醫療照護疏失原因之探討

The Study of Healthcare Malpractice

本研究旨在依護理人員所知，了解過去醫療照護疏失的原因和類型，以作為未來醫療照護疏失預防決策之參考。本研究採用橫斷式結構問卷調查法，以參加「以病人為中心之安全照護」護理論壇的成員為對象。資料以個數、百分比與卡方檢定進行統計。本研究共發出問卷1119份，有效回收491份，回收率為43.88％。研究結果顯示，造成醫療照護疏失原因的前五項為：1.手寫醫囑潦草(59.7％)；2.專業能力不足(55.4％)；3.口頭醫囑傳遞不清楚(42.2％)；4.指派或任用無經驗者(39.3％)；5.溝通不良(38.9％)。醫療照護疏失原因與醫院層級有十項呈現統計上的顯著差異(p<.05)。本研究結果不但有助於了解過去醫療照護疏失所發生的原因，更可在提醒下降低或預防未來醫療照護疏失的發生及協助進行預防措施的選擇。

The aim of this study was to explore the causes and types of healthcare malpractice. In this crosssectional study, data were collected by a structured questionnaire administered among subjects participating in Patient Safety Forum. Data were analyzed using frequency, percentage and Chi-square test. Among 1119 nurses, 491 returned the questionnaire, representing a 43.88% response rate. The results indicated that the top five leading causes of healthcare malpractice were: (1) unreadable preprinted orders (59.7%); (2) a lack of competence of nurses (55.4%); (3) unclear oral orders (42.2%); (4) assignment of inexperienced staff (39.3%); and (5) poor communication (38.9%). Association was found between causes of healthcare malpractice and hospital levels. The findings provided information on the causes of healthcare malpractice and facilitated the reduction of the incidence by developing preventive strategies in the future.