提升醫療工作職業健康──6年臨場服務經驗探討杜宗禮

Advancing Occupational Health Services for Healthcare Workers: Six Years of Insights

本研究旨在透過6年期的臨場服務資料，分析臺灣北部某醫學中心醫護人員所面臨的職業危害，並評估相關防護措施的成效，期望能提昇醫療工作者之職業健康。採用現場訪視、問卷調查、資料分析及風險評估等方法，針對醫療人員的針扎、工作負荷、母性健康保護及骨骼肌肉危害等面向進行分析。研究過程運用佛萊明漢（Framingham）風險評估工具進行員工健康風險分層，並參考國際勞工組織（International Labour Organization, ILO）/世界衛生組織（World Health Organization, WHO）的健康服務工作改進計畫（Work Improvement in Health Services, HealthWISE）手冊建立預防性計畫。醫院透過推動「拒絕針扎運動」及強制使用安全針具等措施，使6年間針扎事件顯著降低。工作壓力評估發現高工作量、輪班制度及休息時間不足是主要壓力來源。在母性健康保護方面，醫院建立涵蓋物理、化學、生物和心理社會層面的危害評估機制，並實施工作調整方案。而骨骼肌肉傷病防治的現場訪視發現重複性動作、不當姿勢及負重搬運是主要危害因素。COVID-19疫情加重醫護人員的職業風險，措施包括改善隔離病房通風系統、監測廢水病毒，以及為COVID-19提供職業病認定。儘管醫院已降低部分職業危害，但醫療人員仍面臨工作壓力報告不足及代謝症候群發病率上升等挑戰。建議未來可導入AI技術減輕工作負荷、強化心理健康支持系統，並持續與國際職業安全衛生標準接軌，以建構永續的醫療工作環境。

This six-year study aimed to analyze occupational hazards faced by healthcare workers (HCWs) at a major medical center in Northern Taiwan and evaluate the effectiveness of protective measures to enhance occupational health for medical professionals. The study employed workplace inspections, questionnaire surveys, and risk assessments to analyze needle injuries, workload, Maternal Health Protection, and musculoskeletal hazards. The Framingham risk assessment tool was utilized for employee health risk stratification, and preventive programs were established based on the ILO/WHO HealthWISE manual. Implementation of the“No Needlestick Campaign”and mandatory safety needle usage significantly reduced needle injury incidents over six years. Workload stress assessment revealed that high workloads, shift work, and insufficient rest periods remained primary stressors. For maternal protection, the hospital established comprehensive hazard evaluations covering physical, chemical, biological, and psychosocial aspects, implementing corresponding work adjustments. Workplace inspections identified repetitive motions, improper postures, and heavy lifting as major factors in musculoskeletal disorders. The COVID-19 pandemic intensified occupational risks, leading to enhanced protective measures including upgraded isolation ward ventilation systems and wastewater monitoring. While the hospital has reduced certain occupational hazards, HCWs continue to face challenges such as underreported work stress and increasing metabolic syndrome rates. Future recommendations include implementing AI technology to reduce workload, strengthening mental health support, and aligning with international occupational safety standards to build a sustainable healthcare environment.