醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701012
王淑芳 王淑芳
{"title":"周產期醫療照護的性別意識—從「消除對婦女一切形式歧視公約」檢視","authors":"王淑芳 王淑芳","doi":"10.53106/199457952023011701012","DOIUrl":"https://doi.org/10.53106/199457952023011701012","url":null,"abstract":"\u0000 性別平等是一種生活態度、一種尊重個別差異的信念價值，而非特定人群的福利。臺灣性別平等表現排名 全球第六，居亞洲之冠。回顧臺灣性平發展歷程，從葉永鋕事件到鄧如雯案，一條命換一個法律修正的平 等歷程，實在太沉重。《CEDAW公約》第12條聚焦消弭對婦女的保健歧視，確保其取得各種計畫生育等保 健服務與權利。本文盤點實證醫學下，臺灣周產期照護落實2018年世界衛生組織提出「正向／積極的待產 照護」現況，以及秉持共享決策促進最佳孕家庭備孕的結果，提供醫療產業實踐不因性別或階級在健康照 護差別待遇的永續生活願景。\u0000 Gender equality pertains to a life attitude and belief in respect toward individual differences and should not be treated as a privilege of specific groups. Taiwan ranks sixth globally and first in Asia in upholding the principle of gender equality. However, the development of gender equality in Taiwan has been achieved through incidents including those of Yeh Yung-Chih and Teng Ju-Weng, in which the amendments of relevant regulations were driven by the loss of innocent lives. Article 12 of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) focuses on eliminating discrimination against women in the field of health care to ensure their access to various health care services, including their rights to family planning. The World Health Organization also advocates the concept of intrapartum care for a positive childbirth experience in 2018. Under the principle of evidence-based medicine, this study examined the implementation of the aforementioned expectant care concept in the perinatal care of Taiwan. The goal was to determine whether shared decision making (SDM) is adopted by physicians and expectant mothers to ensure the optimal pregnancy outcomes. The study results can serve as a reference for the sustainable development of the health care industry through the elimination of discrimination against specific genders or social classes.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115975463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701009
曾嫦嫦 曾嫦嫦, 王馥亭 王馥亭
{"title":"可信賴專業活動於兒癌心理照護之經驗分享","authors":"曾嫦嫦 曾嫦嫦, 王馥亭 王馥亭","doi":"10.53106/199457952023011701009","DOIUrl":"https://doi.org/10.53106/199457952023011701009","url":null,"abstract":"\u0000 本案例報告為試用可信賴專業活動(Entrustable Professional Activities, EPAs)於兒童癌症心理照護臨床教學的經驗分享。對象為1位臨床心理PGY(Post-graduate year)學員在1位臨床教師督導下，於某醫學中心癌童病房執行心理照護，從2020年8月至11月探視16人，計34人次；每次照會，學員及教師分別填寫EPAs即時評量，內涵可對應ACGME(Accreditation Council for Graduate Medical Education)六大核心能力，針對當次照會做即時信賴等級的評量及需加強項目之量化與質性雙向回饋討論。EPAs量化結果呈現教師評核學員專業任務表現之進步，質性討論反映出教學效能增進，可作為總評及勝任能力授權依據。EPAs的推廣需要更多臨床教師的修正討論並試用，以確認其信、效度，優化臨床心理教學效能及照護品質。\u0000 This study describes the experience of a postgraduate clinical psychology student working with children with cancer and their families as part of a training program that incorporated entrustable professional activities (EPAs) into its framework. The student was supervised by a clinical supervisor. The training program involved providing psychological care for 16 children with cancer in the pediatric ward of a medical center from August to November 2020. The student and supervisor both assessed EPAs corresponding to the six general competencies defined by the Accreditation Council for Graduate Medical Education and used quantitative and qualitative two-way feedback to explore the relationship between EPAs and the core competencies. The quantitative results revealed progressive improvement over the different training phases, and qualitative feedback indicated increased comprehension by and self-modification from the student. This information can be used to assess the student’s performance and authorization for managing EPAs. Programs that adopt EPAs would benefit from increased participation by clinical supervisors, who are best positioned to discuss, revise, and support the implementation of EPAs to ensure their reliability and validity, thereby optimizing educational effectiveness and the quality of health-care services.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127769232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701005
黃鈞麟 黃鈞麟
{"title":"社會安全網下的轉型，看見需要而成為必要：花蓮縣身心健康及成癮防治所","authors":"黃鈞麟 黃鈞麟","doi":"10.53106/199457952023011701005","DOIUrl":"https://doi.org/10.53106/199457952023011701005","url":null,"abstract":"\u0000 強化社會安全網計畫自2018年推展以來，於各縣市成立第二期計畫社區心理衛生中心，花蓮縣有別於其他縣市，將心理衛生業務與物質成癮業務整併為花蓮縣身心健康及成癮防治所，同時聘任期精神科專科醫師帶動團隊，整合花蓮縣心理健康相關工作，藉此將民眾需求，透過完善的服務，逐步讓鄉親有感而能體認須對自我身心的重視。\u0000 The project to reinforce social security networks was launched in 2018. In its second phase, Taiwan counties and cities were required to establish community mental health centers. Unlike other counties and cities, Hualien County integrated the businesses of mental health and substance addiction to establish the Hualien County Center for Mental Health and Prevention of Addiction. The center recruited psychiatrists to lead the integration of mental health–related services in Hualien County to provide comprehensive services catering to people’s needs. With time, the center will increase Hualien residents’ acknowledgement and recognition of the importance of physical and mental health. \u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126516416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701008
吳慧菁 吳慧菁, 何建忠 Hui-Ching Wu
{"title":"臺灣心理衛生社工於社區心理衛生中心之布建","authors":"吳慧菁 吳慧菁, 何建忠 Hui-Ching Wu","doi":"10.53106/199457952023011701008","DOIUrl":"https://doi.org/10.53106/199457952023011701008","url":null,"abstract":"\u0000 社區心理衛生照護模式是以病人居家照護為主軸，提供精神病人社區生活支持體系，協助並結合家庭照顧者的精神疾患的服務模式，推動心理衛生照護的可近性、可及性與在地化，預期至2025年，全國將設置71處社區心理衛生中心，針對心理脆弱族群的早期介入，結合社區資源，因應需求，提升全國的心理健康知能、心理適應、韌力與復原能力。心理衛生社工員（師）評估個案與家庭的核心問題，協調跨專業合作，整合心理衛生、保護性、家庭、司法與法律等社會工作領域，透過個別性的服務計畫，提供連續性、支持 性精神病人照護\u0000 Community mental health care is a medical service model that centers on patient home care, provides psychiatric patients with a community life support system, and involves assistance from family caregivers. This in turn promotes the proximity, accessibility, and localization of mental health care. A total of 71 community mental health centers are expected to be constructed by 2025 to provide early interventions to psychologically vulnerable groups. Accordingly, community resources will be incorporated to fulfill the needs of these groups, improving the mental health literacy, psychological adaptation, and resilience of psychiatric patients across Taiwan. Mental health social workers are tasked with assessing the core problems facing case patients and their families; coordinating interdisciplinary collaborative care; integrating resources from various social work fields, including mental health, protective, family, judicial, and law fields; and providing continual and supportive psychiatric care through individualized service plans. They are also in charge of reinforcing the medical referral system and using multicultural and strength-oriented perspectives in social work to support and assist psychiatric patients in community life.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114156752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"以病人為中心的整合照護—義大醫院經驗分享","authors":"吳姵錡 吳姵錡, 紀淑靜 紀淑靜, 葉日熹 Shu-Ching Chi, 袁立仁 袁立仁, 劉子熒 劉子熒, 王蕾伊 王蕾伊, 侯傑議 侯傑議, 林佳貞 林佳貞","doi":"10.53106/199457952023011701010","DOIUrl":"https://doi.org/10.53106/199457952023011701010","url":null,"abstract":"\u0000 義大醫院的宗旨為品質、卓越與創新。我們的策略目標是成為南臺灣社區健康的靠山，為了達到以病人為中心整合照護的價值，我們建置有效的品質監測及臨床稽核機制，以達到良好的品質成果，指標皆穩定達閾值之上。為達卓越與創新，每年會重新檢視監測品質指標項目，並依據照護服務執行狀況進行指標項目調整。本團隊與物理治療師著重個別性衛教指導及專門的諮詢管道，更結合長照2.0多元復能轉介，減輕病人在面對術前焦慮及術後復原的不安，增加居家自我照護能力。面臨臺灣老化社會，義大醫院關節置換術疾病照護團隊努力讓南臺灣的高齡者，擁有良好的生活品質。\u0000 The mission of E-Da Hospital is to strive for excellence, to innovate, and to provide high-quality services. Our strategy is to be a beacon of health in South Taiwan. To ensure patient-centered integrated care, we have implemented a quality management system and clinical audits to provide precise services to the highest level of excellence in all areas. Every year, all items are re-examined and adjusted in accordance with the status of the program. In combination with multifunction rehabilitation and Long-Term Care Service 2.0 , our team of physical therapists focuses on individualized education and professional consultation to reduce patients’ anxiety before and after surgery and increase their self-care abilities. As the population of Taiwan ages, our joint replacement team is taking a major step forward in advancing the quality of life for elderly people.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132078847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701004
王瑜鈞 王瑜鈞, 黃昱姗 Yu-Jun Wang
{"title":"彰化縣社區心理衛生中心實務經驗分享","authors":"王瑜鈞 王瑜鈞, 黃昱姗 Yu-Jun Wang","doi":"10.53106/199457952023011701004","DOIUrl":"https://doi.org/10.53106/199457952023011701004","url":null,"abstract":"\u0000 本文為彰化縣社區心理衛生中心的實務經驗介紹：一、服務佈點：配合社會安全網全力推動轄區內服務佈點，以八大生活圈規劃1中心8副中心27據點；二、個案管理為共同照護整合服務，以家庭為中心，發掘「潛在個案」並給予協助及資源連結。三、簡介中心6項特色服務：1.高齡者整合式健康檢查（4D健檢）、2.物質濫用防治—菸害防制教育、3.物質濫用防治—第三、四級毒品危害講習、4.精神病友照顧者成長團體、5.長照2.0家庭照顧者支持網絡計畫、6.安寧居家療護；四、人員訓練機制。期能讓各界更了解地方社區心理衛生中心提供的服務與資源，照顧需要的病友，進而減緩家庭照顧者之壓力。\u0000 This article introduces the practical experiences of the Changhua County Community Mental Health Center. Part I. Service deployment. Changhua County Government has aligned itself with the effort to establish a social safety net and has established service locations across 8 regions of the county, with services available at 1 center, 8 subcenters, and 27 other locations. Part II. Case management. It involves shared care and integrated services that are family-centered. We identify potential cases of mental illnesses, provide them with assistance, and connect them with resources. Part III. Brief introduction to the 6 featured services of the center. (1) Integrated geriatric health check (a.k.a. the 4D health check). (2) Substance abuse prevention: tobacco hazard prevention education. 3. Substance abuse prevention: Lectures on the hazards of Category 3 and Category 4 narcotics. 4. Growth group for caregivers of patients with mental illnesses. 5. Long-term Care 2.0 Plan’s family caregiver support network program. 6. Hospice home care. Part IV. Personnel training. We hope to offer further understanding to the services and resources provided by local community mental health centers, to care for patients, and to ameliorate the stress of family caregivers. \u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125465561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701006
陳嘉容 陳嘉容, 馮瑞鶯 馮瑞鶯, 王維芳 Jui-Ying FENG
{"title":"新冠肺炎疫情下應用陪病訪客資訊系統管理成效評估之探討","authors":"陳嘉容 陳嘉容, 馮瑞鶯 馮瑞鶯, 王維芳 Jui-Ying FENG","doi":"10.53106/199457952023011701006","DOIUrl":"https://doi.org/10.53106/199457952023011701006","url":null,"abstract":"\u0000 目的：評估陪病訪客資訊系統應用之使用現況與管理成效。方法：疫情期間護理部與資訊室共同規劃建置此系統，分析2021年7月起一年內登錄於系統內資料筆數與登錄資料、查詢檢驗報告或疫苗施打狀態所需花費時間，分析其成本效益。結果：應用陪病與訪客管理資訊系統，包含(1)陪病及訪客登錄平台；(2)陪病者採檢提醒平台及(3)統計管理報表平台。資料收集期間共登錄27萬0836陪病人次、7萬2148訪客人次。相較使用此系統前後護理師登錄時間每位陪病者可顯著節省64.6%時間 (t=7.10, p< .000)、訪客則節省62.4%的時間(t=8.50, p< .000)，同步連動顯示檢驗報告可節省63.9%查詢快篩檢核資料時間(t=5.95, p< .000)。結論：結合資訊管理系統有效控制感染來源，減少隱形傳染鏈，減輕臨床工作負擔，降低失誤，並能整合檢驗與疫苗資訊，增進管理及防疫效果。\u0000 Purpose: To evaluate a digital system for ensuring compliance with patient visitor regulations in hospitals during the COVID-19 pandemic. The digital system was intended to reduce the time required to collect information and vaccination status from people accompanying patients (patient companions) and hospital visitors.Materials and methods: The visitor information management system was jointly established by the Nursing Department and the Information Office and comprised (1) patient companion and visitor login, (2) inspection reminder , and (3) statistical reporting systems. System logins were collected from July 2021 to July 2022 and evaluated to determine whether the system is cost effective.Results: During the data collection period, 270,836 patient companions and 72,148 visitors were registered. Compared with the previous system, nurses spent 64.6% less time logging in each patient companion (t = 7.10, p < .000 ) and 62.4% less time for visitors (t = 8.50, p < .000). Hence, synchronizing and linking inspection reports can reduce the time required for information collection by approximately 63.9% (t = 5.95, p < .000). Conclusion: The information management system can effectively identify sources of infection and reduce the invisible chain of infection while also reducing the amount of clinical work and number of errors. It also integrates patient information and vaccination status to improve hospital management.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116085863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"2022臺灣智慧醫療發展現況調查","authors":"林宛儀 林宛儀, 林勤真 Wan-I Lin, 鍾翰其 Chin-Chen Lin, 洪聖惠 Han-Chi Chung, 王拔群 Sheng-Hui Hung, 郭惠雯 Pa-Chun Wang, 饒孝先 Hui-Wen Kuo, 徐珮嘉 Hsiao-Hsien Rau","doi":"10.53106/199457952023011701001","DOIUrl":"https://doi.org/10.53106/199457952023011701001","url":null,"abstract":"\u0000 世界衛生組織不僅將智慧醫療（eHealth）定義為資通訊科技在醫療及健康領域的應用 ，亦認為數位科技（Digital technologies）有助於推進全民健康覆蓋以及健康福祉相關的永續發展目標 ，衛生福利部第九期醫療網，亦將創造具韌性且智能的醫療照護體系訂為總目標之一。財團法人醫院評鑑暨醫療品質策進會持續於本（2022）年度進行全國醫院智慧醫療發展問卷普查。在疫情影響下，視訊診療、數位學習系統及遠距教學等導入比率較高，而環境管理智慧化導入則相較門急住診等應用要來得低。AI技術的應用是醫學中心未來一年的發展重點，非醫學中心則放在資訊安全。醫院政策、醫療人員需求及衛生政策分別為前三項推動的關鍵因素，差別在於地區醫院更看重醫院政策與衛生政策。\u0000 The World Health Organization defined eHealth as “the use of information and communications technology in support of health and health-related fields”, and it considered digital technologies conducive to promoting universal health coverage as well as to sustainable development goals related to health and welfare. The ninth phase of the medical network of the Ministry of Health and Welfare has established one of its overall goals as establishing a healthcare system that is resilient and smart. As in the past, in 2022, the Joint Commission of Taiwan continued to conduct a census of the development of eHealth in medical institutions in Taiwan. Affected by the COVID-19 pandemic, video teleconferencing for disease diagnosis and treatment, digital learning systems, and distant teaching have been more widely introduced compared to the application of environmental smart management in outpatient clinics, emergency departments, and inpatient clinics. In the following year, the application of artificial intelligence technology will be a key development point for medical centers; by contrast, the focus of non-medical centers will be information security. The top three key factors for promoting eHealth among medical institutions will be hospital policies, medical personnel demands, and health policies, with the only difference being that local community hospitals will focus more on hospital policies and health policies.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124534763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701002
徐淑婷 徐淑婷
{"title":"協助精神病人跨越社區生活障礙：康復導向個案管理","authors":"徐淑婷 徐淑婷","doi":"10.53106/199457952023011701002","DOIUrl":"https://doi.org/10.53106/199457952023011701002","url":null,"abstract":"\u0000 個案管理是社區精神病人精神照護服務的核心工作，而社區心理衛生中心在新版的精神衛生法中被賦予此項職責。已有明確的個案管理實證研究指出，資源連結模式有其侷限，而有效的元素包含穩固的治療性結盟、外展服務與為其需求提供連續性與整合性的服務。呼應衛生福利政策白皮書「以人為中心，社區為導向，康復為目標」的宣示，本文建議在精神病人個案管理服務中，康復導向應與問題導向並重，採用實證與促進康復的工作方法，並重視社區心理衛生中心對於服務使用者的心理與社會的可近性。方法包括：在分級納入康復的指標、彈性調整外展服務的焦點、將同儕納入個案管理服務中，以及架構社區心理衛生中心各類員工的康復導向在職教育訓練。\u0000 Case management is a core service in community mental health care for people with major mental illness and a responsibility granted to community mental health centers by the new Mental Health Act of 2022. Empirical case management studies have reported that limitations exist in broker model. Studies also reveal that effective elements include strong therapeutic alliance, outreach services, and needs-based continual and integrated services in case management process. In response to the White Paper of the National Health and Welfare Policy 2025 in which person-centered, community-oriented, and recovery-targeted care is emphasized, we suggest that case management services targeting people with psychosis be both recovery-oriented and problem-oriented. Evidence-based and recovery-promoting care approaches should be adopted, and emphasis must be placed on the psychological and social accessibility of the community mental health centers to service users. This involves introducing recovery indicators into the client grading system, flexibly adjusting the focus of outreach services, involving peer support and workers in case management services, and establishing recovery-oriented on-the-job education for all employees in community mental health centers.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"159 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125229573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
醫療品質雜誌Pub Date : 2023-01-01DOI: 10.53106/199457952023011701007
蘇芝庭 蘇芝庭, 戴宏達 戴宏達, 袁秋榮 袁秋榮
{"title":"住院期間非計畫性重返手術室之相關因素探討","authors":"蘇芝庭 蘇芝庭, 戴宏達 戴宏達, 袁秋榮 袁秋榮","doi":"10.53106/199457952023011701007","DOIUrl":"https://doi.org/10.53106/199457952023011701007","url":null,"abstract":"\u0000 目的：本回溯性研究是探討病人住院期間非計畫重返手術室(Unplanned Return to the Operating Room, UROR)的情形。方法：研究資料來源收集2015至2019年住院手術病人，以描述性統計分析病人基本、手術屬性及年度分布，以卡方、獨立t檢定及邏輯斯複迴歸進行推論性統計檢定。結果：研究期間UROR共658人次，發生率1.25%；發生科部前四名是口腔醫學部、婦產部、神經醫學部及外科部共佔總發生率77.51%。邏輯斯複迴歸分析結果發現男性、年齡調整後查爾森共病指數越高、手術傷口分級越髒及全身麻醉，發生UROR的機率會上升，而發生UROR的前三大原因為感染、前次手術未達預期功能及出血。結論：UROR是監測手術醫療品質的重要指標，醫院管理者及外科團隊應瞭解發生原因，擬訂適當照護策略以提升整體醫療品質。\u0000 Purpose: This retrospective study aimed to explore the risk factors for and causes of unplanned return to the operating room (UROR) during hospitalization.Methods: Data on inpatient surgical patients were collected from 2015 to 2019. Descriptive statistics were used to analyze the patients’ demographic and clinical characteristics and their annual admission rates. A chi-square test, independent t test, and logistic regression analysis were used.Results: The number of instances of UROR and rate of UROR were 658 and 1.25%, respectively.The most frequented departments were dentistry, gynecology, neurology, and surgery, accounting for 77.51% of the total rate. The logistic regression analysis revealed that male sex, older age (using age-adjusted Charlson comorbidity index), poor wound management, and the use of general anesthesia were the risk factors for UROR. Infection, primary surgery failure, and bleeding were the most common causes of UROR.Conclusion: UROR can be used as a key indicator for quality of care in surgery. Hospital administrators and clinicians should recognize the risk factors for UROR and develop appropriate treatment strategies to improve the overall quality of medical care.\u0000 \u0000","PeriodicalId":260200,"journal":{"name":"醫療品質雜誌","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126298075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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