台灣醫療職場暴力事件之省思與安全防範

Medical Workplace Violence Incidence and Prevention Strategies

10.6142/VGHN.33.4.419

陳麗琴(Li-Chin Chen)；黃集仁(Chip-Jin Ng)

醫療職場暴力 ； 醫療暴力零容忍 ； 暴力事件警兆 ； 跨領域團隊合作 ； medical workplace violence ； zero tolerance against medical workplace violence ； alertness to the signs of violence ； multidisciplinary approaches

榮總護理

33卷4期（2016 / 12 / 01）

419 - 424

繁體中文

台灣醫療職場暴力事件屢於媒體上揭露，而且發生類型更是多樣化，有單人或多人施暴，有言語身體或刀械器具實在是不容忽視，尤其是第一線醫療服務的工作人員除了肩負病人生命維護使命與醫療照護任務，又需面對安全堪慮的工作職場暴力，在如此艱困的挑戰下，雖然國內各醫事專業團體，運用群體力量共同譴責暴力並發出嚴正聲明「醫療暴力零容忍zero tolerance」，但暴力事件的發生仍無法避免。研究結果顯示身體攻擊暴力事件將近86% 是可以預防的(Zafar et al.,2013)，他山之石，可以攻錯，醫療機構管理者必須責無旁貸肩負起維護醫療工作人員安全的責任，並要全面性深思如何防範暴力的策略，其中包含：建立暴力事件即刻通報啟動處理機制，強化人員對暴力事件警兆之評估判斷與自我防護措施，事件發生後人員關懷與權益保障，以及跨領域團隊合作共同進行案例檢討與預防策略管理，持續提升人員對暴力事件防範與處理之能力，致力維護醫療環境安全與反暴力事件。同時也要加強呼籲及宣導民眾重視及杜絕醫療暴力事件的發生，妥善維護醫療人員無憂的醫療照護環境，進而提供病人就醫期間優質的照護服務。

Recently, many incidents of medical workplace violence have been reported by the Taiwanese media. Such incidences include single- and multiple-attacker transgressions, verbal violence, physical violence, and knife assault. Such violence should be considered a serious threat to the safety of first-line medical staff who protect patients' lives. Under these circumstances, the medical professional society announced a ＂zero tolerance against medical work place violence＂ statement; however, violence has remained unavoidable. Studies from other countries have indicated that 86% of cases of body assault are preventable. This information could be applied to facilitate the establishment of strategies to ensure the safety of medical staff. The medical authorities are fully responsible for protecting medical staff from assault and therefore must establish a wide range of prevention strategies, including violent incident reports and response systems, improving alertness to the warning signs of violence, self-defense precautions among medical staff, and caring and protecting the rights of medical staff who have suffered violence. Other areas that require focus are multidisciplinary approaches and careful analysis of every violent incident, as well as the application of appropriate prevention strategies and continuous improvements in the ability of medical staff to manage violence. In addition, widespread public support and working together to stop medical workplace violence are both key to ensuring a safe workplace environment for providing high-quality medical care.

1. Calabro, K.,Mackey, T. A.,Williams, S.(2002).Evaluation of training designed to prevent and manage patient violence.Issues in Mental Health Nursing,23(1),3-15.
2. Ferri, P.,Silvestri, M.,Artoni, C.,Lorenzo, R. C.(2016).Workplace violence in different settings and among various health professionals in an Italian general hospital: A cross-sec tional study.Psychology Research and Behavior Management,9,263-275.
3. Kowalenko, T.,Cunningham, R.,Sachs, C . J.,Gore, R.,Barata, I. A.,Gates, D.,McClain, A.(2012).Workplace Violence in Emergency Medicine: Current Knowledge and Future Directions.The Journal of Emergency Medicine,43(3),523-531.
4. Zafar, W.,Siddiqui, E.,Ejaz, K.,Shezad, M. U.,Khan, U. R.,Jamali, S.,Razzak, J. A.(2013).Health Care Personal and Workplace Violence in the Emergency Departments of a Volatile Metropolis: Results From Karachi, Pakistan.Journal of Emergency Medicine,45(5),761-772.
5. 李選、白香菊、顏文娟(2010)。台灣護理人員職場暴力經驗及其相關因素研究。護理雜誌，57(2)，61-69。
6. 張孟源、盧言珮(2011)。醫療暴力─不能忽視的危險犯罪。台灣醫界，54(8)，37-42。
7. 陳柑伴、楊秀芬、陳慧蘭、楊美賞(2010)。醫院護理人員遭受職場暴力後情緒反應及調適處理。護理暨健康照護研究，6(3)，163-171。
8. 陳維恭(2011)。暴力陰影籠罩─急診醫護需要遠離恐懼的環境。中國醫訊，49，38-40。

1. 陳鏡華(Ching-Hua Chen);李曉惠(Hsiao-Hui Lee)(2021)。從「情境犯罪預防」論醫療暴力。台灣醫學。25(3)。403-410。