e化護理工作站臨床使用之探討-以某區域教學醫院為例

Exploring Clinical Use of e-Nursing Work Stations: A Case Study of a Regional Teaching Hospital

蔡麗娟(Tsai Li-Chuan)

指導教授 ： 張怡秋

國立中正大學/管理學院/資訊管理學系/碩士(2013年)

摘要

隨著資訊科技演進的日新月異，其資訊系統在各醫療機構被廣為導入使用，無線區域網路在醫療機構的應用也日益成長，帶動行動醫療之發展，同時對傳統的護理作業模式造成前所未有的衝擊與影響，在這競爭激烈醫療產業中，應用e化護理工作站於臨床護理人員的照護上，其中護理整合系統之應用可解決及簡化傳統護理站固定式資訊化系統之作業方式，可增強護理照護業務之效率及正確性、使資訊能即時傳遞、並促進與其他醫事人員之溝通、以達到病患之照護需求、提昇護理照護服務品質，亦可滿足醫院與社會觀感之期望。然而目前國內對行動護理資訊系統的研究，大多著重在技術平台的開發、或是探討醫院導入行動護理資訊系統的因素與使用者的滿意度，而忽略了護理人員持續使用e化護理工作站層面的考量，導致無法讓醫院上級樂見其成其所投資和花費大筆資金引進技術或設備之成效、系統發展是否如預期。
因此，本研究著重於整體系統發展導入後在護理人員持續使用的層面，也應考量相關的組織層面中有關此e化護理工作站導入後的影響；以雲林縣第一家導入e化護理工作站資訊系統之醫院為研究標的，使用深度訪談、實地觀摩和相關資料問卷調查收集方式，從問卷主要由三大部分構成，分別為個人基本資料、行動護理資訊系統使用頻率及e化護理工作站之建置效益與影響部分。以內容分析之方法進行分析與探討。藉此了解，以降低醫院發展行動護理資訊系統失敗之風險，並提供未來或正在發展之醫院有一參考依據。
護理人員實際使用e化護理工作站後，其研究顯示：在護理人員基本屬性與實用性、確認性、滿意度與持續使用之相關性皆未呈現顯著相關(P>0.05)。使用e化護理工作站的看法及感受，護理人員對使用e化護理工作站的實用性、確認性、滿意度、持續使用e化護理工作站的看法及感受皆為正向及認同。相反的，對於使用e化護理工作站後，實際上護理人員也表達出一些特別看法，其中「使用e化護理工作站的整體經驗，覺得很挫折」與「使用e化護理工作站的整體經驗，覺得相當麻煩」高於平均數、「未來我會持續使用e化護理工作站，勝過使用傳統桌上型電腦」低於平均數，代表使用e化護理工作站確實會影響護理工作，導致使用者產生以上負向感覺。
建議此「e化護理工作站」運用於臨床上其實是不應只限於護理人員使用，其他團隊包括醫師、專科護理師、出院準備護理師、營養師、社工師、物理治療師等醫療團隊人員皆可使用，不用只侷限於護理人員使用，後續可以將其推展至更多醫療團隊人員共同使用，讓此「e化護理工作站」更能全方位輔助醫療團隊的應用於臨床上，以利提高與醫療團隊成員的訊息交換，其可提供病人照護的即時性、完整性、連續性以提高其照護品質。

關鍵字

滿意度 ； e化護理工作站 ； 持續使用

並列摘要

With the rapid evolution of information technology (IT), the information systems (IS) in medical institutions have been widely used. Applications of wireless LAN in the medical institutions are also growing. It promotes the development of mobile medication, while the traditional care practices brought about unprecedented challenges and impact. In this highly competitive medical industry, we apply e-nursing station on the clinical nursing care. In e-nursing station, Nursing Integrated system can solve and simplify traditional nursing station fixed practices of information technology systems, enhance nursing care efficiency and accuracy, make information passed immediately, promote cooperation with other medical personnel to communicate in order to achieve Patient care needs, improve nursing care services quality, and to meet the expectations of hospitals and social perception. However, current domestic research of mobile nursing information systems, tend to focus on the development of technology platforms, or explore the factors of mobile nursing information system implementation and user satisfaction. It neglects the e-nursing station continued usage considerations, because they cannot get satisfied with effectiveness which hospital superiors spend a lot of capital investment and import of technology or equipment.
Therefore, this study focuses on the development of the whole dimension after the implementation of nurses continued usage, and it should also be considered relevant effects after implementation of e-nursing workstation in organizational level. We take first e-nursing workstation hospital in Yunlin County as our research subject. We use depth interviews, field observation and related data questionnaire as our research methods. Questionnaire mainly consists of three parts, namely, demographic data, frequency mobile nursing information systems usage and development effectiveness and impact of e-nursing workstation, then, we use content analysis and discussion. Reduce mobile nursing information systems failure risk and provide reference to hospitals for future development.
After the actual usage of e-nursing workstation, the research result shows: correlation of basic properties and practicality in nurses, confirmation, satisfaction and continued usage all show no significant correlation (P> 0.05). Views and feelings of e-nursing workstation practicality, confirmation, satisfaction, the continued usage of e-nursing workstations by nurses are positive and recognition. In contrast, nurses also expressed strong views for the usage of e-nursing workstation. "Overall experience of e-nursing workstation usage, I feel very frustrated" and "Overall experience of e-nursing workstation usage, I feel quite troublesome" above average. "In the future, I will continue to use the e-nursing workstations, better than using a traditional desktop PC" below average, which indicate e-nursing workstations does affect nursing care, resulting in more user-generated negative feeling.
Suggested "e-nursing workstation" can not only in the clinical use for nurses, but also for physicians, nurse specialists, discharge planning nurses, nutritionists, social workers, and physical therapists. Following can be extended to more medical team for common use, so this "e-nursing station" assists more comprehensive medical team clinically. To the to improve medical team members facilitate exchange of messages, which can provide real-time patient care, integrity, continuity in order to improve their quality of care.

並列關鍵字

Satisfaction ； e-Nursing Workstation ； Continuous usage

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