新進護理人員交班完整性之研究

The Study of Shift Handover Integration among Newly Nurse

黃恔婷(Chiao-Ting Huang)

指導教授 ： 張鐵軍

朝陽科技大學/管理學院/企業管理系/碩士(2010年)

摘要

在醫療體系中，護理人員扮演守護民眾健康的關鍵角色，提供連續性、個別化之照護，而有效率的護理交班，得以讓接班者迅速掌握病人的病情，減少重覆評估病人問題，增加照顧病人的時間，因此有效的溝通即成為十分重要的課題。基此，故本研究目的主要在瞭解影響新進護理人員交班易遺漏或不完整的項目，建構出新進護理人員交班完整性之組成因素。
本研究首先針對30位醫院的資深護理人員，進行新進護理人交班易遺漏項目的深度訪談，來蒐集新進護理人交班易遺漏事項，再對30位新進護理人員對交班看法進行訪談與問卷調查，並採用重要事件技術法(Critical Incident Technique；CIT)及頻次統計分析作為資料分析之方法，所得結果如下：新進護理人員交班遺漏項目之影響因素有八大項，分別是病況追蹤或處理、專業知識不足、認知、經驗不足、缺乏交班訓練、交班規範不熟悉、人員態度有待改善、家屬、輔助人員、儀器問題、工作安排、工作分配問題。此外，新進護理人員交班中最感困擾的事項分別是醫學專用名詞看不懂、交班內容很多，無法連貫、交班缺乏統合能力、交班缺乏邏輯性、交班時容易受接班人的態度而影響自己交班的情緒。
建議護理管理者可透過以下策略提升交班品質，首要加強對於交班重要性的認知，進而增加警覺性，共同重視交班的議題；舉辦系統性交班訓練課程，課後給予測驗，並將交班課程納入年度在職教育；定期稽核、舉辦座談會以了解執行概況和需求；編訂臨床護理手冊隨時提供查閱、透過資訊系統建立知識管理平台，以輔助交班工作；將交班情形列入績效考核中，讓護理人員重視交班之完整性。

關鍵字

新進護理人員 ； 交班 ； 不完整

並列摘要

In medical healthcare system, the nurse plays a key role in protecting the public health by providing continuity and individualized care. So an efficient nursing shift handover is able to allow the successor to grasp hold of the patient’s conditions quickly, reduce repetitive evaluation on the patient, and increase the patient caring time. Therefore, an efficient communication has become an important issue. Based on this, the purpose of this study is to understand the impacts caused by easily omitted and incomplete handover matters to new nurses by constructing the complete composition factors for the new nurses in the shift handover event.
An in-depth interview was initially conducted on 30 senior hospital nurses by this study on easily omitted handover matters to new nurses in order to gather the easily omitted matters of the event, and an interview and questionnaire investigation were then conducted on 30 new nurses towards their opinions on shift handover. The Critical Incident Technique (CIT) and frequency statistical analysis were adopted as the data analysis method. The research findings are listed as follows: There are eight major influential factors on easily omitted handover matters to new nurses, namely condition tracking and handling; a lack of expertise, cognition and experience; a lack of shift handover training; unfamiliar with the shift handover norms; improvement needed on personnel attitude; problems with the families, support staff and equipment; work arrangement; and work allocation problems. In addition, the most disturbing handover matters to new nurses are unable to understand the medical-specific terms, unable to connect too many handover contents, a lack of integration ability on handover matters, a lack of handover logic, and personal emotion that can be easily affected by the successor attitude during the shift handover process.
This study suggests a need for the nursing managers to improve the shift handover quality through the following strategies. The first priority is to strengthen the cognition towards the importance of shift handover, thereby increasing the alertness and paying attention to shift handover issue altogether; organize a systematic shift handover training course, conduct a test after the lessons, and introduce the shift handover course into the annual in-service education program; conduct periodic audit, and organize seminars to understand the implementation status and demands; compile clinical healthcare manual as a reference for momentarily reading, and establish a knowledge management platform through the information system to assist in the handover work schedules; and finally to include the shift handover conditions into the performance examination to allow the nursing staff to pay attention to the integrity of shift handover.

並列關鍵字

New nurses ； shift handover ； Integration

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