提升門診護理人員暴力防範處置能力之專案

目的：醫療場域暴力常造成醫護人員身心靈嚴重創傷，第一線門診醫療暴力防範更顯重要。本專案在提升教育訓練，評估其降低暴力事件的有效性。方法：於某醫學中心門診護理人員施予暴力事件防範訓練，於訓練前後，以結構式問卷調查其各項暴力處理能力是否增進。排除產、病假共收案109位，經本專案介入教學策略，包括實例教育影片、案例討論及行動防暴闖關情境遊戲，增加學習動機及實務操作理解，提升門診護理人員暴力防範及暴力處理之認知與能力成效。結果：護理人員暴力防範處理能力由專案執行前的29.4%-33.0%提升到82.3%-83.5%。其中「能辨識暴力高風險情況」從29.4提升83.5%、「能於暴力行為發生時緊急處理」由29.4提升至83.5%。本專案介入後約10個月期間統計監測暴力事件數為0，後續將持續監測，本專案能提升暴力防範關切度及警覺性。結論：本專案對提升門診護理人員暴力防範能力，成效顯著，可列入常規防暴教育教材達到職場安全零暴力之終極目標。

關鍵字

暴力；門診暴力防範；暴力防範處置能力

並列摘要

Objectives: Violence in the medical field causes severe physical and mental trauma to medical staff in the outpatient workplace. Therefore, providing staff members with an effective educational program to improve their ability to manage violent occurrences in the medical field is critical. Methods: Outpatient nurses participating in an educational project on medical field violence management and prevention were interviewed by using a structured questionnaire to compare their ability to manage various violent incidents both before and after the training program. After employees on maternity and sick leave were excluded, a total of 109 outpatient nursing staff participated. Prior to training, the staff's ability to engage with various violent incidents was only 29.4%-33%. Through engaging teaching strategies, including viewing examples of violence prevention, watching videos, and playing innovative violence management mobile games, the participants' motivation to learn, understanding of practical operations, and awareness and ability to handle violent incidents improved. Results: Participants in violence prevention and management ability programs increased from 29.4%-33% before training to 82.3%-83.5% after training. The number of participants who were ＂able to identify high-risk situations of violence＂ increased from 29.4% to 83.5%, and those ＂able to deal with violent acts urgently＂ increased from 29.4% to 83.5%. After the execution of this project, to April 2020, zero violent incidents occurred among outpatients in the unit. Conclusions: This project demonstrates the effectiveness of improving outpatient nurses' ability to manage and prevent violence, and its use as a routine antiviolence guideline to improve safety and mitigate violent incidents in medical workplaces is recommended.

並列關鍵字

violence ； outpatient violence prevention ； violence prevention ； treatment capacity

參考文獻

林霏儀、黃麗華（2016）‧某醫學中心護理人員職場暴力發生率及其相關因素探討‧秀傳醫學雜誌，15(3&4)，79-91。http://doi.org/10.3966/156104972016121503002

邊立中、鄭雅文、陳怡欣、陳秋蓉（2014）‧職場暴力盛行率與受雇者健康狀況之相關‧台灣公共衛生雜誌，33(1)，36-50。http://doi.org/10.6288/TJPH201433102088

陳麗琴、黃集仁（2016）‧台灣醫療職場暴力事件之省思與安全防範‧榮總護理雜誌，33(4)，419-424。http://doi.org/10.6142/VGHN.33.4.419

趙莉芬、黃湘萍、倪麗芬、蔡佳蘭、黃翠媛（2017）‧護理創新教學科技的建置與應用‧護理雜誌，64(6)，26-33。http://doi.org/10.6224/JN.000080

吳婷婷、呂宜臻、張磊（2017）‧行動科技導入於護理教育之現況探討‧護理雜誌，64(6)，19-25。http://doi.org/10.6224/JN.000079

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提升門診護理人員暴力防範處置能力之專案

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