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  • 學位論文

急診醫療人員衝突頻率及程度與病人安全文化之探討

The Investigation of the Relations between the frequency and the level of the Conflict and patient safety of medicnl professionals at Emengency Room

指導教授 : 劉芹芳
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摘要


背景:急診是醫院另一道大門,主要處置緊急病人的突發病況及意外事故之緊急救護且不限制看診人數。在執行醫療服務時可能因病人、家屬或醫療科等部門因訊息誤解或訊息交換不明確、專業領域差異、目標不一致等因素造成衝突。急診相關研究缺乏文獻探討急診衝突與病人安全文化之相關研究,希望將結果回饋給醫院,利用品管手法以找出真因,以提升病人安全及醫療品質。 目的: 探討急診醫療團隊(包含醫師、護理師、藥師、社工師、行政人員)自覺衝突頻率及程度與病人安全文化之相關性。 方法: 本研究採描述、相關性研究設計,收案期間2013年3月至2013年4月,採用立意取樣方式,針對南區某醫醫學中心急診醫療團隊為研究對象,以自填問卷進行約20分鐘收集資料。衝突程度量表自行修訂,安全態度量表問卷(Safety Attitude Questionnaire, SAQ)應用Dr. Bryan Sexton授權醫策會翻譯為中文的問卷以描述性統計分析、獨立樣本t檢定、單因子變異分析、皮爾森績差相關分析、逐步複迴歸分析資料。 結果: 257 位急診醫療人員填答(回收率為100%),衝突頻率及程度屬中度頻率;病人文化安全態度屬中立意見與有些同意之間。衝突頻率和程度兩個構面與團隊合作、安全風氣、工作滿意度、管理感受、工作狀況、溝通等皆為負相關。 結論:應用衝突程度量表與安全態度量表問卷,調查急診醫療人員衝突頻率程度與病人安全之相關性,可於運用品質管理方法及病人安全教育,以提升急診病人安全之品質。

關鍵字

急診 衝突 病人安全

並列摘要


Background:Emergency room, as another door into the hospital, deals with those urgent cases of acute illness and accidents without the limitation of patients number. During the medical services, conflict may happen because misunderstanding, errors of message exchange, differences in professional fields or target inconsistencies between the patients, family members or medical staffs. There are only few research studies about safety and conflict of patient in emergency department. I hope to use the methods of quality control to identify true reason and feedback the result to the hospital in order to enhance patient safety and quality of care. Objective:To investigate the frequency and extent of perceived conflict in the emergency medical team (including physicians, nurses, pharmacists, social workers, administrative staff)with the correlation between patient safety culture. Methods:This was a descriptive, correlational design, enrolled during March 2013 to April 2013, using purposive sampling for the Southern Area with Hospital Medical Center emergency medical team for the study, to be self-administered questionnaire about 20 minutes to collect data. Scale to revise the level of conflict, Safety Attitude Scale Questionnaire (Safety Attitude Questionnaire, SAQ) Application Dr. Bryan Sexton III authorized health questionnaire translated into Chinese by descriptive statistical analysis, independent samples t-test, ANOVA, Pearson correlation analysis, stepwise multiple regression analysis. Results:Questionnaire was delivered to 257 emergency medical personnel and response rate was 100%. The frequency and extent of the conflict is a moderate frequency; attitude to patient safety culture is neutral to somewhat agree. Conflict frequency and extent had negative correlation to teamwork, safety climate, job satisfaction, management experience, working conditions, communication. Conclusion:Using of the degree of conflict and security Attitude Scale questionnaire to investigate the relation between the frequency of conflict of emergency medical personnel and patient safety, can apply in quality management and patient safety education, enhance the quality of patient safety emergency.

並列關鍵字

emergency conflict Patient Safety

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