增進精神科護理人員處理病患暴力事件能力之行政專案

To Improve the Ability of Dealing with the Violence for Psychiatric Nurses

本專案乃因精神科病房暴力事件增多，影響到護理同仁工作士氣，造成身心受創，有鑑於此而引發做此行政專案之動機。經知識調查與能力觀察，發現同仁在處理暴力事件時有能力不足之問題，針對此問題，乃提出下列的解決方案：(1)課程講授：包含六項主題：a、暴力處理之法律觀，b、引發暴力事件之原因探討，c、如何降暴力氣氛，d、如何脫離病患之束縛，e、如何約束病人，f、暴力事件處理流程(2)每月舉行兩次個案討論會(3)視情況對需要的護理人員做個別輔導。經執行改善方案後，其結果顯示：（一）護理人員對處理暴力事件之知識得分由45.8分提升為66.7分，（二）處理暴力事件時發生缺失的項目由12項降到3項，發生缺失的件次由32次降為3次。藉由此專案之進行，不僅增進了精神科護理人員處理暴力事件之能力，同時在執行改善方案過程中，同仁發揮了團隊精神，在專業的成長中提高了工作效率，病患發生暴力行為時，亦能獲得較高護理品質的處理。

The motive of this investigation resulted form the low morale of psychiatric nurses owing to many violence events in psychiatric wards. A survey of the professional knowledge and skill showed lack of ability in dealing with violence events. As to solving the problem, the following programs are: (1) The course of lectures. There are six topics in the lectures: A. The concept of law about dealing with violence. B. The causes of violence events. C. How to decrease the mood of violence? D. How to free oneself from violent patients? E. How to restrain violent patients? F. The procedure for dealing with violence events. (2) Case conferences of the violence events twice a month. (3) Counseling psychiatric nurses if it is needed. The results are: (1) Having increased the professional knowledge about dealing with violence events from 45.8 to 66.7. (2) Having minimized both the items of violence (from 12 to 3) and frequency of violence events (from 32 to 3).Upon investigation, we found that our colleagues not only achieved improvement in dealing with violence events but also showed the team power and the efficiency to the work. The psychiatric nurses have better ability and nursing care quality in dealing with the violence events.