一般護理之家照護標準作業流程項目需求探討

Importance–performance analysis for the evaluation of care standard operating procedures in Taiwan nursing homes

目標：本研究旨在探討臺灣一般護理之家對照護標準作業流程的重要性及需要性，作為政府協助擬訂照護標準作業流程項目的優先順序參考。方法：本研究為一橫斷性研究，以結構式問卷調查一般護家管理者對照護標準作業流程項目的重要性及需要性認知。統計分析先以成對樣本t檢定檢視受調查者對照護標準作業流程項目的重要性及需要性認知間是否存在顯著差異，再以「重要-表現分析法」探討重要性高需要性高的項目。結果：53個照護項目中有34個項目之重要性顯著高於需要性；31項照護項目落在第一象限（重要性高需要性高），應列為優先考量訂定照護標準作業流程的項目。結論：一般護家照護標準作業流程可強化護理人員及照顧服務員提供完整、正確的照護，達到照護有效性以及降低變異性。本研究發現一般護家重要性高且需要性高的照護標準作業流程項目，且發現需求項目因規模而有不同，主管機關可依研究結果，考量規模因素，制定公版流程供一般護家參考，提升住民照護品質。（台灣衛誌 2020；39(1)：90-101）

Objectives: The aim of this study is to identify and prioritize standard operating procedures (SOPs) for nursing home care based on the perceptions of their importance and desirability reported by nursing home administrators. Methods: This was a cross-sectional study. Structured questionnaires were used to measure the perceptions of importance and desirability toward SOPs for care among nursing homes administrators. A paired t-test was used to test the differences between the administrators’ perceptions of the importance and desirability of these SOPs. Importance–performance analysis (IPA) was adopted to explore the “concentrate here” items for further improvement. Results: For 34 SOPs, the perceived importance was significantly higher than the perceived performance. In quadrant I items (i.e., concentrate here), administrators perceived SOPs as highly important, and perceptions of desirability were above average, indicating that these SOPs required the greatest attention. Conclusions: Nursing home SOPs not only ensure that nurses and nursing assistants provide complete and accurate nursing home care but also improve the care effectiveness and reduce the care variability. This study revealed that the nursing home scale affects the SOP desirability. The results are useful for identifying areas for strategic focus to facilitate the development of SOPs for nursing home care. (Taiwan J Public Health. 2020;39(1):90-101)