手術室病患安全3P確認作業指標落實相關性分析之研究

Correlation Analysis with Implementation of the 3P Patient Verification Procedure at the Operating Room

本研究目的主要在研究手術室人員執行「病人（patient）、手術部位（operation site）及手術程序（procedure）」確認作業指標落實相關性分析。 方法：以北部某區域教學醫院手術室醫護人員作為研究對象，採用結構式問卷 及觀察法，以便立取樣方式進行調查。研究結果顯示：1.醫師人員在「手術室病患安 全3P確認作業指標」之「熟悉程度」與「遵循度」以及執行上的「難易度」與「規範 程度」呈正相關，達統計上顯著差異，顯示對3P確認作業指標熟悉度愈高，遵循的程 度也愈高；同時規範程度愈清楚，執行程度越容易。2.非醫師人員在年資與「熟悉程 度」呈正相關，顯示年資愈久，熟悉度愈高；在「可行性」與「熟悉程度」及「規範 度」兩項變數顯示愈熟悉、規範愈清楚，則愈可行；且「遵循度」與「熟悉程度」、 「規範程度」呈正相關，而執行「難易度」與內容「熟悉程度」「規範程度」亦呈正 相關。3.稽核制度設定影響醫療人員落實手術室病患安全3P確認作業指標執行成效達 統計上顯著差異。 結論：除了建立標準指標外，同時也應落實稽核制度，以促進安全的手術環境。

The aims of this study were to determine the Factors Associated with implementation of patient safety practice guidelines for verification of patients, operative sites, and surgical procedures at the operating room (OR). Methods: Members of the OR medical and nursing staff of a regional teaching hospital were enrolled in this study. Observation by researcher and a questionnaire were used in this study. Results: 1. In the medical staff, compliance with implementation of 3P verification was positively correlated to the staff’s proficiency in 3P practice. In addition, the more explicit the guideline, the easier the implementation of 3P verification. 2. In the nursing staff, level of seniority was positively correlated to proficiency in 3P practice; the explicitness of guideline was positively correlated to feasibility and proficiency in 3P practice; compliance, proficiency, and explicitness of guideline were positively correlated; the ease of practice, proficiency, and explicitness of guideline were also positively correlated. 3. An auditing system significantly influenced the efficacy of implementation of 3P practice. Conclusion: In addition to the establishment of standard indicators, but also the audit system should be implemented to further enhance the safety of surgical environment.