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從非臨床照護工作人員觀點探討突發緊急醫療能力提升

Improving the Capacity of Emergency Resuscitation from the Perspectives of Non-Medical Staff

摘要


從醫學中心非臨床照護工作人員觀點來探討在現行醫療環境與體制下,其面對緊急醫療態度、認知與需求,進而提升緊急醫療能力。本研究以計畫行為理論為基礎,針對作業項目與病人實際接觸之一線科部或工作鄰近地區發生緊急狀況比率較高之醫務行政部門人員進行問卷調查。以SPSS 18版為資料分析工具,分別探討「不同部門」與「不同任職年資」人員於「面對緊急醫療態度」、「主觀處置規範」、「知覺行為控制」及「緊急應變處置意向」等四個構念是否其有顯著差異;以路徑圖呈現前述三個構念對「緊急應變處置意向」影響程度。問卷共發放151份,回收139份,有效回收率92.1%。統計結果「門診庶務部門」於「知覺行為控制」構念優於其他部門(p<0.01);「不同任職年資」人員於各個構念均無顯著差異。路徑圖得到統計上支持,「面對緊急醫療態度」、「主觀處置規範」及「知覺行為控制」對「緊急應變處置意向」路徑係數分別為0.325*(p<0.05)、0.270*(p<0.05)與0.149。「面對緊急醫療態度」對於提升「緊急應變處置意向」及促成行動力最其影響性;「信心不足」及「病況辨識能力較弱」為執行處置過程中最大困境。對於提升突發緊急醫療能力的建議:(1)不定期辦理緊急醫療演習。(2)規劃全院共通性,或部門各別性緊急醫療事件案例討論會。(3)推動「突發急救時的病況辨識與分級處置」定期教育訓練課程。(4)加強鄰近醫技與行政部門合作及相互支援訓練。

關鍵字

突發急救 病人安全

並列摘要


This project aims to investigate the awareness and perception of non-medical staff in encountering with unexpected resuscitation, and improving their appropriate response to these events. Based on "Theory of Planned Behavior", this study was aimed on questionnaire for staff of medical administrative departments where higher incidence of emergency resuscitation has found. We analyze the responses of non-medical staff to the following factors: face emergency medical attitude, subject process norm, perceived behavior control, and emergency management intention. The relationships and differences between these issues were compared across each unit and seniority of the staff. One hundred and fifty-one questionnaires were delivered and 139 of the completed sheets were collected. Analysis of these 4 factors showed that outpatient administrator was more excellent than any other department in the "perceived behavior control"(p<0.01). There were no significant relationships among different seniority staff. Using structural equation models, the individual path coefficient of "face emergency medical attitude", "subject process norm" and "perceived behavior control" to "emergency management intention" were 0.325*(p<0.05), 0.270*(p<0.05) and 0.149. The influence of "face emergency medical attitude" to "emergency management intention" is powerful. The most difficult position is less confidence and weaker medical judgment. Following proper training courses, staff could develop higher confidence in the critical assessment and management of resuscitation events. Our ongoing project integrates the resources of the medical and non-medical departments to promote the efficacy of primary in-hospital resuscitation, reduce inappropriate callings, and enhance the competence in the assessment of resuscitation scenes.

參考文獻


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