台灣地區國民小學校園緊急傷病處理現況與相關因素探討

彭秀英

指導教授 ： 陳政友

國立臺灣師範大學/教育學院/衛生教育學系/碩士(2000年)

摘要

摘 要本研究旨在瞭解台灣地區國民小學校園緊急傷病處理現況及其相關影響因素。研究工具為自擬之結構式問卷，研究對象是八十九學年度台灣地區公私立國民小學。總計發出問卷360份，收回有效問卷309份，回收率為86.6﹪。研究結果主要發現如下：目前台灣地區校園緊急傷病事前規劃措施的實施缺乏整體性和協調性；大部分學校在學生發生緊急傷病時，有聯絡不到家長的現象；只有三成學校完成緊急傷病處理組織運作及程序擬訂；學校健康中心處理緊急傷病的人力支援、通訊廣播及緊急照護設備不足；雖有七成學校進行傷病處理紀錄卻只有不到兩成學校能善加應用；各校辦理一般急救訓練課程內容不一、時數及次數不足，參加人員不能普及，經費支援不足，預期成效有限；有八成學校以校護為緊急傷病處理工作主要執行人員，其接受專業急救訓練的時數不足，亟待加強；學校對學生參加保險情形疏於關注；校護差假期間只有二成學校能指定特定職務代理人實質代理其職務。校園急症以發燒、腹痛最多；受傷以裂傷、骨折最多。傷病處理人員以校護和級任老師為主。只有一成的學校在事前規劃整體周延性上屬於良級，而有四成學校在緊急傷病處理表現較佳。校園緊急傷病處理事前規劃措施越週延，事發後處置表現越好，其中「組織運作」、「程序擬訂」、「支援聯絡網建置」、「急救訓練」、「職務代理人安排」等與事發後處置關係密切，而這五項措施又受到「學校所在地」、「工作主要執行人員職稱」及「其最近一次接受急救訓練時間間隔」的影響。因此建議，教育單位應加強建立校內緊急救護系統，制定相關法令，落實事前規劃措施，加強評鑑考核；建議提高急救訓練的質與量，尤其是校護的緊急救護知能訓練；建立長期監測指標，整合學校附近醫療資源，發展符合各校特色之緊急傷病救護系統。 ABSTRACT The purpose of this study was to find out the current practice of the management of the school injuries and sickness in the campus of primary schools around the Taiwan area as well as its relevant influences and factors. In order to do this, a structural questionnaire was created as a tool for the study. Targets for the study were the public and private primary schools of the 2000th academic year around the Taiwan area. Three hundred and sixty copies were issued in total; 309 effective ones were retrieved, with a successful retrieving rate of 86.6%. The main findings of the study are the following： The implementing of the measures for emergency preparedness in the campus around Taiwan lacked coordination and consistency. Most schools had trouble of contacting the parents at the critical moment of an emergency when a student is injured or sick. Only thirty percent of the schools had set up school emergency care committee and written emergency care procedures. The health centers of the schools were insufficient in man power, communication and broadcasting systems, as well as emergency care equipment. Although seventy-percent schools kept injuries and sickness records., less than twenty percent of them have really made good use of them. These schools set up emergency training programs with different designings. They had no enough training hours and the needed attendance frequency. Chances of taking part in these programs were not available to all, and financial supports were inadequate. Consequently, one can hardly expect any good results from them. About eighty percent schools appointed their school nurses as the main agent for taking care of these unintentional injuries and sickness. As these nurses had no enough training hours for handling these, much needs to be done to them yet. And schools paid little attention to students’ insurance for their attendance hours. When school nurses ask for leave, only twenty percent of them have appointed proxies to take care of their duties for them. Fever and abdomen pains occurred the most among all the emergent sickness in campus, while laceration and fractures were the main causes of injuries. Most sicknesses and injuries were taken care of by teachers and school nurses. Only one tenth of the schools could be evaluated as good in their emergency care plans, and forty percent of them treated these emergencies acceptably. Schools with better planning and measures for emergency cares performed the better at the occurrence of emergencies. Among them, emergency care committee, written emergency care procedures, the establishment of supporting and connecting network, first aid training, and duty proxy system were all very consequential to the efficient management of the emergencies at the first time. However, these five measures were also highly influenced by the location of the school, the title of the job’s main performers, and the time span lagging for receiving the latest first-aid training. Therefore, it is suggested that the authorities give more stress on the setting up of the campus emergency care systems, compile the concerning laws and regulations, execute down-to-earth plans and procedures that should have set up beforehand, and give more critical evaluations and appraisals for each schools’ concerning performance. It is also recommended to improve the quality and quantity of first-aid training, especially school nurses’ cognitive and competence training for emergencies. Moreover, setting up long-term surveillance indicators, coordinating the medical care resources nearby, and developing emergency care system fit for the characteristics of each school would all be very helpful.

關鍵字

國民小學 ； 校園緊急傷病 ； 緊急照護 ； 校園緊急傷病處理 ； 校園緊急照護系統 ； 事前規劃 ； 事發後處置

並列摘要

The purpose of this study was to find out the current practice of the
management of the school injuries and sickness in the campus of primary
schools around the Taiwan area as well as its relevant influences and
factors.　In order to do this, a structural questionnaire was created as a
tool for the study.　Targets for the study were the public and private primary
schools of the 2000th academic year around the Taiwan area.　Three hundred and
sixty copies were issued in total; 309 effective ones were retrieved, with a
successful retrieving rate of 86.6%.
The main findings of the study are the following：
The implementing of the measures for emergency preparedness in the campus
around Taiwan lacked coordination and consistency. Most schools had trouble of
contacting the parents at the critical moment of an emergency when a student
is injured or sick.　Only thirty percent of the schools had set up school
emergency care committee and written emergency care procedures.　The health
centers of the schools were insufficient in man power, communication and
broadcasting systems, as well as emergency care equipment.　Although seventy-
percent schools kept injuries and sickness records., less than twenty percent
of them have really made good use of them.
These schools set up emergency training programs with different designings.　
They had no enough training hours and the needed attendance frequency.　
Chances of taking part in these programs were not available to all, and
financial supports were inadequate.　Consequently, one can hardly expect any
good results from them.
About eighty percent schools appointed their school nurses as the main agent
for taking care of these unintentional injuries and sickness.　As these nurses
had no enough training hours for handling these, much needs to be done to them
yet.　And schools paid little attention to students’ insurance for their
attendance hours.　When school nurses ask for leave, only twenty percent of
them have appointed proxies to take care of their duties for them.
Fever and abdomen pains occurred the most among all the emergent sickness in
campus, while laceration and fractures were the main causes of injuries.　Most
sicknesses and injuries were taken care of by teachers and school nurses.　
Only one tenth of the schools could be evaluated as good in their emergency
care plans, and forty percent of them treated these emergencies acceptably.　
Schools with better planning and measures for emergency cares performed the
better at the occurrence of emergencies.　Among them, emergency care
committee, written emergency care procedures, the establishment of supporting
and connecting network, first aid training, and duty proxy system were all
very consequential to the efficient management of the emergencies at the first
time.　However, these five measures were also highly influenced by the
location of the school, the title of the job’s main performers, and the time
span lagging for receiving the latest first-aid training.
Therefore, it is suggested that the authorities give more stress on the
setting up of the campus emergency care systems, compile the concerning laws
and regulations, execute down-to-earth plans and procedures that should have
set up beforehand, and give more critical evaluations and appraisals for each
schools’ concerning performance.　It is also recommended to improve the
quality and quantity of first-aid training, especially school nurses’
cognitive and competence training for emergencies.　Moreover, setting up long-
term surveillance indicators, coordinating the medical care resources nearby,
and developing emergency care system fit for the characteristics of each
school would all be very helpful.

參考文獻

王國川（1997）。台灣地區青少年非致命性事故傷害之描述性流行病學研究。中等教育

方禎鋒（1992）外傷病患之初期急救、評估及轉送。當代醫學19（8），665-669。

行政院衛生署（1996）。公共衛生概況。

行政院衛生署（1997）。衛生白皮書。

行政院衛生署（1998）。醫療管理法規。