建構醫療機構病人安全監測指標之前驅實證研究

Establishing of Patient Safety Monitoring Indicators for Healthcare Institutions in Taiwan: a Pilot Study

楊哲銘(Che-Ming Yang) ； 邱文達(Wen-Ta Chiu) ； 林靖瑛(Jessica Lin) ； 許英娟(Ying-Chuan Hsu)

《台灣公共衛生雜誌》 28卷1期 (2009/02) Pp. 78-84

https://doi.org/10.6288/TJPH2009-28-01-08

摘要

目標：病人安全乃全球關注之焦點，目前台灣尚無一套客觀適用的病人安全監測工具，本研究擬建構一套適用、客觀及可量化的病人安全指標系統。方法：彙整國內外病人安全相關指標，進行專家會議，再以德菲法進行病人安全指標適用性與資料取得難易度調查，最後透過臨床前驅測試，建議一套台灣病人安全監測指標系統。結果：產生47項病人安全指標，依衛生署95-96年病人安全年度目標進行指標系統的分類，分為7大類2級，分別是用藥安全（5項）、醫療機構感染控制（9項）、手術正確性（1項）、病人辨識（2項）、預防病人跌倒（1項）、異常事件通報（3項）、醫療照護監測（5項）。第一級可選指標10項、第二級基礎指標37項。結論：本研究經由建立各項病人安全指標定義之共識，初步發展出適用於台灣的病人安全指標系統，研究產生之指標仍需在臨床使用後持續增修，以作為醫療機構促進病人安全的工具。

關鍵字

病人安全 ； 指標 ； 醫療品質

並列摘要

Objectives: A campaign to improve patient safety is being conducted globally. Taiwan does not have an objective patient safety monitoring indicator system. This research was designed to develop a patient safety monitoring system appropriate for implementation in Taiwan. Methods: The development processes included literature review and expert focus group meetings incorporating the Delphi method, and pilot testing to evaluate the validity and reliability of the potential indicators. Results: The 47 indicators selected were classified according to the 2006-2007 patient safety goals of the Department of Health (Taiwan). The indicators, which consisted of 7 categories separated into 2 levels, included medication safety (5 items), infection control (9), surgical site accuracy (1), patient identification (2), fall prevention (1), incident reporting (3) and healthcare monitoring (5). Of the 47, 10 indicators are at the optional level and 37 are at the basic level. Conclusions: We developed a patient safety indicator monitoring system through a consensus-building process for use in healthcare institutions in Taiwan. We believe that the system needs constant evaluation during clinical application. We hope that this system can be used in healthcare institutions in Taiwan as a tool to promote patient safety.

並列關鍵字

patient safety ； indicator ； healthcare quality

參考文獻

Patient safety

Quality and patient safety

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Linstone HA,Turoff M.(2004).The Delphi Method: Techniques and Applications.MA:Addison-Wesley.

critical access hospital and hospital national patient safety goals