醫療異常事件對護理人員身心影響及其因應行為之相關探討

A study of Incident Event on Nurses' Physical and Psychological Response and Coping Behaviors

目的：探討醫療異常事件對護理人員身心影響及其因應行為。方法：採結構式問卷，於中部某醫學中心，工作滿三個月之基層護理人員為研究對象，以醫療異常事件調查表、護理人員因應行為量表、身心影響頻率與嚴重度量表做調查，有效問卷460份。結果：護理人員在發生醫療異常事件中，以服務年資3～5年內科病房護理人員居多；通報最多的是病人跌倒；97.3％護理人員贊成無罰通報。異常事件對身心影響中以疲倦及睡眠障礙最常見；因應行為則以「主動向病人及家屬解釋致歉」最常被使用；參與者最希望醫院管理者主動處理後續醫療糾紛。結論：當醫療異常事件發時，醫院管理者對發生事件之護理人員，應提供支持性關心，並不以懲罰性檢討，針對異常事件宜進行系統性思考改善問題，必要時將防範教育納入新進人員訓練計畫中，以預防護理人員醫療異常事件的再發生。

Purpose: The purpose of this research is to study incident event on nurses´ physicaland psychological response and coping behaviors. Methods: Structured questionnaires were used in this study. Primary nursing staffs who worked for more than three months at a medical center in thecentral part of Taiwan were recruited as research subjects. Structured questionnaires, including medical incident event questionnaire, nursing staff'scoping behavior scale, physical and mental impact frequency and the severity scale,were used in this study. A total of 460 questionnaires were collected. Results: In the occurrence of incident events for nursing staff, nursing staff in theward for 3 to 5 years of service were the most common group; patient falls is themost common reason; 97.3% of the nursing staff in favor of notification withoutpenalty. Tiredness and sleep disorders are most common effects in terms of physicaland mental effects ''Active explaining and apologizing to patients and their families'' is the most often used coping behavior; Nursing staff hope hospital administratorsactively handle those medical disputes. Conclusion: When incident events occur, the hospital administrator should providesupportive care to the nursing staff in the incident, but not punitive review It isnecessary to systematically thinking about the improvement of the incident events,and, if necessary, incorporate preventive education into the employee orientation forpreventing the recurrence of incident events of nursing staff.