探討COVID-19 疫情對病安通報之影響──以中部某醫學中心為例

Impact of the COVID-19 Pandemic on Patient Safety Reporting: A Case Study of A Medical Center in Central Taiwan

2020年1月起台灣出現首例COVID-19確診案例，民眾開始了防疫新生活，醫療院所亦改變了原有的醫療模式，發展出多元因應政策，故想探討疫情衝擊之下是否影響到病安通報案件之變化情形。
個案醫院以2019-2021年病安通報資料共3838筆進行統計分析，依職稱分為醫師(n =536)、護理人員(n =2496)、醫事人員(n =500)及行政人員(n =306)進行探討。資料分析以統計軟體SPSS 22.0版進行彙整與分析。
結果顯示，2019-2021年病安通報數量依序為1391例、1356例、1091例，醫師端部分，未受疫情影響到其通報意願；護理師通報數量則有減少跡象，通報案件以跌倒事件、管路事件居多，且多發生於白班時段，病人端部分以有陪伴者及事件發生當下有陪伴者居多；醫事人員部分亦有減少現象，通報事件以藥物事件、檢驗檢查事件居多，且多為跡近錯失案件；行政人員部分則無顯著影響，通報事件以檢驗檢查、其他事件居多，且大都為無傷害事件。
病安通報為醫院持續進步的動力，經由研究結果可知COVID-19疫情讓護理人員與醫事人員之通報有下降趨勢，推估可能受防疫相關政策調整影響到臨床業務執行，但若以病安文化大調查之結果觀察則於各職類無明顯之差異，顯示同仁對病安通報文化之認同與信心。

Since January 2020, when Taiwan reported its first confirmed case of COVID-19, members of the public have substantially adjusted their lifestyles to prioritize epidemic prevention. Simultaneously, medical institutions have restructured their traditional health-care models, implementing a diverse range of response policies. Therefore, this study examined whether the pandemic has influenced changes in the reporting of patient safety incidents.
A case study was conducted at a hospital, and a total of 3,838 patient safety incident reports from 2019 to 2021 were analyzed. The reports were categorized by job role: physicians (n = 536), nursing staff (n = 2,496), medical personnel (n = 500), and administrative staff (n = 306). Data were analyzed using SPSS version 22.0.
The findings revealed that the number of patient safety reports in 2019, 2020, and 2021 were 1,391, 1,356, and 1,091, respectively. Among physicians, the willingness to report remained consistent, unaffected by the pandemic. However, a notable decrease in reports was observed among nursing staff, with the majority of incidents involving falls and catheter-related events, predominantly occurring during the day shift. For patients, most incidents involved those accompanied by or in the presence of others at the time of the event. Similarly, reports from medical personnel also declined, with most incidents relate to medication and laboratory test–related issues, often categorized as near-miss incidents. Administrative staff demonstrated no significant change in reporting patterns, with the majority of incidents related to laboratory tests and other nonharm events.
Patient safety reporting is a driving force for continuous improvement in hospitals. The study findings suggest that the COVID-19 pandemic led to a reduction in reporting by nursing staff and medical personnel, potentially due to the operational changes necessitated by pandemic-related policies. However, results from a comprehensive survey of patient safety culture revealed no significant differences across job categories, indicating that staff recognition of and confidence in the culture of patient safety reporting remained unchanged despite the challenges posed by the pandemic.