住院病患及醫護人員對病人安全目標及達成作法重視度認知差異探討

本研究旨在探討醫病雙方對病人安全目標及其達成作法重要性的認知差異、可能的傳播管道及成效，提供醫護人員及醫院管理者參考。本研究於2007年11月16日至同年12月30日，由6位受過訪員訓練之訪視人員，以結構式問卷對中部某區域教學醫院住院病患及醫護人員進行調查，爲一橫斷性研究。問卷分爲醫護人員版及住院病患版兩種，各有58題及56題。問卷整體Cronbach's α值爲0.9767，量表各題項CVI值介於087-092之間。住院病患及醫護人員各發出500份問卷，有效回收率分別達92.24%及89.14%。雙方對「提升手術正確性」、「預防病人跌倒」、「提升用藥安全」及「提升民眾參與病人安全」的重視度無顯著差異。住院病患重視度較高的作法有17項，醫護人員較高的有14項；有24項作法醫護人員之重視度顯著高於住院病患；住院病患對病人安全議題宣導的評價顯著較低。54.53%的住院病患看過或聽過病人安全相關訊息，但僅17.24%的住院病患自醫護人員獲得病人安全相關訊息；約50%的住院病患認爲病人安全相關訊息對後來接受醫療服務的過程中有幫助且認爲病人安全相關訊息重要；然仍約三分之一的住院病患對瞭解病人安全訊息持普通程度(34.48%)。多數的醫護人員自其工作場所獲得病人安全相關訊息；將近四分之三的醫護人員認爲病人安全訊息有助於就醫(73.98%)且重要(88.91%)；但仍有27.38%的醫護人員對瞭解病人安全訊息持普通程度。雙方多認爲醫療院所應負起病人安全訊息宣導責任(87.28% vs 90.50%)。住院病患與醫護人員對病人安全目標及達成作法的重視度存有差異，醫院應積極分由政策宣導及實務作法提出對策，填補此一「顧客缺口」。

關鍵字

病人安全；住院病患；醫護人員；認知

並列摘要

This study aimed to identify how inpatients and healthcare personnel in a central Taiwan regional hospital setting rank the importance of patient safety goals and related implementation practices. A fifty-six item questionnaire and a fifty-eight item questionnaire were developed and used to survey inpatients and healthcare personnel in a government-owned central Taiwan regional hospital from Novemeber 16, 2007 to December 30, 2007. Cronbach α for the questionnaire was 0.9767, and CVI values were between 0.87-0.92. Descriptive statistics and independent t-test were conducted to analyze the difference in perceived importance of safety goals and related implementation practices. The 500 questionnaires were distributed to inpatients and healthcare personnel. The response rates for the inpatietnts and the healthcare personnel were 92.24% and 89.14%, respectively. The analysis results showed that both the inpatients and healthcare personnel differed in perceived importance of ”improve the safety of surgery,” ”reduce the risk of patient falls,” ”improve the safety of using medications,” ”encourage the active involvement of residents and their families.” Inpatients gave a higher likelihood score than healthcare personnel for seventeen items; healthcare personnel gave a higher likelihood score than inpatients for fourteen items. For twenty-four implementation practices, perceived importance was significantly higher in healthcare personnel than in inpatients. Inpatient satisfaction was significantly lower in patient safety health care education aids. Although 54.53% of inpatients had seen or heard patient safety-related health care educational aids, only 17.24% of them had received information from healthcare personnel. Approximately 50% of inpatients recognized that patient safety-related information is helpful for health-seeking and important, however, 34.48% of inpatients showed neutral interest in patient safety information, and 87.28% of inpatients recognized that the hospital held patient safety related-health care educational aids accountable. Most of the healthcare personnel received the information from their workplaces. Nearly three quarters of inpatients recognized that patient safetyrelated information was helpful for health-seeking and important, however, 27.38% of healthcare personnel showed neutral interest in patient safety information. Certain differences in patient safety goals and the related implementation practices between the inpatients and healthcare personnel were found in this study. The analysis results provide valuable baseline data and identify the key areas needing improvement. The goals of healthcare providers should be to determine the action required to fill the customer gap.