以人因工程觀點評估病人安全因素之研究

Assessment of patient safety from human factors perspetive

周蕙慈(HUI-TZU CHOU)

指導教授 ： 林維儀

長榮大學/管理學院/高階管理碩士在職專班(EMBA)/碩士(2012年)

https://doi.org/10.6833/CJCU.2012.00180

摘要

病人安全的議題近年來受到世界各國的重視，而我國同樣因為出現一些重大的病安事件 ，才使得政府開始重視病安問題。2011年8月臺灣器官移植史上，堪稱極度嚴重的醫療疏失案件，由臺大醫院與成大醫院誤將罹患愛滋病所捐贈的心、肺、肝、腎等五例移植手術。故本研究選定以影響病人安全的因素為課題，引用飛航業的人因工程理論模式，選擇南台灣地區級以上的醫院之醫療從業人員為影響病人安全之因素進行探討。本研究採兩階段研究方式，第一階段依文獻探討以及問卷調查與因素分析法找出五個構面和十八個因素，評選出重要之病人安全因素及命名，修改成新的研究架構；再進行第二階段專家問卷，以層級分析程序法 (Analytic Hierarchy Process，AHP)進行構面與因素之調查，衡量各評估指標間對應之權數，最後排出各構面人為因素的優先順序。構面權重之優先順序為高層承諾，病安提升能力，隱藏錯誤，組織溝通力和外在壓力。本文建構的研究模式，雖然已針對國內南部四家醫療從業人員進行施測，然而仍未經大量樣本在效度與信度上的驗證，因此，本研究所建構病人安全人為因素衡量模式其效度與信度仍有加強之空間。後續研究者可擴大研究的樣本進行實證分析，以考驗本衡量模式之信度與效度，使本衡量模式更趨完善。

關鍵字

病人安全 ； 人因工程 ； 層級分析程序法

並列摘要

In August 2011, a serious medical negligence case happened in Taiwan. National Taiwan University Hospital and National Cheng Kung University Hospital committed an amazing error by transplanting the organs of an HIV carrier into other patients. This study focused on the factors affecting patient safety and explored into medical practitioners of district hospitals in Southern Taiwan as factors affecting patient safety by using the human factors engineering theory for the aviation industry. This research included two stages. In the first stage, the researcher found out 5 dimensions and 18 factors based on the results of literature review, questionnaire survey, and factor analysis, from which the important factors affecting patient safety were chosen, named, and modified into a new research structure. In the second stage, questionnaires were sent to experts for conducting investigations on dimensions and factors by using the Analytic Hierarchy Process (AHP), measuring the corresponding weights among various evaluated indexes, and finally determining the priority of the artificial factors of each dimension. The priorities of dimensions in the descending order are: top management commitment, ability in enhancing patient safety, error hiding, organizational communication and external force. The research model constructed by this study has been used to measure the medical practitioners of four hospitals in Southern Taiwan; however, its validity and reliability have not been verified by a great deal of samples. Therefore, there are still rooms for improvement in the validity and reliability of the measurement model with respect to the artificial factors of patient safety. The subsequent researchers are suggested to carry out experimental analysis by expanding research samples, so as to verify the validity and reliability of this measurement model and make it more perfect.

並列關鍵字

patient safety ； human factors ； AHP( analytic hierarchy process)

參考文獻

1.王昱豐、徐美菁、林俊龍，2005，病人安全及以病人為中心之醫療照護－兼論本院推動之經驗。慈濟醫學雜誌，17 （4），1-13。

2.王美文、黃麗鳳、台麗珍、陳淑華，2012，「恢復室護理人員術後交班作業完整性之改善」，護理雜誌第59卷第2期，80-87頁。

6.李偉強，2007，病人安全文化調查與對提高醫療安全的應用，重症醫學雜誌，8(4)，175－183。

8.邱文達、石崇良、侯勝茂，2004，「病人安全與醫學倫理－建構以病人為中心的醫療體系」,台灣醫學人文月刊第5卷第1-2期，頁66-96。

13.林廣易，2011，以AHP模式評估台灣PC零組件供應商綠色供應鏈管理項目 創新研發學刊ISSN：1814-1927 第七卷，第一期．, Vol. 7, No. 1.