臺北市醫學中心藥師對病人安全文化態度及其影響因素探討

A Study of Pharmacists’ Attitudes toward Patient Safety and Related Factors in Medical Centers in Taipei

增進病人安全是近年來一個相當重要的議題。過去研究指出病人安全文化始為改善病人安全的起始點，目前台灣已有針對全院員工及醫師所做的安全文化調查，但卻沒有針對藥師的相關研究，而藥師在「病人用藥安全」中扮演了相當重要的角色，故本研究即針對台北市醫學中心的藥師進行病人安全文化的調查。本研究的研究目的為：探討醫院的藥師對病人之安全態度，以及探討藥師是否會因為個人屬性及醫院屬性的不同而對安全文化有不同的態度。本研究使用SAQ—藥局版為研究的工具，於96年3至4月間針對台北市醫學中心的藥師進行調查，問卷回收率為32.87%（共有235位有效樣本）。本研究主要的研究結果為：（1）藥師在組織的安全承諾上有較正向的態度，在自覺壓力的態度上較為負向。（2）各家醫院的藥局在安全文化上的差異雖然較在作業單位不同的差距小，但扣除其它因素外，醫院間的不同卻仍為影響文化的重要因素。藥師的年齡愈大，在安全文化上的態度愈正向。擔任管理職的藥師較非管理職的藥師有較正向的安全文化。（3）雖然受訪者都知道如何通報醫療錯誤，也知道不會被懲罰，但願意使用通報系統的人仍為少數。且面對與醫療錯誤相關較敏感或負面的問題時，傾向較保守的回答。（4）藥師人力的工作負荷大，可能是造成病人安全的一大隱憂。

Background: The Institute of Medicine has recommended improving patient safety by addressing issues of organizational culture since 2000. Surveys of safety culture have been considered as the beginning of the improvement of patient safety. Safety culture of hospital employees and physicians were well investigated, but we still lack the investigations on safety culture of pharmacists. The objective of this study is to investigate pharmacists’ attitudes toward patient safety and its related factors in medical centers in Taipei. Methods: In this study, we use Safety Attitudes Questionnaire-Pharmacy version developed by Dr. Sexton to find out pharmacists’ safety culture and its effects, and to understand their attitudes toward patient safety among different hospitals. Results: Two hundred thirty five (32.8%) surveys were included in the analyses. Pharmacists who hold management position have more positive attitudes toward safety cultures. The older the pharmacists are, the more positive attitude they have toward safety culture. Pharmacists tend to response conservatively when they face the questions about medical error events or related adverse issues. Although pharmacists understand how to report medical error events without being punished, few pharmacists use the reporting system. In addition, heavy workload may lead to potential threats to patient safety.