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題名 | 衛生所電腦化後健兒門診工作模式之建立及執行問題探討=A Pilot Study on Computerized Model of Well-Child Clinic at Health Station |
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作者 | 柯麗貞; 林金玉; | 書刊名 | 公共衛生 |
卷期 | 24:2 1997.07[民86.07] |
頁次 | 頁63-75 |
分類號 | 419.21 |
關鍵詞 | 衛生所; 健兒門診; 電腦化工作模式; Health station; Well-child clinic; Computerized model; |
語文 | 中文(Chinese) |
中文摘要 | 本研究旨在建立衛生所電腦化後健兒門診工作模式,及探討執行後的影響。選取 群醫型及都市型衛生所各一所,實地操作規劃之模式,另選取同類型衛生所各一所為對照組 。以小組討論、實地操作及觀察、同儕及專家審查等方法,修正模式及解決遭遇的問題,並 以結構式觀察表收集資料比較模式介入前後的差異。 執行模式前,群醫型實驗與對照衛生所即有醫師提供所有預防接種個案身體檢查服務,都市 型實驗與對照衛生所均無醫師提供身體檢查服務,四所衛生所每半天預防接種個案接受保健 指導的比率依序為 11.5 %、5.6%、2% 及 1%。 執行模式後,兩所實驗衛生所依據模式之標 準配合該所作業環境,修改服務流程,加強醫師提供身體檢查及護士提供保健指導服務。群 醫型實驗衛生所每半天保健指導比率明顯增加到 54.4 %, 其對照衛生所相同期間內為 11.3%; 都市型實驗衛生所平均每半天接受醫師檢查及護士指導比率達 43%,其對照衛生所 雖配合健保開辦兒童預防保健服務,加強醫師身體檢查服務,但未加強保健指導,平均每半 天接受醫師身體檢查及保健指導的比率各為 15.8% 及 1.5%。另兩所實驗衛生所護士能定期 列印健診異常個案名單及追蹤,管理者利用電腦監測追蹤情形,同儕及專家審查認為能提升 健兒門診服務品質。 建議有關單位將模式評價指標納入現有的評價系統,及訓練衛生所人員,以利模式推展。 |
英文摘要 | The purpose of this study is to establish a feasible model of computing workflow of computing workflow of well-child clinic at health stations. We selected one rural and one urban health stations as the experimental group and another two health stations(i.e., one rural and one urban) as control group by purposive sampling. The development of the model is based on group discussion, field testing, observation, and peer reviewing. The data were collected according to structured list before and after the implementation of the model. The differences between pretest and posttest were analysed. Before implementing the model, there was a doctor providing physical examination at both rural stations but not at the two urban stations. On half day basis the percentages of children receiving health counseling at the rural experimental, rural control, urban experimental and urban control station were 11.5%, 5.6%, 2% and 1%, respectively. After implementing, the standardized protocol of the model, the two experimental stations could modify the procedure of well-child clinic to reinforce physical examination and health counseling, and the percentage of children receiving health counseling increased to 54.4% at the rural experimental station, 11.3% at the rural control station at the same period. As for the urban group, the percentage of children receiving both physical examination and health counseling increased to 43% at the experimental station, but for the control urban station, the percentage of physical examination was 15.8% and health counseling was only 1.5% at the same period. In addition, the nurses at the experimental stations could regularly print out the rosters of abnormal cases and follow-up these cases. The supervisors could use computers to trace the results of the follow-ups. The peer group considered that implementation of the model could improve the quality of well-child clinic at health stations. Therefore, we recommend the health related organizations to implement the model to their health stations, evaluate health stations based on the standard of the model, and train the personnel of health stations. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。