優化氣道管理護理教育需求評估：重要性──績效分析與焦點軌跡模式之應用

Needs Assessment for Optimizing Airway Management Nursing Education: Application of the Importance-Performance Analysis and Locus for Focus Model

背景：氣道相關事件在臨床上常見，且具高度急迫性與複雜性，若未能及時處置，將嚴重威脅病人安全，然而許多不良事件可透過有效的氣道管理教育加以預防。
目的：探討護理人員氣道管理中的優先教育需求，以提升臨床實務能力，並降低不良事件發生。
方法：採橫斷式設計，招募北部某醫學中心100名護理人員參與，透過線上問卷蒐集資料，並運用重要性－績效分析模式（importance-performance analysis）、Borich需求分數及焦點軌跡模式（Locus for Focus Model）綜合評估護理教育的優先需求。
結果：位於重要性－績效模式象限II，Borich需求分數排名前10名，及焦點軌跡模式象限I之項目被定義為最優先教育需求。其中，「快速誘導插管程序」及「呼吸衰竭治療」為最關鍵的學習項目。
結論：本研究揭示護理人員在氣道管理上的認知與表現差距，尤其在快速誘導插管程序及呼吸衰竭治療方面最為明顯。因此，建議針對此差距設計目標明確且實效性強的教育方案，以提升臨床護理品質，並強化病人安全。

Background: Airway-related incidents, common in clinical settings, are characterized by high urgency and complexity. Failure to manage these incidents promptly can pose serious threats to patient safety. However, many of these incidents can be prevented through the effective implementation of airway management education.
Purpose: The objective of this study was to identify the priority educational needs of airway management for nurses to enhance clinical practice and reduce the risk of adverse events.
Methods: A cross-sectional design was employed and 100 nurses from a medical center in northern Taiwan were enrolled as participants. Data were collected via an online questionnaire and analyzed using importance-performance analysis (IPA), Borich’s Needs Score, and the Locus for Focus (LF) model, all of which have previously been shown to be effective in identifying educational priorities.
Results: Items identified as top-priority educational needs were respectively located in Quadrant II of the IPA model, ranked among the top-10 in terms of Borich’s Needs Score, and situated in Quadrant I of the LF model. The results highlighted“rapid sequence intubation procedures”and“treatment of respiratory failure”as the areas in most need of attention.
Conclusions: The results of this study support that significant gaps exist between the perceived importance and self-assessed performance of nurses with regard to airway management. In this study, these gaps were most significant in the dimensions of rapid sequence intubation procedures and respiratory failure treatment. Targeted, outcome-focused educational programs are recommended to address these gaps to improve patient safety and the quality of clinical nursing care.