病患安全與醫療疏失－－淺談重症加護病房注意事項

The Patient Safety and the Medical Malpractice-- Precautions of the Intensive Care Units

隨著知識教育的普及化，顧客的消費意識、人權觀念也相繼的提高，醫療提供者在面對病患的就醫需求時，已不再只是單純扮演著『看病包藥』的被動角色，而是更進一步的在整體的醫療作業過程中，主動提供病患安全性、可近性、適切性、參與性、完整性及持續性的醫療照護服務。近年來病患安全的議題受到世界各國的重視，特別是探討醫療疏失的幾個大型的流行病學研究，揭露了在目前的醫療環境中存在了相當程度的疏失或危險。回溯民國九十二年三月北臺灣所爆發的嚴重急性上呼吸道症候群(SARS)疫情，著實讓全國人民陷入一片恐慌，更使得病患、家屬及醫護人員人心惶惶，誰都害怕自己成為下一個不注重病患安全環境的犧牲者。從這個事件可以看出病患就像嬰兒一樣，沒有安全的家庭環境，是很容易受傷的。在此人人自危的情況下，我們更應該提升人員素質、減少錯誤、全心投入、制定工作規範及改善工作環境，來加強病患及自身安全。尤其內外科加護病房為一重症單位，主要是給予施行重大手術及病情危急，變化快速而須24小時生命跡象監測的病患，全天候積極之治療的特殊病房，相較於一般普通病房，於此單位服務之醫療相關人員更應具備完善專業知識與優良醫護技能，以提供病患優質健康照護，確保病患安全。

As the knowledge and education are becoming more popular, customers' consumer consciousness and human right concept are thereby enhanced gradually. Facing with the medical demands from the patients, the medication suppliers are no longer act simply as the passive roles of 'symptom diagnosis and medicine prescription', They must furthermore provide the patients with safe, accessible, appropriate, participative, integral and continuous medical caring service in the whole medical processing procedures. Recently, the issue of patient safety has been respected all over the world. Especially, there are several large-scale epidemic researches that investigate the medical malpractices have disclosed the careless or dangers existed in the current medical environments. As we recall the spreading of Severe Acute Respiratory Syndromes (SARS) at the north part area of Taiwan in March of 2003, there was surely a panic for the people in this country. Patients, their families and medical staff members were in a great uneasiness. Everyone is afraid to be the next victim for the environment that didn't watch the safety of the patients. We can see from this incident that patients are as fragile as infants. Without safe household environment, they are very easy to get hurt. In the situation that anybody can be suffered, we should work harder to promote the personnel quality, to eliminate errors, to devote with all resources, to set up the work protocols and to improve the working environment so as to reinforce the safety of the patients and ourselves. Especially, the intensive care units of the internal medicine and the surgery are for the severe patients. They are special wards for the day and night caring that are mainly used for those patient in need of large scale operations and those patient in urgent situations that might change rapidly and need to be watched twenty four hours a day for their vital signs. As compared with the general wards, the relevant medical personnel working in these units need to own more complete professional knowledge and superior medical caring technologies so as to provide the patients with high quality health care and to secure the safety of the patients.