- 學位論文
醫療指導醫師制度實施前後對台中市到院前救護品質影響之分析
The quality of pre-hospital care in Taichung-Difference between before and after of Medical Direction implementation
摘要
目的：本研究之目的在透過EMT（救護技術員）了解醫療指導醫師制度執行前後對於到院前救護品質之提昇是否有影響。研究採量性之橫斷性調查，運用開放式問卷對台中市390位EMT進行普查，研究資料建檔後以SPSS軟體進行統計分析。 方法：我國於99年7月1日起執行「醫療指導醫師實施辦法」，本研究利用問卷調查 以分析EMT人員對於此制度執行前後期的看法與救護技術能力之自我評估，並比較在執行後是否有提昇。填寫對象以台中市EMT為主，收案期間：前測為99年6月1日至6月30日，後測為100年1月1日至2月15日。 結果：於「自我評估」與「對此制度了解程度」皆以EMTP（高級救護技術員）分數較高，EMT1（初級救護技術員）之「救護技術能力」有明顯上升；綜合各級EMT之自我評估有微幅之成長，但對於此制度之贊成與了解度卻有明顯的下滑。 結論：本研究之結論是，經由醫療指導醫師工作之執行後，EMT對此制度反而未有更深的了解，故應更有效執行教育訓練，除有利於EMT對此制度的了解，也更能提升各項救護技術。雖然數據顯示EMT自我評估與教育訓練的參與中僅有微幅成長，但本研究並不認為醫療指導醫師工作的執行對提昇到院前救護品質沒有幫助；或許在足夠的經費以及更完善的法令支持下，能使EMT對醫療指導醫師制度產生足夠的認同感進而有效提昇到院前救護品質。
並列摘要
Purposes: The purpose of this study is to understand if there’s any difference on the quality of pre-hospital care between before and after of medical direction implementation. Methods: On July 1st, 2010, Taiwan has started to implement "Medical Direction"; therefore, in order to understand the effects of Medical Direction on EMT（Emergency Medical Technician）, this research adopted two stages survey and utilized the questionnaire as the research tool. The participants were the EMT who works in Taichung. The questionnaire distribution of time 1 was June 1st, 2010 and the time 2 was January 1st, 2011. Results: EMTP had higher scores on the "self assessment " and "understanding of this system”; "rescue technical capability” increased significantly on EMT1; each levels of EMT increased on their self assessment, however, the supporting and understanding of Medical Direction declined significantly. Conclusions: The study concluded that after implementing Medical Direction, EMT did not understand it further, therefore, the government should execute training more effective for EMT’s better understanding and rescue technique. Although the data showed that self-assessment and training of EMT had only grown slightly, but it could not be considered as helpless on the quality of pre-hospital care. Perhaps, once EMT has more confidence on Medical Direction, it will enhance the quality of pre-hospital care in the future.