護理交班調適行為的研究

在現今的醫療體系中係屬於複雜且高危險的作業環境，其護理交班扮演著病患安全的重要關鍵一環，提供患者持續性與個別化的照護，然護理交班是如此頻繁與緊密的作業；每日當中最少要交班三次，過程中不太可能每次都以一樣的方式進行交班，其中可能會有些微的調適使交班順利進行。故本研究以人因工程的角度進行研究與探討；本研究將透過兩場的焦點團體討論進而收集內科加護病房與內科病房之護理交班調適的相關資料，並藉由質性研究的內容分析法來分析本研究收集的資料，據研究結果顯示護理交班調適的行為是存在的、且經常性得被啟動，然產生調適的因素有：人與環境的變化以及人和人之間的默契、彼此工作上的經驗、個人的習慣與模式、患者發生的變化，其調適的現象不僅在作業上更有效率亦間接消除不安全的因素，調適的過程是可以被用來學習使作業更為安全的。

關鍵字

病患安全；焦點團體法；調適行為；護理交班

並列摘要

It is a complex and high-risk operating environment for nowadays health care system. Nursing handover plays an important role in patient safety, which provide continuous and individual care for patients. However, nursing handover are frequent and tight task. There are at least three shifts per day and all are unlikely to be performed in the same way every time. There may have slight adjustments to make the shift smoothly. Therefore, this study conducts research and exploration from the perspective of human factors engineering. This study will focus on two sets of focus group discussions to collect relevant data on the adjustment of nursing handover from internal medicine intensive care unit and medical ward. Then analyze the data by qualitative analysis of content analysis. According to the results, the behaviors of nursing handover adjustments are existent and often started. The factors that produce adjustments includes the changes in people and the environment, the understanding between people, work experience, personal habits and patterns and the changes on patients. The phenomenon of adjustment is not only more efficient in operations but also indirectly eliminates unsafe factors. The process of adaptation can be used to learn to make operations more secure.