長期照護機構住民安全指標項目之探討-以機構實務工作者為對象

The Indexes of Safety and Dimensions in Long Term Care Institution-From the Perspective of the Practitioner －From the Perspective of the Practitioner The Indexes of Safety and Dimensions in Long Term Care Institution －From the Perspective of the Practitioner The Indexes of Safety and Dimensions in Long Term Care Institution

凌家如(Chia-Ju Ling)

指導教授 ： 龍紀萱

亞洲大學/健康學院/長期照護研究所/碩士(2008年)

摘要

摘要
研究目的 為建構一套完整且可測量的住民安全指標與項目，以作為長期照護機構評量住民安全與品質提昇之依據。

方法 研究對象為長期照護機構實務工作者。研究方法包括德菲法及焦點團體，來發展住民安全測量指標以及分析項目之測量方式、適切性與困難度。

研究結果 住民安全構面包含：褥瘡、人員、營養、跌倒、感染、約束與溝通等構面。各構面適用之測量指標與項目資料取得難易度分別為：「褥瘡構面」首重住民褥瘡評估與機構全部住民得到褥瘡比率、「人員構面」首重機構人力狀況與護理人員與住民比率、「營養構面」首重營養監測與個別住民定期體重變化紀錄、「跌倒構面」首重住民跌倒情形與機構全部住民跌倒率、「感染構面」首重住民感染評估與機構全部住民感染率、「約束構面」首重住民約束評估與住民約束原因分析、「溝通構面」首重工作人員間相互溝通與工作人員間交班紀錄。

結論與建議 根據研究結果，研究對象均對發展住民安全指標持正向態度，亦認為建立測量項目相當重要，並建議與品質指標應有所區別。進一步分析發現，愈容易實際測量及收集的指標，則機構認為較適切。因此，建議政府應重視運用住民安全指標，並請機構開始實際執行測量工作，以便日後成為實際可行的測量指標，有效落實住民安全的議題。

關鍵字：住民安全、安全指標、安全項目、長期照護機構

關鍵字

住民安全 ； 安全指標 ； 長期照護機構 ； 安全項目

並列摘要

Abstract
Purpose To construct a wholesome and measurable safety indexes and dimensions for the residents as a basis for long term care Institution to evaluate the quality and safety of the residents.

Method The researched objects are the Practitioner of the long term care Institution. The study methods, Delphi method and Focus group method, are used to develop the safety index for the residents and to analyze the method, suitability and difficulty of the index.

Result The order of the important aspects for the safety of the residents: pressure ulcer, staff, nutrition, falling, infection, restriction and communication. The measure suitability of indexes and difficulty of dimension for the above aspects are as follows : The pressure ulcer aspect focuses on the pressure ulcer assessment of the residents and ratio of the residents who catch pressure ulcer. The staff aspect focuses on the organization manpower condition and ratio of nursing staff and resident. The nutrition aspect focuses on the nutrition monitoring and record of changing weight for each resident. The falling aspect focuses on the falling situation of the residents and ratio of falling among the residents. The infection aspect focuses on the infection assessment of the residents and ratio of infection occurred among the residents. The restriction aspect focuses on the restraint assessment of the residents and analyzing the reasons of restriction of the residents. The communication aspect focuses on the between the staff mutually links up and between the staff passes on to the next shift the record.

Conclusion and Suggestion According to the research result, all the researched objects possess a positive attitude toward the development of the safety index of the residents; in addition, they also agree on the significance on this research project for establishing an index for the resident’ s safety. They also suggested that this index for resident’s safety should be distinct from the index of service quality. As the result of further analysis, the institution believes that an index which is easier to collect and measure would be the most applicable. Therefore, the government should value and manipulate the index for the resident’ s safety. Also, the institution should start the measuring work for making the index practical and effective to the theme of the resident’ s safety.

Key word：Safety for the residents, Safety index, Safety dimension,
Long term care institution

並列關鍵字

Safety for the residents ； Safety index ； Safety dimension ； Long term care institution

參考文獻

林谷俊、鄭文凱(2007)。護理人力資本量化投入與離職率之關聯醒研究。第八屆管理學域學術討論會論文集，台北。

徐新政(2002)。壓瘡。中醫骨傷科醫學雜誌，(1)，37-39。

謝昌成、蔡坤維、劉鎮嘉(2007)。老年人的跌倒問題。基層醫學，22(10)，352-357。

廖婉君、蔡明岳(2006)。老人虐待。基層醫學，21(7)，183-186。

葉莉莉、溫敏杰、杜淑玲、林寁、戴臆珊(1999)。台南市不同生理年齡層安療養機構住民之生理照護需求與功能狀態探討。中華公共衛生雜誌，18(5)，319-326。