從醫護人員的觀點探究影響病人安全文化狀態之重要影響因子──以中部某區域級教學醫院為例

The Investigation on the Critical Factors Affecting Patient Safety Culture from the Perceptions of Hospital Staff in A Regional Teaching Hospital in Central Taiwan

目的： 透過調查醫護人員對於病人安全文化之態度， 醫療機構管理者可據此進而改善病人安全管理之各 項做為，進而提升醫病關係及醫療品質。 方法： 本研究採用Sexton等學者於2006年發展之病人 安全態度量表（Safety Attitudes Questionnaire）探究 病人安全文化，並以2015年某中部區域教學醫院之 醫護人員為對象。問卷共發出450份，有效問卷為 376份，有效回收率為83.55％。另外，本研究利用皮 爾森相關分析探究病人安全文化各構面間之關聯程 度，以及迴歸分析檢核病人安全文化各構面對整體 醫護人員病安滿意度之影響程度。 結果： 若醫護人員之間的團隊合作越高，則帶動其對 於安全風氣的重視。本研究亦強調壓力認知與工作狀 況之間存在顯著的負相關，說明當醫護人員壓力越高 時，則工作狀況越差。另外，在衡量病人安全文化的 六個構面中，工作狀況的表現是最差的，顯示多數的 醫護人員認為其目前身處的工作環境不甚理想。 結論： 醫師與護理人員是服務病人的第一線核心人 員，若能加強其對病人安全文化的態度，不但能預 防各項醫療錯誤的發生，也可提升更具品質的醫療 服務。本研究建議醫療機構管理者可從強化團隊合 作、持續監控壓力與改善工作狀況三方面著手。

Purposes: This study aims to provide implementations for hospital management that may be used to enhance physician-patient relationships and medical quality, by investigating the perceptions regarding patient safety of hospital staff. Methods: Sexton et al.'s (2006) safety attitudes questionnaire (SAQ) was used to assess the patient safety culture of hospital stuff in a regional teaching hospital in central Taiwan. A total of 450 questionnaires were issued, and 376 valid questionnaires were collected; the effective response rate was 83.55%. Additionally, a Pearson correlation analysis was conducted to identify the relationships among the six patient safety dimensions. Regressions analysis was then conducted to demonstrate the impacts of each of the six patient safety dimensions on overall patient safety satisfaction. Results: The results of this study demonstrate the relationship in which increased teamwork among hospital staff is associated with increased safety climate. Stress recognition and working conditions were negatively related. Moreover, inappropriate working conditions were identified by most of the hospital staff. Conclusions: Hospital staff includes core personnel who are dedicated to servicing patients in healthcare organizations. It is critical to understand the attitudes of hospital staff towards patient safety, in order to prevent medical mistakes and improve medical quality. Three implementations are suggested based on the current study: enhancing teamwork, monitoring stress, and improving work conditions.