某醫學中心加護病房護理人員對臨床資訊系統滿意度之探討

The Exploration of Satisfaction about Clinical Information System Application in the Intensive Care Unit of a Medical Center

隨著電腦、通訊與網路科技的日新月異，醫療資訊也不斷在臨床上增加科技產品的應用，近年來政府的醫療政策更促使醫院加快資訊化腳步，醫療機構引入大量資訊科技後，讓整體的醫療資訊系統應用範圍大大的擴充， 其中強調整合的臨床資訊系統（Clinical Informatics System； CIS），以優質的醫療照護品質為終極目標，也因此被應用於瞬息萬變的加護病房中，在此高成本的投入之後，加護病房護理人員使用臨床資訊系統之滿意度應是最被關注的重點， 本研究為描述性橫斷式研究，針對使用臨床資訊系統 6個護理站的 168 位護理人員，運用結構式問卷及開放式問答題，以網路問卷方式，來探討護理人員使用臨床資訊系統之滿意程度。有效問卷為 118 份，有效回收率為 70%。研究發現在 CIS 整體滿意度上， 60%以上滿意者佔 57.6%， 40-60%滿意者佔 27.1 %， 40%以下滿意者佔 15.3%。最滿意的子系統為評分系統，其次是表單系統。在系統項目內容中受試者對輸出輸入量查詢計算、登入密碼管控、電腦列印畫面清楚、印出之紀錄表單美觀整齊、 範本內容較為滿意。較不滿意之項目為傷口照片匯入病歷方式、基本資料不夠完整、表單新增項目、反黃顯示、螢幕轉換速度、資料修改方式。未來建議主管應針對不滿意之項目進行改善，依使用者提出之問題給予正向回饋，即時告知修正進度之相關訊息，並持續追蹤 CIS 使用成效。

Objective: It is a trend to use the computer science and products in the field of patients’ care. The application of Clinical Informatics System(CIS) in the intensive care unit(ICU) to get a higher quality care is one of our hopes. This descriptive cross-sectional study is going to explore the satisfaction of nurses to the application of CIS in ICU. Materials and Methods: The constructed and open-end questionnaire was put on our website. The nurses working in the ICU were invited to fill out the questionnaire. There were 168 nurses totally from 6 units. Results: The recovery rate of questionnaire was 70%(118/168). The degrees of satisfaction of the application of CIS were divided into three levels, i.e. >60%, 40-60%, and <40%. The results were 57.6%, 27.1% and 15.3% respectively. The scoring system was the most favorite sub-system in this survey, and the second was CareVue chart system. For the specific items, the ranks of popularity were as following: auto-calculation of patient’s intake/output, ID/password, clarity of computer screen, neat working of print, and plurality of formats of Focus charting system. The disappointing parts of CIS were transferring method of photography into the chart, incompleteness of basic data of patient, the method for adding a new table, whiteout labeling, the velocity of screen change, and the method of modifying data. Conclusion: The efforts should be given to the disappointing parts as mentioned above in the next version. The users should always be informed if there were any progress regarding the modification. Checking and action were the key elements to make CIS effective day by day.