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  • 學位論文

地區醫院員工對病人安全相關議題認知之研究

Employee’s Recognition on Patient safety in Local Hospital

指導教授 : 白佳原

摘要


近年來,病人安全之議題受到世界各國之重視,我國在政府與醫療體系的一連串變革行動中,中區醫療網病人安全專家每年會偕同衛生局人員至中部各縣市醫療院所進行病人安全推展之訪查工作。許國敏以2006年為例共計訪查中部地區115家醫院。由實地訪查之資料可知,醫學中心、區域醫院級之醫院,病人安全八大目標落實率皆在90%以上,然而地區醫院除了「提升手術正確性」與「提升病患辨識之正確性」之落實率尚屬良好外,其他目標之落實皆有待加強。 有鑑於此,本研究乃針對地區型醫院之員工進行病人安全相關議題之問卷調查,旨在了解地區醫院員工對主管機關推動病人安全相關政策與八大目標之認知情形,並調查地區醫院員工對於影響地區醫院推動病人安全成效的因素及改善病人安全策略之認知,以進一步探討地區醫院之員工認知情形與衛生主管機關實地訪查結果之異同,期研究結果提供衛生主管機關及地區醫院主事者作為推動病人安全策略之參考依據,以營造國內優質醫療環境。   本研究工具採結構式問卷,問卷乃依據財團法人醫院評鑑暨醫療 品質策進會「95年醫院執行病人安全現況調查問卷」之內容並參考 95年度病人安全工作目標及Durbin et al.(2006) 探討醫護人員對於病 人安全認知研究之相關內容形成。以彰化縣7家地區醫院之各專業別 員工作為研究對象,進行問卷調查,調查樣本共455份,有效問卷 209份,有效問卷比率為45.9%。本研究經資料蒐集建檔後,以描述 性分析及推理性分析呈現,分析方法以SPSS for windows 13.0版套裝 軟體進行「信度分析」、「變異數分析」及事後比較採Tukey posteriori comopasrison 進一步檢定之。 其結果得知受訪之地區醫院員工個人屬性無論是對我國主管機關推動病人安全相關政策、病人安全八大目標作業、對影響地區醫院推動病人安全成效的因素及針對地區醫院改善病人安全策略等方面,大都皆有一致性之認知;惟部分之差異,乃在於填表人之職稱、位階(是否為主管)、是否為病人安全推動小組成員、工作年資有較顯著差異,其中以護理人員之認知較高於其他人員,位階則以組長級人員之認知評價較高於非主管級人員,若身為病人安全推動小組成員則也有較高之認知評價。在病人安全八大目標中之排序以「改善交接病人之溝通與安全」、「提升民眾參與病人安全」、「鼓勵異常事件通報」為末三名,與2006年之實地訪查結果是一致的。   就其研究結果,本研究建議衛生主管機關在推動病人安全相關政策時,能強化地區醫院之輔導與教育,以彌補地區醫院政策較不易推行之窘境。另地區醫院對病人安全之推動與認知,大都集中於少數人之身上,如具主管級身分者、護理人員、病人安全推動小組成員等,故應強化對其他人員之宣導與教育訓練,以提昇地區員工對病人安全認知及執行成效。

並列摘要


In recent years, patient safety is a very important issue to healthcare system in many countries. The experts came from central area medical service network and the government health bureau formed a committee. The mission of the committee is to improve the safety and quality of care provided to the public in healthcare organizations through the assessment of compliance in safety goals in healthcare organizations every year. Xu GuoMin surveyed 115 hospitals in the middle part of Taiwan in 2006. The result showed the compliance expectation in the eight safety goals is 90% or better in the medical centers and regional hospitals, but the implementation expectation of the safety goals in local hospitals is only about 40~60%, except 「improve the surgical accuracy」and 「patient identification」. In order to understand the correlation between employee’s cognizance and implementation expectation, a question-survey was carried out in this research. The questions of the survey were designed based on the topics of patient safety goals. The answers wrote by the staff of seven local hospitals in the middle part of Taiwan were analyzed by statistic program to determine whether the degree of their understanding of the policy is relative to the degree of compliance expectation or not. There were 455 survey participants. The effective survey was only 209. Thus the recovery is 45.9% for this question-survey. After the data collection, valid samples were processed and analyzed by descriptive statistics, ANOVA by SPSS for windows 13.0. The result showed that all participants were aware of patient safety policy, the eight safety goals, the factors that influence the implementation, and the strategy of implementing the requirements across the organization. The leaders of organizations, department managers, the committee of “patient safety implementation”, and nurses had better understanding of the “eight safety goals”. The survey participants who were senior healthcare workers also had better understanding. Among “eight safety goals”, 「To encourage the public involve the improvement of patient safety」, 「To report abnormality about safety」, and 「To improve communication between work shifts about patient safety」were less aware. This result was consistent with the implementation expectation accredited by the Hospital Accreditation Committee in 2006. According to the results of this survey, my suggestions are as following: in order to improve the patient safety practice, the authorities of the local hospitals have to strength education course for all the staffs, especial for junior staff. Hope all the staff can compliant with all patient safety goals across all healthcare organizations in Taiwan and create a high-quality healthcare system.

參考文獻


財團法人醫院評鑑暨醫療品質策進會:病人安全資訊網網址:http://www.patientsafety.tw/big5/default.asp。線上檢索時間:2007年2月13日。
財團法人醫院評鑑暨醫療品質策進會(2006),「95年醫院執行病人安全現況調查問卷」。
財團法人醫院評鑑暨醫療品質策進會網址:http://www.ticha.org.tw ,線上檢索時間: 2007年2月8日。
財團法人醫院評鑑暨醫療品質策進會,2006年度醫院執行病人安全工作目標之建議參考手冊。
廖慧娟(2007),醫院評鑑制度之革新-新制醫院評鑑制度,醫療品質雜誌,第1卷第1 期,26-29。

被引用紀錄


何清幼(2010)。醫療工作人員的病人安全認知、態度與行為間關係之探討-以臺北某醫院為例〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU.2010.00446
楊雲湘(2010)。護理人員醫療異常事件通報意向之探討-以台南不同層級醫院為例〔碩士論文,長榮大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0015-0202201013124300
孫沛君(2011)。影響民眾參與病人安全工作的因素〔碩士論文,臺北醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0007-2607201121170000

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