虛驚事件定義對呼吸治療師意外事件分類之影響

王思惠

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虚惊事件定义对呼吸治疗师意外事件分类之影响

The Effect of Near-miss Definitions on Classifying Respiratory Therapist Incidents

王思惠 , 硕士　　导师：谢贤书　　

繁体中文

自我陈述的医疗事件；虚惊事件；瑞士乳酪模型；病人安全； Self-reporting medical event ； near miss ； Swiss Cheese model ； patient safety.

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摘要 │ 参考文献 (30) │ 国际计量

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Objective :
The nature of medical treatments is involved with many uncertain factors, which include physical instruments, facilities, human skills, and cooperation among team works.  Any medical error, no matter which is slip or lapse arising in the intensive working atmosphere could cause abnormal events, even harm to a life.  One way to reduce medical errors is the promotion of near miss reporting.  One of the aims of this study is to investigate how the ways of defining near miss event and no harm event affect the accuracy of classification of these two kinds of events in near miss reporting.  Another aim is to understand how much level of safety awareness can be lifted via group discussion of self-reporting medical events.  The final aim is to differentiate the potential significance of near-miss event.  The limited resources should be spent on investigating those events which could cause significant harm to reduce medical errors.
Methods:
In the first phase of this study adopts the cross-sectional approach with a structured questionnaire, which include 25 questions to be classified as either a near-miss event or a no-harm event by participants with/without the hint of the Swiss-Cheese model. In the second phase, the comparisons of the number of self-reporting medical events by medical staff are made between before and after a group discussion on the reported events. In the third phase, the set of 25 questions are discussed and scrutinized to reach consensus on their significance of potential harm.     
Results: 
In the first phase of the study, the correct classification with the hint of the Swiss Cheese model is 90.3% while it is 69.6% without the hint. In the second phase, after a group discussion on the reported events, the number of self-reporting events increases.  And the consensus among the focus group is reached to determine that 62.5% of questionnaires are potential to cause significant harm. 
Conclusion: 
The application of the Swiss Cheese model help the participating medical staff correctly classify the medical events.  The group discussion on the self-reporting medical events help improve the safety awareness among the participants and increase self-reporting cases.

参考文献 ( 30 ) 〈TOP〉

1. 中华民国呼吸治疗师公会全国联合会(2015) ・104年RT执登会员数・取自http://www.rtsroc.org.tw/affair/统计数据。
连结：
2. 周郁芳、叶淑娟、袁国书、张朝卿、游秋月、林慧真、陈彦澄 (2015)・探讨不安全感与健康意识程度对健康预防行为之影响・台湾公共卫生杂志，34(6) ， 605-615。DOI:10.6288/TJPH201534104007[Y.F., Chou, S.C.,Yeh, K.S., Yuan, A., Chang, C.Y., You, H.C., Lin, Y.C.Chen.(2015) Do You Feel Insecure? Influence of Health Consciousness on the Relationship between Existential Insecurity and Health Prevention. Taiwan Journal of Public Health,34(6), 605-615. DOI:10.6288/TJPH201534104007]
连结：
3. 林玲钦(2007)・护理人员的职业安全卫生知识、态度及行为相关因素之探讨・(硕士论文)。取自http://handle.ncl.edu.tw/11296/ndltd/41909283720113927574[Lin, L.C.(2007) The analysis of the knowledge, attitude and behavior of occupational safety and health among nurse(master thesis). Retrieved from http://handle.ncl.edu.tw/11296/ndltd/41909283720113927574]
连结：
4. 侯胜茂、陈欣欣(2004)・提昇病人安全的新作为・台湾医学，8(4)，504-509。DOI： 10.6320/FJM.2004.8(4).07 [S. M., Hou, H. H., Chen.(2004) New Efforts in Promoting Patient Safety. Formosan Journal of Medicine,8(4), 504-509. DOI： 10.6320/FJM.2004.8(4).07]
连结：
5. 翁豊荣(2005)・医疗从业人员对医院安全文化之认知・ (硕士论文)。取自http://handle.ncl.edu.tw/11296/ndltd/74208523779899238288[Weng, L.J(2005) The Perception of healthcare workers an hospital safety culture(master thesis). Retrieved from http://handle.ncl.edu.tw/11296/ndltd/74208523779899238288]
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使用DOI作为永久连结

引用含有DOI的文献

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。 如想对DOI的使用与概念有进一步了解，请参考 （ ） 。

DOI可强化引用精确性、增强学术圈连结，并给予使用者跨平台的良好使用经验，目前在全世界已有超过五千万个对象申请DOI。如想对DOI的使用与概念有进一步了解，请参考（）。