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从台湾护理视角看预防医疗纠纷的危机干预与行动的模型测试

Model testing on the crisis interventions and actions to prevent medical disputes: a Taiwanese nursing perspective.

作者信息

Tzeng Huey-Ming

机构信息

Nursing Department, I-Shou University, Kaohsiung, Taiwan.

出版信息

J Clin Nurs. 2006 May;15(5):554-64. doi: 10.1111/j.1365-2702.2006.01365.x.

Abstract

AIMS AND OBJECTIVES

This study investigated the contributions of comprehensiveness and necessity scales on crisis interventions and actions toward nursing practice-related medical disputes in Taiwanese hospitals and institutions' demographic characteristics, to overall satisfaction toward nursing-related crisis management policies and interventions and overall satisfaction toward their institution's crisis management system.

BACKGROUND

In a health-care environment that is focused on cost containment, for overworked nurses and understaffed medical wards, patients still expect nurses to provide high quality, compassionate care. Patients usually regard nurses as the principal link between the technical and interpersonal aspects of their care. However, current hospital systems tend to require patients to be self-reliant in managing their own care. Patient mistrust of medical care providers might have contributed to the current medical error/dispute crisis.

METHODS

In this cross-sectional study, the subjects were nursing directors of Taiwanese hospitals (197 valid subjects). The author developed the questionnaire used in this study.

RESULTS

The ordinal logistic regression analyses demonstrated that being a public hospital managed by the government, being a hospital operated by a corporate body, the more comprehensive the technical/structural aspect and the assessment aspect and the more needed the psychological aspect, contribute to higher general satisfaction levels toward nursing-related crisis management. The more comprehensive the strategic aspect and having more acute beds, contributes to higher satisfaction levels with their institution's overall crisis management activities.

CONCLUSIONS

These findings inferred a possible change in a hospital's resource allocation or power structure when dealing with issues of patient care quality, including nursing practice-related crisis management policies, interventions and actions. RELEVANT TO CLINICAL PRACTICE: A good crisis management system may help to keep a crisis from worsening, which might lead to a serious situation that includes malpractice litigation. It is believed that the questionnaire used in this study may be used as a diagnostic tool for assessing a crisis management system within a hospital's nursing environment.

摘要

目的与目标

本研究调查了全面性和必要性量表对台湾医院与护理实践相关医疗纠纷的危机干预及行动、机构人口统计学特征,以及对护理相关危机管理政策和干预措施的总体满意度和对机构危机管理系统的总体满意度的贡献。

背景

在注重成本控制的医疗环境中,对于过度劳累的护士和人员配备不足的医疗病房,患者仍期望护士提供高质量、富有同情心的护理。患者通常将护士视为其护理技术和人际方面的主要纽带。然而,当前的医院系统往往要求患者在管理自己的护理方面自力更生。患者对医疗服务提供者的不信任可能导致了当前的医疗差错/纠纷危机。

方法

在这项横断面研究中,研究对象为台湾医院的护理主任(197名有效对象)。作者编制了本研究中使用的问卷。

结果

有序逻辑回归分析表明,作为政府管理的公立医院、作为企业机构运营的医院、技术/结构方面和评估方面越全面以及心理方面越必要,对护理相关危机管理的总体满意度越高。战略方面越全面且急性病床越多,对机构整体危机管理活动的满意度越高。

结论

这些发现推断,在处理患者护理质量问题时,包括与护理实践相关的危机管理政策、干预措施和行动,医院的资源分配或权力结构可能会发生变化。与临床实践的相关性:良好的危机管理系统可能有助于防止危机恶化,否则可能导致包括医疗事故诉讼在内的严重情况。据信,本研究中使用的问卷可作为评估医院护理环境中危机管理系统的诊断工具。

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