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研究生:余錦美
研究生(外文):Ching-Mei Yu
論文名稱:病人安全文化初探-以臺北市某醫院為例
論文名稱(外文):An Exploratory Study of Patient Safety Culture in a Taipei Hospital
指導教授:郭乃文郭乃文引用關係
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:醫務管理學研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:93
中文關鍵詞:病人安全文化病人安全病人安全文化量表
外文關鍵詞:Patient safety culturePatient safety Patient safety culture scale
相關次數:
  • 被引用被引用:20
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  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:3
本研究係使用美國醫療照護暨品質研究所(Agency for Healthcare Research and Quality, AHRQ)發展之病人安全文化的調查量表,以探討公立醫院面臨轉型、整併及公務預算逐年縮減,加上醫療環境變遷下,探討醫院員工之病人安全文化及影響因子。希望提供醫院管理階層了解其相關性及問題癥結,提供改善之方向。
本研究以臺北市某區域醫院內所有員工為樣本進行問卷調查,問卷發放728份問卷,回收問卷有效樣本計437份(有效回收率為59.3%)。
研究結果發現:
1.影響病人安全文化之面向包括:單位之團隊合作、醫院管理者支持、單位主管重視、單位合作、暢言的溝通管道、訊息的回饋、組織學習機會、事後懲罰與充足的人力等;其中樣本醫院表現最佳者為單位之團隊合作(3.85),最有待改善者為充足之人力(2.56)。
2.在個人及工作特質對病人安全文化及病人安全有差異的是:年齡不同、有無宗教信仰、工作單位不同、受僱工作類別不同、工作年資及有無擔任主管等有所差異。
3.根據研究結果,本研究建議:(1)醫院管理者應重視組織文化於病人的安全。(2)協助醫療環境工作者舒緩疲勞與釋放壓力。(3)建立病人安全管理系統(4)落實病人安全的執行,建立一個安全的就醫環境。
Objectives: To evaluate patient safety culture of healthcare workers in a Taipei hospital facing during faced re-model organization structure and reducing budge year by year.
Design and Setting: The Chinese edition of the AHRQ Hospital Survey on Patieny Safety Culture questionnaire were distribured among 728 employees of a Taipei hospital. The valid response rate was 59.3%.
Main outcome measures: Patient safety culture was measured by Chinese edition of the AHRQ Hospital Survey on Patieny Safety Culture.
Result: Among those dimensions of patient safety culture measured, the highest one was team-work in the unit(3.85),the lowest one was sufficiency of manpower(2.56).
Conclusion: Hospital administrators should pay attention to patient safety culture. Management level should assist in relief stress of employees.
致謝 II
中文摘要 III
Abstract IV
目錄 V
圖目錄 VI
表目錄 VI
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第二章 文獻探討 3
第一節 病人安全(patient safety) 3
第二節 組織文化 5
第三節 病人安全文化 7
第四節 國內外病人安全文化相關研究 9
第三章 研究方法 11
第一節 研究架構 11
第二節 研究假說 13
第三節 研究變項之操作型定義 14
第四節 研究對象與樣本資料來源 18
第五節 研究工具 19
第六節 資料處理及分析 21
第四章 研究結果 22
第一節 描述性統計分析 22
第二節 病人安全文化及病人安全的平均值描述 27
第三節 推論性統計分析 31
第五章 討論 75
第一節 研究發現與探討 75
第二節 受訪者自由回應部分的討論 81
第三節 研究限制 82
第六章 結論與建議 83
第一節 結論 83
第二節 建議 84
參考文獻 85
附錄一 89
中文部份
石崇良(2003)?G 病人安全之國際趨勢 ?G 醫策會會訊,4(1),8-10。
石崇良(2004)?G 建立病人安全文化-病人安全文化現況調查 ?G 第二屆醫療品質促進年會。
石崇良、薛亞聖。國內病人安全初探。醫策會會訊2004,p4。
吳萬益、郭幸萍、彭奕龍(2002)?G 醫學中心組織文化、管理模式、競爭優勢與經營績效之互動相關影響研究 ?G 醫務管理期刊,3,17-35。
林月桂、盧美秀(2000)?G 運用競值途徑於醫院護理部門組織文化領導型態與組織效能關係之研究 ?G 新臺北護理期刊,2,5-23。
財團法人醫院評鑑暨醫療品質策進會(無日期)?G JCAHO 2005年病人安全目標翻譯內容(93.12.20修訂版)?G 2005年12月2日取自Http://www.tjcha.org.tw
財團法人醫院評鑑暨醫療品質策進會(無日期)?G 九十五年病人安全目標及執行策略?G 2005年12月2日取自Http://www.tjcha.org.tw/default.asp
張緯良 (2003)•管理學•台北:雙葉書廊。
臺北市政府衛生局(2004)•病患安全經驗交流研討會。
郭鈺延(2004)?G 醫師對病人安全文化認知與行為之關聯性-以台灣某醫學中心醫師為例•未發表的博碩士論文•桃園:長庚大學。
施貞伶(2004)•醫院病人安全文化初探-醫事人員對病人安全氣候知覺與其促進病人安全行為表現之關聯性探討•未發表的博碩士論文•台北:國立台灣大學。
英文部分
Baker, G. R., & Norton, P. (2002). Patient safety and healthcare error in the Canadian healthcare system: A systematic review and analysis of leading practices in Canada with reference to key initiatives elsewhere. A report to Health Canada.
Brennan, T. A., Leape, L. L., Laird, N. M., Hebert, L., Localio, A. R., & Lawthers, A. G., et al. (1991). Incidence of adverse event and negligence in hospitalized patient. Results of the Harvard Medical Practice Study I. New England Journal Medicine, 324, 370-376.
Bate, D. W.,Cullen, D., Laird, N., et al. (1995). Incidence of adverse drug events and potential adverse drug prevention. JAMA, 274, 29-34.
Bates, D. W., Cullen, D., Laird, N., Petersen, L., Small, S., & Servi, D., et al. (1995). Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. JAMA, 274, 29-34.
Bates, D. W., Spell, N., Cullen, D. J., Burdick, E., Laird, N., Petersen, L. A., et al. (1997). The costs of adverse drug events in hospitalized patients. Adverse drug events prevention study group. JAMA, 277, 307-311.
Battles, J. B., & Lilford, R. J. (2003). Organizing patient safety research to identify risks and hazards. Quality Safety Health Care, 12(Suppl Ⅱ), 2-7.
CDC. (2003). Severe acute respiratory syndrome-Taiwan 2003. MMWR, 52, 461-466.
Cooper, J. B., Gaba, D. M., Liang, B., Woods, D., & Blum, L. N. (2000). National patient safety foundation agenda for research and development in patient safety. MedGenMed, 2(4). Retrieved October 30, 2006, from:www.medscapc.com/ MedGenMed/Patient Safety
Deal, T. E., & Kennedy, A. A. (1982). Corporate cultures: the rites and rituals of corporate life Reading. MA: Addison-Weslys.
Firth-Cozens, J. (2001). Cultures for improving patient safety through of learning: the role of teamwork. Quality in Health Care, 10, 26-31
Hofstede, G., Neuijen, B., Ohayv, D., & Sanders, G. (1990). Measuring organizational culture: a qualitative and quantitative study across twenty cases. Administrative Science Quarterly, 35(2), 286-316.
IOM. (2000). To err is human. Building a Safer Health System, 165-182.
Lesar, T. S., Briceland, L., & Stein, D. S. (1997). Factors related to errors in medication prescribing. JAMA , 277, 312-317.
Leape, L. L., Brennan, T. A., Laird, N., Lawthers, A. G., Localio, A. R., & Barnes, B. A., et al. (1991). The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practics Study ll. New England Journal Medicine, 324, 377-384.
Mohr, J. J., Barach, P., Cravero, J. P., Blike, G. T., Godfrey, M. M., Batalden, P. B., et al. (2003). Microsystems in health care: part6. designing patient safety into the microsystem. Jonint Commission Journal on Quality and Safety, 29(8), 401-408.
Nelson EC. Microsystems in Health Care: Part 6. Designing Patient Safety into the Microsystem. Joint Commission Journal on Quality and Safety, 29(8) 401-408, August 2003.
National Patient Safety Foundation. (1999). Agenda for Research and Development in Patient Safety.
Neal, A., & Griffin, M. A. (2002). Safety climate and behaviour. Australian Journal of Management, 27, 67-75.
Nieva, V. F., & Sorra, J. (2003). Safety culture assessment: a tool for improving patient safety in healthcare organizations. Quality Safety Health Care, 12(Suppl Ⅱ), 17-23.
Pennsylvania Patient Safety Collaborative. (2001). Elements of a culture of safety: patient safety is our top priority. Reported at HAP’s Leadership Summit. Retrieved October 13, 2006, from: http://www.papatientsafety.net
Pronovost, P. J., Weast, B., Holzmueller, C. G., Rosenstein, B. J., Kidwell, R. P., Haller, K. B.,
et al. (2003). Evaluation of the culture of safety: Survey of clinicians and managers in an academic medical center. Quality Safety Health Care , 12(6), 405-410.
Reason, J. T. (1997). Managing the Risks of Organizational Accidents. Aldershot Hants England Brookfield, Vt.USA:Ashgate.
Scally, G., & Donaldson, L. J. (1998). Clinical governance and the drive for quality improvement in the new NHS in England. British Medical Journal, 317(7150), 61-65.
Schein, E. (1985). Organizational Culture and Leadership. San Francisco: Jossey-Bass.
Scott, T., Mannion, R., Davies, H., & Marshall, M. (2000). The quantitative measurement of organization culture in health care: a review of the available instrument. Health Services Resarch, 38(3), 923-945.
Shortell, S. M., Rousseau, D. M., Gillies, R. R., Devers, K. J., & Simons, T. L. (1991). Organizational assessment in intensive care units (ICU): Construct development, reliability and validity of the ICU nurse-physician questionnaire. Medical Care, 29(8), 709-726.
Singer, S. J., Gaba, D. M., Geppert, J. J., Sinaiko, A. D.,S. Howard, K., & Park, K. C. (2003). The culture of safety: results of an organization-wids survey in 15 California hospitals. Quality and Ssfety in Health Care, 12, 112-118.
Sorra, J.S, & Nieva, V.F. (2004, September).Hospital Survey on Patient Safety Culture. (Prepared by Westat, under Contract No. 290-96-0004). AHRQ Publication No. 04-0041. Rockville, MD: Agency for Healthcare Research and Quality.
Thomas, E. J., Studdert, D. M., Burstin, H. R., Orav, E. J., Zeena, T., Williams, E. J.,
et al. (2000). Incidence and types of adversevevents and negligent care in Utah and Colorado. Medicine Care, 38(3), 261-271.
Zohar, D. (1980). Safety climate in industrial organizations: theoretical and applied implications. Journal of Applied Psychology, 65, 96-102.
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