林世華博士

李光大博士 

研究背景：促進病人安全是現今各醫療院所重視的議題，亦為醫院評鑑的重點項目之ㄧ。在醫院中提供照護是以護理人員居多，護理工作為醫療照護工作的重要組成部分，因此，護理照護品質和其專業知識水準，會直接影響到醫療安全和醫療服務品質，在病人安全關卡中佔有極為重要的地位。然而目前國內針對護理人員對組織安全氣候文化的研究有限，故引發探討護理人員對組織安全氣候文化感受現況的動機，進而能了解影響護理人員對組織安全氣候文化感受的因素，作為日後提供護理人員病人安全教育之相關在職教育的參考依據。

研究目的：藉由問卷測量，瞭解護理人員的安全氣候感受之現況，並進一步探討分析影響護理人員安全氣候感受的相關因素，以作為醫療機構安全管理上之參考。

研究方法：資料來源取自台灣北部某醫學中心於2007年針對全院護理人員進行之病人安全文化調查的資料庫。資料分析首先為描述性分析以了解護理人員之年齡、服務年資、單位別、工作滿意、工作壓力、團隊合作、管理制度與工作環境等變項之影響情形，並以皮爾森積差相關、複迴歸方法探究各自變項對組織安全氣候的預測能力與整體模式解釋力。

研究結果：護理人員的年齡和單位年資與「組織安全氣候」成正相關，但不同單位別護理人員對於「組織安全氣候」之認知程度則無顯著差異。另在個人因素方面，涵蓋工作滿意與工作壓力兩因素，結果指出工作滿意與「組織安全氣候」成正相關，但工作壓力與「組織安全氣候」則無顯著相關。組織因素方面，包含團隊合作、管理制度及工作環境三因素皆與「組織安全氣候」成正相關，並達統計顯著意義。

研究討論：應用安全態度問卷進行病人安全文化調查，可瞭解護理人員對安全文化的認知，醫療機構應系統性了解並掌控院內病人安全之結構與機制，跨科室部門分析與應用，創造有利於工作人員安心的工作的環境和條件，加強對他們的教育訓練，並定期檢視病人安全文化，以便能更清楚了解組織的安全現況並積極處理病人安全之相關問題。

關鍵字：病人安全文化、安全態度問卷

Background：Nursing staffs are the major role to care patients in hospital.  The most important part of medical care are the nursing tasks. Hence, nursing care quality and professional knowledge that would directly impact the healthcare safety and service quality are also holding a strong position in patient safety subject. However, there are only few researches on the relationship between nursing staff and organizational security culture. This motivates the research to study the current perception of nursing staff on the organizational safety culture. The research would find out the factors that influent the perception of nursing staff and be as the basis theory for the professional training of patient safety to the nursing staff. 

Purpose: This research would like to understand the current perception of nursing staff about the safety climate through questionnaire measure. The factors that impact the perception of nursing staff are then investigated and analyzed as the reference of medical organization safety management. 

Method: The data source of the research is the database of a patient safety culture survey that conducted by a medical center located in north Taiwan in 2007. All nursing staffs of the medical center were the targets of the survey.  The 1^st part of data analysis is the description analysis to know the nursing staff profile including their age, seniority, department, working satisfaction, working pressure, teamwork, management system, and working environment. The Pearson’s correlation, multiple regression are further applied to discover these individual characteristics influence to the forecast ability and the integral model explanation to organization safety climate. 

Result: There is positive correlation between the age/seniority of nursing staff and the organization safety climate. But there is no obvious difference for the perception of nursing staff to organization security climate between different departments.  Working satisfaction and working pressure are two personal factors to be studied.  The result showed working satisfaction is positive correlative to organization security climate. As for working pressure, there is no positive correlation with organization security climate. Three organization factors including teamwork, management system, and working environment are all positive correlative to organization security climate and achieve the statistical significance. 

Discussion: Applying SAQ questionnaire to survey patient safety culture may understand the perception of nursing staff to safety culture. Medical organizations need to understand and control the structures and mechanisms systematically and then make further analysis and application across diverse departments. This will create a comfortable working environment and conditions for the staffs. Regular training and investigation on patient safety culture are very helpful to know the current safety status of the medical organization and to deal with patient safety issues proactively. 

Key word：patient safety culture、safety attitudes questionnaire