台灣醫院加護病房最適規劃設計準則之研究

A Study on Establishing the Optimal Planning and Design Criteria for the Intensive Care Unit of the Hospital in Taiwan

加護病房空間之新建或整修，攸關醫療照護品質，並涉及跨領域之專業，惟目前國內缺乏其規劃設計準則。本研究為增進台灣加護病房之規劃效率與實用效能，應用具專家獨立判斷決策品質之修正德菲法問卷統計，據以提出規劃設計準則建議。研究依據國內外文獻，提出31項重要性與14項選擇性題項規劃設計要素；選取國內教學醫院決策高層、加護病房醫師團隊及護理主管等共20位資深臨床主管參與研究。 研究結果顯示專家整體意見收斂比率為95.56%；Kruskal-Wallis檢定結果，有43項題項三組專家意見一致。共識標準進一步採以「高度共識」定義(Q.D.≦0.60)、「很重要」定義(Q1≧4，Q3＝5)，以及Murry 與Hommons(1995)之「共識標準」觀點(P≧0.75)，歸納整併其設計準則25項重點，分別依加強感染管制、提升照護效率與適切之環境設計三項主軸，提出台灣本土加護病房最適規劃設計之建議

 

ICU space design is related to the quality of medical care and the integration of multidisciplinary. However, the relative studies are insufficient and the design guidelines are deficient currently in Taiwan. This study use the Modified Delphi Method based on domestic and foreign literatures develops the questionnaire proposing 31 important score items and 14 selective items of planning and design elements for ICU. It selects 20 experts including hospital decision-makers, ICU attending physicians and their teams, and ICU ward nursing heads to participate in the Delphi research. Further, it uses statistic function to analysis whether the experts opinions converge. The results show that the overall consent convergence rate of experts was 95.56% and 43 iteams reach the agreement in three groups by the Kruskal-Wallis test. The consensus criteria are further defined by the definition of “high consensus” (Q.D.≦0.60) by Mead (1992), “very important” (Q1≧4, Q3=5) by Huang Youjie, Luo Shaolin (2001) , and the “consensus standard” view (P≧0.75) by Murry and Hommons (1995). This study summarizes the 25 key points as its design guidelines of ICU in Taiwan hospital. According to the three main axes, these 25 guidelines are divided to strengthening infection control, improving care efficiency and appropriate environmental design.