我國人工呼吸道病人照護安全現況與呼吸道意外事件發生之調查分析

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題名:	我國人工呼吸道病人照護安全現況與呼吸道意外事件發生之調查分析 Artificial Airways Patient Safety-A Survey on Current Situations and Airway Accidents
作者:	黃鈞鴻 HUANG, CHUN-HUNG
貢獻者:	醫務管理學研究所
關鍵詞:	人工呼吸道病人安全呼吸道意外 artificial airways patient safety airway accidents
日期:	2006
上傳時間:	2009-09-11 15:52:49 (UTC+8)
摘要:	背景：人工呼吸道的設置是急重症加護單位內呼吸障礙病人最常見的侵入性處置。該疾病類型之病患若發生人工呼吸道相關之意外，其易引起嚴重的合併症甚至為不可逆的傷害。因此，本研究以問卷調查方式來了解國內人工呼吸道照護安全現況及人工呼吸道相關之意外事件分布情形。材料與方法：本研究根據相關文獻及專家學者意見發展「人工呼吸道照護安全現況」的調查問卷，並向全國急重症、呼吸及胸腔相關專科醫師發出問卷進行調查。結果：本研究問卷共回收198份。受訪醫師大多數均為資深的急重症加護專科醫師，其中包括124位胸腔暨重症專科醫師，而有73.7% 的受訪醫師有4年以上實際從事呼吸暨重症照護的年資。從受訪醫師回覆的單位照護現況結果以及呼吸道意外事件發生頻率中，本研究發現醫療人員平均照護的病人數越多、無專責呼吸道意外處理人員、主要照護人工呼吸道病人的負責人為護理人員、呼吸器未設置警報系統及保養維修週期過長、氣管內插管品牌數過多及固定插管的材料使用方式未有標準作法等，為影響呼吸道意外發生頻率重要的原因。結論：本研究調查提供了本國人工呼吸道照護安全現況的資料；雖然人工呼吸道發生意外事件的比例不高，但其後果均相當嚴重。因此，本研究建議，在人工呼吸道照護安全促進方面，仍需加強教育訓練以及引進醫療品質管理的方法。關鍵字: 人工呼吸道、病人安全、呼吸道意外 Objectives: The artificial airway is the most frequently found invasive device on the respiratory distress patient in the acute intensive care unit. Any adverse event caused by the artificial airway may lead to severe complications. The objective of this study was to address the current situation of the artificial airway care safety and the occurrence of the related incidents. Materials & Methods: A questionnaire entitled “The Current Situation of the Artificial Airway Care Safety” was developed according to related literature and opinions of a group of experts. The survey was administrated on critical care, respiratory and pulmonary specialists in Taiwan. Results: One hundred and ninety-eight valid questionnaires were available for analysis. Most respondents are senior critical care specialists, including 124 pulmonary & critical care specialists. More than half of the respondents (73.7%) had experiences in intensive care more than 4 years. It was found that the key factors of adverse events of the artificial airway are higher ratio of patients to medical staff, lack of staff in charge of emergency events, nursing staff in charge of caring patients with the artificial airways, no alarm system attached to the artificial airways, long period of maintenance, different brands of the endotracheal tubes, lack of standardized procedure of materials used to fix the tubes, etc. Conclusions: This study provides the information on the current situation of the artificial airways safety in Taiwan. Though the occurrence of the artificial-airway- related adverse events is few, the outcomes can be severe. Therefore, it is recommended that regular education and implementation of healthcare quality management is essential to improve safety of the artificial airways. Key Words: artificial airways, patient safety, airway accidents
資料類型:	thesis
顯示於類別:	[醫務管理學系暨研究所] 博碩士論文

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