醫護人員病人安全文化對其工作滿意之影響-以某區域醫院為例

The Impact of Patient Safety Culture on Job Satisfaction of Medical Professions-An Example of Regional Hospital

汪念琪(Nien-Chi Wang)

指導教授 ： 邱雅萍 ； 周大森

中原大學/商學院/企業管理研究所/碩士(2019年)

https://doi.org/10.6840/cycu201900121

摘要

摘要
隨著環境的變遷、人民所得增加、醫療科技的進步、逐漸老化的人口、醫療費用支付制度的調整與醫療消費者意識的抬頭之影響，隨之而來衍生出醫療市場競爭的日趨激烈、對醫療品質與病人安全的高要求、護理成本增加與健保費用給付偏低、基層醫師人力不足及護理人力短缺等問題，造成醫護人力需求持續上升已成事實。由於醫療工作具有高度的複雜性與不確定性，也包含一定程度的風險，而無論發生何種程度的失誤，都可能危害病人的生命，甚至造成病人難以彌補身心傷害，醫療疏失的發生已非個人問題，是醫務相關機構甚至整個體系的職責。
病人在接受治療與處置，醫療團隊精密的分工與合作過程中，任何一個醫療行為都是複雜團隊的運作結果，為避免疏失的發生，病人安全的提升須建立在良好的病人安全文化基礎上，提供「以病人為中心」的醫療服務，改造完善醫療體系制度，醫護人員提高壓力承受度，管理支持提供必要資源，營造安全風氣，建構較低風險安全醫療環境，先從間接影響醫護人員工作滿足因素著手，才能落實病人安全作業。因此，本研究擬探討病人安全文化對醫護人員工作滿足之影響，並利用統計模型來進一步確認各項變項間之關係。
本研究探討的病人安全文化，包括壓力承受、團隊合作、管理支持、安全風氣四個面向，並透過實證資料分析其如何影響醫護人員工作滿意。研究對象以某區域醫院之全職醫護人員為研究對象，利用醫院現有之106年病人安全文化之問卷調查資料，醫護人員填答之部分共有753份有效問卷，以進行後續資料分析。運用迴歸分析來探討變數間之關係，驗證本研究之假設。實證分析結果顯示：壓力承受對工作滿意具有顯著的負向影響；團隊合作、管理支持、安全風氣對工作滿足具有顯著的正向影響。
關鍵字：病人安全文化、壓力承受、管理支持、安全風氣、工作滿意

關鍵字

病人安全文化；壓力承受；管理支持；安全風氣；工作滿意

並列摘要

Abstract
With the changes in the environment, the increase in people's income, the advancement of medical technology, the aging population, the adjustment of the payment system for medical expenses and the rise of medical consumer awareness. As a result, the increasingly fierce competition in the medical market, the high requirements for medical quality and patient safety, the increase in nursing costs and the low cost of health insurance, the shortage of grassroots physicians and the shortage of nursing staff have caused the demand for medical staff to continue to rise. It has become a reality. Due to the high complexity and uncertainty of medical work, it also contains a certain degree of risk. No matter what kind of mistakes occur, it may endanger the patient's life, and even cause the patient to make up for physical and mental harm. The medical malpractice is no longer happening. Personal problems are the responsibility of medical institutions and even the entire system.
In the process of receiving treatment and treatment, and the precise division and cooperation of the medical team, any medical behavior is the result of the operation of a complex team. To avoid the occurrence of negligence, the improvement of patient safety must be based on a good patient safety culture. Provide "patient-centered" medical services, transform and improve the medical system, improve the pressure tolerance of medical staff, provide necessary resources for management support, create a safety climate, and construct a low-risk safe medical environment, which will indirectly affect the work of medical staff. Factors can be used to implement patient safety. Therefore, This study intends to explore the impact of patient safety culture on the job satisfaction of health care workers. A statistical model is used to further confirm the relationship between the variables.
The patient safety culture discussed in this study includes four aspects of stress tolerance, teamwork, management support, and safety, and analyzes how it affects the work of medical staff through empirical data. The study subjects were based on the full-time medical staff of a regional hospital. Using the 106-year patient safety culture questionnaire survey data, the medical staff answered a total of 753 valid questionnaires for follow-up data analysis. Use regression analysis to explore the relationship between variables and verify the hypothesis of this study. The empirical analysis shows that stress tolerance has a significant negative impact on job satisfaction; Teamwork, management support, and safety climate have a significant positive impact on job satisfaction.
Keywords: patient safety culture, stress tolerance, management support, safety climate, work satisfaction

並列關鍵字

patient safety culture；stress tolerance；management support；safety climate；work satisfaction

參考文獻

一、中文部份：

1.中華民國護理師護士公會全國聯合會(2018 )。2018護理人員人力調查。取自http://www.nurse.org.tw/publicUI/H/H10201.aspx?arg=8D68860750A36CC005

2.台灣病人安全資訊網，2018，1月29日。107〜108年度醫療品質及病人安全年度目標（醫院版），http://www.patientsafety.mohw.gov.tw/ Content/zMessagess/list.aspx?Sit eID = 1＆MmmID =621273300317401756

3.王桂芸、廖美南(2018)。護理行政學，三版。臺北市：永大書局。

4.王雪鳳、楊豐華、羅月英、楊慧滿 (2016) 。護理人員酬勞公平、工作滿足及離職意圖相關因素之探討。弘光學報， 78期，203-221。