Taipei Medical University Institutional Repository:Item 987654321/58349
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    題名: 癌症病房護理人員組織溝通與遺漏護理照護的關係
    The Relationship between OrganizationalCommunication and Missing the Nursing Care of Nursesin Oncology Wards
    作者: 潘仕萍
    Pan, Shih-ping
    關鍵詞: 遺漏護理照護;組織溝通
    missed nursing care;Organizational Communication
    日期: 2018-12-20
    上傳時間: 2020-01-07 09:49:01 (UTC+8)
    摘要: 溝通不良容易造成護理人員遺漏或延誤執行某些例行的照護工作，影響病人安全。但是癌症病房組織溝通與發生遺漏護理照之間的關聯性到底有多強，以及遺漏護理照的嚴重度與主要原因，過去在台灣鮮少人進行探究，因此，本研究目的旨在了解護理人員遺漏護理照護發生的情形、影響護理人員發生遺漏護理照護的因素，比較護理人員特性與組織溝通滿意度的差異和分析護理人員特性對發生遺漏護理照護情形的影響、護理人員組織溝通滿意度對遺漏照的關係。
    本研究採 橫斷式描述性研究設計，研究計劃經IRB 審核通過後，於2018年6月開始，針對北區某癌症專科醫院病房之20歲(含)以上領有護理師證書從事臨床實務工作之護理師，以立意取樣方式完成111份結構式問卷調查。問卷內容包含三大部分：第一為基本資料；第二部分為遺漏護理照護；第三部分為組織溝通滿意狀態。進行調查前於各病房的病房會議中解釋研究進行之目的及方式後將問卷留在現場，開放人員自行拿取和填寫，2週內回收問卷。最後以 SPSS 統計軟體分析個數、百分比、平均值、標準差、卡方檢定、t-檢定、變異數分析及回歸分析等統計方法進行。
    研究結果發現，護理師最常遺漏的護理照護項目有:在15 -30 分鐘內按臨時處方進行給藥、評估病人用藥後藥物療效、於正確時機洗手。與上述之遺漏護理照項目相關之因素有:單位病人數突然增加或病人病情變嚴重、病人出現緊急狀況、護理人力不足。 病情變嚴重、人出現緊急狀況護理力不足。 病情變嚴重、人出現緊急狀況護理力不足。不同職級、年齡、職稱、單位人力等人員特性會影響組織溝通滿意度，而離職意願、班別對發生遺漏護理照情形具有影響，而護理人員組織溝通滿意度與遺漏護理照護之間無顯著相關。建議未來可以應用該問卷進行更深入的探討，或以病人的觀點來檢視遺漏護理照， 提供更完整的訊息。另外，針對遺漏護理照護及溝通問題，建議優化電子護理資訊系統、改善工作流程、應用情境教學增進團隊溝通技能、建立安全管道，以提升整體管理成效，避免遺漏護照影響癌症病人照護品質。
    Increases in nursing communication can lessen medical errors and make a difference in positive patient outcomes. However, the relationship between organizational communication and missing nursing care in oncology wards, the severity and the reason of missing nursing care were not certain in Taiwan. The aims of the study were to measure the amount and type of care missed by nurses in oncology wards and the reason for omitted care; to compare the differences between nursing staff characteristics and organizational communication satisfaction; to compare the differences between and nursing staff characteristics and missing nursing care. Eventually to analyze the relationship between communication satisfaction and missing nursing care.
    In June 2018 after the study was approved by the IRB we carried on a cross-sectionalstudy. We applied purposive sampling design and had 111 questionnaires completed. The sample for this study consisted of staff registered nurses and nursing leaders providing direct patient care in a cancer center in Taiwan. The questionnaire contented 3 parts including characteristics of participants; missing nursing care elements and communication satisfaction. The questionnaires were placed in staff’ lounge for who voluntary participated in research. Responses were collected in locked boxes located on the units. Data were collected within two weeks’ timeframe within each of wards. For data analysis, descriptive and inferential statistics were used and SPSS version 14 was utilized. P-value less than or equal to 0.05 was considered statistically significant.
    V
    The results of the study showed the frequency analysis for elements of missed nursing care for Taiwanese translation version were PRN medication requests, assess effectiveness of medication, hand washing, and the relevance ranking analysis of the reasons of missing nursing care were unexpected rise in patient volume, urgent patient situation condition and inadequate number of staff. The differences between nursing staff characteristics and organizational communication satisfaction were title, age, level, workload. The difference between and nursing staff characteristics and missing nursing care was plan to leave. Moreover, we found there were no significant relationships between nurses’s organizational communication satisfaction and missed nursing care in oncology Wards.
    According to our study findings, we suggested the leaders of health care institutions and experts could apply MISSCARE Survey Taiwanese version to collect more information especially for the patient''s point of view and build up a big picture for missed nursing care. In addition, it is recommended to optimize the electronic nursing information system for missing care and communication problems solutions. Applying situational teaching strategy to improve team communication skills and established care-oriented ethical climate to construct a safe communication working environment in order to improve the management effectiveness and to ensure the quality of care for cancer patients.
    描述: 碩士
    指導教授：林秋芬
    委員：鄭綺
    委員：賴甫誌
    資料類型: thesis
    顯示於類別:[護理學系] 博碩士論文

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