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

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的醫務行政部門人員進行問卷調查。以SPSS18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」等四個構念是否具有顯著差異；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。

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.