01,r=.581).Fourth, the association of social capital with patient safety culture is partially moderated by knowledge sharing. Conclusions：The results of this study point out that the higher the social capital of registered nurses, the more the impact on knowledge sharing among members. knowledge sharing is significantly associated with patient safety culture in a positive manner. Therefore, this study suggests that hospital administrators should create an open, friendly, and trustworthy environment where registered nurses are willing to share their knowledge to optimize patient safety.