E化五級檢傷分類系統教育訓練對檢傷護理人員之影響

Effect of Education Programs of Electronic Five Levels Triage System on Triage Nurses

背景：國內預推行具有良好信效度之e化五級檢傷分類電腦系統，以增加檢傷分類的精確度。然而，新系統的推行會增加人員抗拒與負擔，故應在推行前期了解人員對新系統之認知與對e化系統期望，以降低推行時之阻力。目的：探討兩種e化五級檢傷分類教育訓練的課程內容設計，對於檢傷護理人員在使用五級檢傷分類系統進行情境判定之差異，以及人員對於e化五級檢傷分類系統之期望。方法：本研究採前瞻性前、後測研究設計。於以課堂授課與實機操作方式進行教育訓練課程之前後，以自擬結構式問卷進行資料收集。所得結果以描述性統計、獨立性t檢定、Paired sample t檢定、卡方檢定、逐步迴歸進行分析。結果：第一類課程組（八小時）收取39位檢傷護理人員，第二類課程組（四小時）收取161位。在接受四小時的教育訓練後，檢傷護理人員對五級檢傷級數判定的成績顯著高於接受八小時的訓練課程者(p< .005)；對e化五級檢傷分類系統之期望包含有：能使用觸碰式螢幕點選、轉換速度要快且有自動連結系統，且電腦操作經驗愈多之人員，對e化五級檢傷分類系統之期望愈高。結論：未來在正式推行五級檢傷分類系統時，四小時的教育訓練可增加人員對級數判定正確性，在硬軟體設計上，應考量符合人員之期望，減少作業流程，增加檢傷效率與提昇檢傷護理人員使用的意願。

In order to improve acuity of triage, electronic Taiwan Triage and Acuity Scale (eTTAS) which had well reliability and validity would be carried out recently. However, learning new system may increase resistance and burden for personnel. Hence, triage nurses’ knowledge and expectation of electronic five levels triage system should be understood before formal used. This study explored the effect on decision making of triage level and expectation of electronic five levels triage system after staffs received two different education training programs. This prospective pre and post test study was conducted in multiple medical centers in Taiwan. Before and after the training program, we asked the participants to complete the questionnaires. The statistic method included descriptive statistic, independent t-test, paired t -test, chi-square, and stepwise linear regression. We enrolled 39 subjects in group 1(eight hours) and 161 subjects in group 2 (four hours). The results showed that triage nurses’ accuracy of sorting triage level was higher after they received 4 hours training program. The expectations on this system included using touch-screen, fast respond time and automatic connective system. Staffs with more computer experiences had more electronic expectation on the system. Four hours electronic five levels triage training programs can improve accuracy of triage assignment. The planner should consider revising the hardware and software design of the system to fit the expectations before implementing in clinical and to improve willingness of triage nurses to use the device in the future.