獨立性護理業務之護病糾紛爭訟

Nurse and Patient Dispute Litigation in Independent Nursing Practice

背景：護理人員與病患爭訟案件與日俱增，然而目前研究護理人員因護病糾紛進入法院爭訟之相關文獻較少。目的：本研究目的為探討護病糾紛中獨立性護理業務爭訟之背景屬性、獨立性護理業務爭訟類別、以及法院裁判案由與判決結果。方法：採質性研究，由司法院法學資料檢索系統選取臺灣地方法院2008－2017年獨立性護理業務爭訟之刑事判決書，以內容分析法進行分析。結果：共有41間醫療院所，55位護理人員涉案。醫院屬性以區域醫院（36.6％）、內科醫療（31.7％）、一般內外科病房（46.3％），及小夜班（40.0％）居多；護理職稱則以護理師（85.5％）最多。獨立性護理業務爭訟可分為觀察評估、環境安全、通報醫師、及護理記錄等四類別。法院裁判案由以業務過失致死（58.2％）最多，共有10名（18.2％）護理人員面臨有罪判決的結果。結論／實務應用：本研究結果可協助臨床護理人員了解獨立性護理業務導致爭訟內容及判決結果，期望能預防護病爭訟發生。

Background: Although medical dispute and other contentious cases involving patients and nurses have risen significantly in recent years, few studies have examined the litigation issues involved in nurse-patient disputes. Purpose: This study was designed to explore the background, categories, and degrees of harm to patients and the judgments made by the courts. Methods: Qualitative research was used. Cases of criminal, written judgments related to nurse practice negligence and recorded in district courts in Taiwan from 2008 to 2017 were selected. Data were analyzed using content analysis. Results: A total of 41 hospitals and 55 nurses were identified. The largest number of cases involved regional hospitals (36.6%), internal medicine departments (31.7%), general wards (46.3%), night shifts (40.0%), and staff nurses (85.5%). Four categories of independent nurse practice negligence were identified, including observation-evaluation, environmental security, physician notification, and nursing records. Negligent homicide (58.2%) was the most common court judgment and ten nurses (18.2%) were found guilty of the charges brought against them. Conclusion/ Implications for Practice: The results of this study highlight for nurses the content of nurse practice negligence and the related judgments by the courts, which hopefully may guide nurses to avoid practice negligence in the future.