護理人員給藥錯誤將危害病人的安全,未執行三讀五對、給藥過程被干擾是常見主要的錯誤給藥行為;高度自我效能可以改善個人表現,是故,若發展線上模擬情境教育於護理人員給藥,有助於引發其行為改變動機、提升給藥自我效能,正確辨認給藥錯誤行為,進而影響其實際給藥行為。 本研究目的為探討護理人員給藥自我效能與辨認給藥錯誤行為之相關性,與線上客觀結構式影像測試(objective structured video examination, OSVE)於提升護理人員給藥自我效能與辨認給藥錯誤行為之成效。採類實驗(quasi-experimental research design)前測、後測研究設計、線上調查,以回應者引介抽樣(respondent-driven sampling),納入條件為醫院臨床第一線照顧病人的護理人員,且已完成新進人員3個月職前訓練;排除條件為護理主管、個案管理師、專科護理師、門診護理師、診所護理師,最終樣本數112人納入本研究分析,以G -power 3.1.9.2以單變項分析以配對t檢定、事後檢定執行檢定力計算,給藥自我效能的effect size = .67、辨認給藥錯誤行為的effect size = .59,設定α = .05,兩個變項的power均達 .99。透過給藥OSVE網站收集資料,自擬研究工具包含「人口學與護理經歷問卷」、「給藥自我效能問卷(前、後測)」、「給藥OSVE(前、後測)」。以描述性統計呈現各變項的分布情形,以皮爾森績差相關係數、成對樣本t檢定、變異數分析進行推論性統計分析。 研究結果顯示(1)護理人員的給藥自我效能後測總分的平均分數(Mpretest = 38.88 ± 4.45 vs. Mposttest = 41.69 ± 4.58),與辨認給藥錯誤行為後測總分的平均分數(Mpretest = 10.71 ± 7.16 vs. Mposttest = 15.32 ± 4.94)均高於前測。(2)性別與給藥自我效能前測(t = 2.21, p = .030)、後測(t = 3.52, p = .001)呈現顯著差異;婚姻(t = 2.27, p = .025)、職級(F = 7.60, p < .001)、工作單位(F = 5.24, p = .007)、工作年資(r = .22, p = .021)與辨認給藥錯誤行為前測均呈現顯著相關。(3)給藥自我效能前、後測呈顯著正相關(r = .57, p < .001),辨認給藥錯誤行為前、後測呈顯著正相關(r = .20, p = .041);但給藥自我效能與辨認給藥錯誤行為的前測r = .03(p = .756)、後測相關係數r = - .03(p = .725),均無統計上的顯著相關。(4)成對樣本t檢定顯示給藥自我效能前測與後測呈現顯著差異(t = 7.11, p < .001),辨認給藥錯誤行為前測與後測達顯著差異(t = 5.90, p < .001)。 由研究結果可知,介入給藥OSVE教育後,辨認給藥錯誤行為的正確性可立即改善,並可提高自我效能程度,推論給藥OSVE能做為有效之教育方式。護理人員從OSVE學習到正確三讀五對以及處理干擾,自信心提升,但是辨認錯誤給藥行為測量仍非護理人員實際給藥行為,僅屬於個人給藥能力(competence),未來仍須進一步探討自我效能與給藥行為間之相關。
Nurses’ medication errors will affect the safety of patients, especially the five rights of and interruptions during medication administration. The aim of this project was to investigate the association between medication self-efficacy and identification of medication errors in nurses, and the effect of online objective structured video examination (OSVE) for promoting medication self-efficacy and identification of medication errors. A quasi-experimental, pretest-posttest design and internet survey was employed, and participants were recruited by using respondent-driven sampling (RDS). Results showed both medication self-efficacy and identification of medication errors’ posttest average scores were higher than pretest average scores. Gender was significantly correlated with medication self-efficacy. Marriage, nursing ladder, working unit had significant association with the pretest of identifying medication errors. By the paired samples t test, the pretest and posttest showed significant differences included medication self-efficacy and identification of medication errors. Findings from this study support that the medication OSVE education can improve identifying medication errors immediately and increase the medication self-efficacy. We inferred that OSVE can be an effective strategy of medication education.