從病人安全談優質健康照護環境

High-Quality Nursing Health Care Environment: The Patient Safety Perspective

病人安全被視為是護理品質的指標，護理人員對於擔負維護病人安全的責任責無旁貸。當今全世界許多國家皆面臨健康照護人員短缺的問題，而照護人力不足與病人安全確實存在著密切的相關性。許多健康照護專業組織共同推動的正向工作環境，其目的是希望透過建構優良的醫療保健工作環境來達成提升健康服務品質的目標。營造優質健康照護環境以保障病人安全，需要護理人員、就醫者及政策制訂者全體共同關注與參與。本文以Donabedian（1988）所建構「結構—過程—結果的分類結構」品質分析理論模式，論述以病人安全為基礎的優質健康照護環境應涵蓋的各層面指標項目，除了藉此喚起大眾重視優質健康照護環境對就醫者本身安全的影響，也希望藉由落實各層面的指標項目營造優質健康照護環境，以做為確保病人安全之參考。未來可進一步針對各層面指標項目收集資料進行實證性研究分析，將有助於優質健康照護環境之建構及護理專業未來之發展。

Patient safety is regarded as an important indicator of nursing care quality, and nurses hold frontline responsibility to maintain patient safety. Many countries now face healthcare provider shortfalls, and recognize a close correlation between adequate manpower and patient safety. Many healthcare organizations work to foster positive work environments in order to improve health service quality. The active participation and “buy in” of nurses, patients and policymakers are critical to maximize healthcare environment quality and improve patient safety. This article adopts Donabedian’s theoretical “Structure-Process-Outcome” model of quality (Donabedian, 1988) and presumes all high-quality healthcare environment indicators to be linked to patient safety. In addition to raising public awareness regarding the influence of healthcare environment quality on patient safety, this research suggests certain indicators for tracking and assessing healthcare environment quality. Future research may design an empirical study based on these indicators to help further enhance healthcare environment quality and the professional development of nurses.