提升急診護理人員對暴力事件處置能力之專案

A Project to Improve the Implementing Competencies of Violence Management in the Emergency Department

近年來急診暴力事件時有所聞，嚴重威脅醫護人員的人身安全，這些暴力事件若未能即時且適當的處置，將阻礙醫療業務的執行，甚至可能導致人員離職，病人的照護品質也會因而受到影響。於某醫院針對急診護理人員進行「急診暴力事件處置能力查檢」後發現，暴力事件處置的執行率僅41.1%，分析其原因包括：護理人員對暴力事件處置方式無統一作業標準、無舉辦防治暴力教育訓練導致對暴力事件認知程度偏低、無定期稽核人員的暴力處置能力以及缺乏防範暴力相關教材。因此本專案旨在提升護理人員對暴力事件的處置能力，以預防暴力事件的發生。專案小組透過跨團隊合作，制訂急診暴力事件處置作業標準、舉辦防治暴力教育訓練、製作防範暴力教育光碟以及建立合宜的溝通應對語句演練、實施暴力處置能力稽核、提供通報獎勵金等改善措施，專案執行後再次查核暴力事件處置執行率由41.1%提升至86.4%、認知正確率由45.8%提升至82.8%，確實有效提升急診護理人員對暴力事件之處置能力，期望日後亦能降低急診暴力的發生，維護安全的工作與就醫環境。

Workplace violence in the emergency department may result in physical and psychological or emotional harm for the employees, including reducing quality of care, causing an unsafe work environment, and leading to high worker turnover. Based on a survey by nurses, the implementation rate of violence management was merely 41.1%. The specific causes were identified as follows: no standards operating procedures for workplace violence management, lack of violence education programs and prevention training materials, and no standards for monitoring violence management. Therefore, this project aimed to improve the implementing competencies of workplace violence management in the emergency department by means of developing violence management standard operating procedures, establishing violence management checklists, holding in-service trainings, developing teaching materials for violence prevention and management, providing bonuses to motivate employees, and practicing effective communication skills. As a result, the implementation rate of violence management has improved from 41.1% to 86.4%. Our project was demonstrated to enhance effectively nurses’ competencies in violence management. In the future, we also expect to reduce the incidence of violence and ensure a safe healthcare environment for patients and health personnel in the emergency department.