頁籤選單縮合
題 名 | 醫院員工對病人安全之認知與態度調查=A Survey of Knowledge of and Attitudes about Patient Safety among Hospital Employees |
---|---|
作 者 | 吳麗蘭; | 書刊名 | 北市醫學雜誌 |
卷 期 | 5:1 2008.02[民97.02] |
頁 次 | 頁75-85 |
分類號 | 419.38 |
關鍵詞 | 醫療品質; 病人安全; 認知; 態度; 行為; Medical quality; Patient safety; Medical incidents; Reporting system; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:本研究著重於醫院不同職務別的員工對病人安全業務之認知、態度、行為之相關分析,作為醫院病人安全推動策略與執行方針的基礎。方法:採橫斷性研究,研究工具係參考行政院衛生署委託計畫2003年「公立醫院病人安全研究與滿意度調查」之問卷。該問卷經信度分析Cronbach's,α為0.81。問卷內容包含病人安全認知、病人安全態度、通報流程等三構面,採李克氏計分法。問卷有效回收520份,回收率為72.1%。結果:本研究之受訪者醫療部門佔128份(22.7%)、護理部門佔318份(61.2%)、醫技部門佔72份(13.8%)、行政人員佔12份(2.3%)。病人安全認知構面顯示受訪者普遍認知「病人安全是醫療照護中最基本的要求」(平均4.29分);病人安全態度構面顯示受訪者認同「自願性、非懲罰性的通報制度」、「主動通報可從預防錯誤的發生」等;通報流程構面顯示護理人員是主要參與職類。此外,平均而言,「主動通報醫療不良事件會招致醫療糾紛」一項的得分較低,且存在著醫師與非醫師(含護理、醫技及行政)間意見明顯不一致的狀況,值得後續研究深入探討;而從職務類別間顯著存在著對通報作業認知差異,且主治醫師、住院醫師及醫檢師等的認知及參與明顯少於護理及行政人員,值得實務推動者參考,但上述發現應用前應進一步深入分析。結論:本研究建議:一、病人安全認知部分:加強醫院員工對於醫療通報系統之認知教育並定期舉辦全院共通性病人安全教育訓練;二、病人安全態度部分:(1)建立資淺員工病人安全的觀念、(2)設置專責單位加重通報系統的宣導與執行面之落實、(3)營造不處罰、隱私、保密原則之安全文化,鼓勵醫師通報;三、通報行為部分:(1)建構線上學習系統,重視及加強非護理單位人員系統技術實務操作及執行、(2)建置內部公開討論平臺,成立品質管理中心專人定期檢討分析。本研究結果期望提供促進醫院同仁之病人安全意識與執行知能之參考,進而提升醫院醫療照護品質。 |
英文摘要 | Background Purpose: The purpose of the study was to investigate the cognition, attitude and reporting behavior of hospital employees towards patient safety across different categories of jobs such as medical treatment, nursing, medical technology and administration. It was hoped that the inquisitional results would be the basis and the guidance used when creating policies and plans for the implementation of clinical patient safety activities in the future. Methods: The study was conducted using a cross-sectional study design in a regional public hospital in Taipei and was carried out from October 1 to October 23, 2006. We interviewed the hospital employees using a questionnaire developed for this study. A total of 721 questionnaires were delivered, and 520 (72.1%) were returned. Most of the respondents were nurses and this was followed by medical treatment staff, medical technologists and administrators. Results: Results indicated that there were significant differences among the departments within the organization, and across the cognition, attitude and reporting behaviors of the employees. These results may be used to guide the actual implementation of patient safety activities in the future, and produced a number of suggestions, which are outlined below. Conclusions: Firstly, from the construct involving the concept of patient safety: (1) educational training should be held periodically to identify the definition of patient safety (2) the individual educational training o doctors should be enhanced; (3) training courses on service etiquette and taking complaints seriously should be held and (4) courses need to focus more on medical disputes and crisis intervention. Secondly, from the attitude to patient safety standpoint: (1) junior staff need help constructing a notion of patient safety; (2) a unit needs to be set up that is responsible for publicizing, executing and reporting patient safety and (3) doctors need to be encouraged to report medical safety incidents and be involved in the development of a non-punitive, private and confidential reporting system. Thirdly, from the reporting procedure standpoint: (1) the training in actual operational processes for doctors and technical staff needs to be improved; (2) an on-line learning system that emphasizes technical operational procedures and their implementation needs to be created and (3) a quality management center that examines and analyzes medical incident events periodically needs to be set up. Since the orientation of the study was focused on any practical training implications specifically, the following recommendations are made. First, it sis suggested that policy makers try to construct a culture of patient safety. Second, the hospital's patient safety system needs to be built up and explained to the staff. By implementing the above, we hope to reduce any unsafe systems, activities and behavior and this will place more effort in turn on reducing medical events that causes harm. By implementing an appropriate reporting system, the quality of care within the hospital will be significantly improved. |
本系統中英文摘要資訊取自各篇刊載內容。