醫院護理人員執行病人交班安全之探討

Exploration on Patient Safety during Shift Change of Hospital Nurses

黃翠簾(huang ts'ui lien)

指導教授 ： 楊漢湶

亞洲大學/健康學院/健康管理研究所/碩士(2007年)

摘要

本研究目的在探討醫院護理人員對病人交班安全之執行現況。本研究採橫斷式
調查研究法，參考國內外文獻資料，擬定『醫院護理人員執行病人交接班現況調查
表』，總計寄發132 份調查表至各醫院護理部，回收63 份問卷，有效問卷率達47.7%，
並訪談15 位各醫院層級之資深護理人員。加以整理、統計、分析。結果發現：各不
同屬性的醫院，其對病人交班安全的規範是一樣的，各醫院護理交班規範項目與交
班單內容是相同的；層級較高醫院較注重病人交班安全、病人安全相關議題受到重
視有關，護理方向以病人為中心。
建議衛生主管機關，將病人交班安全相關指標列入稽核督導項目；建議醫療院
所管理者應安排適當護理人員在職教育、運用資訊輔助護理交班之安全性（如以條
碼做病人辨識、行動護理站）、改變排班方式（配合護理照護之連續性，提供充裕的
交班時間）、定期修正規範，並監測交班作業流程執行情形；建議基層護理人員自我
充實（定期接受相關在職教育）、提早到班、簡化護理紀錄方式；建議後續研究者可
針對護理紀錄方式之簡化、排班方式之改善及現行護理人員在職教育之需求評估上
做深入探討。

關鍵字

病人交班安全 (patient shift report safety) 交班標準流程(規範)（standard of procedure） 交班指引(交班單)（Kardex）

並列摘要

The purpose of this study was to explore the current situation of patient safety between
shifts. A cross-sectional research method was adopted. Referring to related domestic and
foreign literature, a questionnaire “Current Situation of Patient Safety during Shift Change of
Hospital Nurses” was developed. The questionnaires were mailed to the nursing departments of
132 hospitals. The 63 questionnaires were returned, giving a response rate 47.7%.The
face-to-face in-depth interview was given to 15 senior nurses from different levels. The
returned questionnaires and the data were sorted and statistics to analyze all the data collected.
The findings of this study revealed: The hospital with different traits had the same rules in
patient safety between shifts. For all the surveyed hospitals, the items listed in the standard
procedure for shift change were the same as the ones listed in the instructions for Kardex. The
higher levels of hospitals pay more attention on patient safety between shifts. It also means
nursing becomes more patient-centered.
For the health authority, it’s suggested that it should formulate rules for nursing
personnel’s on-the-job training and list the indicators concerning patient safety between shifts
into auditing and supervising items. For medical institutions, it’s suggested that they should
provide patient safety related on-the-job training for nurses, use computer-aided information to
improve patient safety between shifts (e.g. using bar code as patient identification, ambulatory
nursing station etc.), alter shift change methods (e.g. taking into consideration the continuance
of nursing care, providing sufficient time for shift change etc.), modify the rules for shift
change on a regular basis, and monitor the actual implementation of shift change procedure.
For entry-level nursing personnel, it’s suggested that they should enrich their professional skills
(e.g. taking part in related on-the-job training on a regular basis), be at work earlier, simplify
the recording method for nursing care, and improve the method for shift change. For the
researchers interested in the related issues, they can focus their research on the simplification
of nursing care record, the improvement of shift change methods and the evaluation on the
current needs of nursing personnel’s on-the-job training.

並列關鍵字

patient safety at shift change, standard procedure for shift change, Kardex

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