| Summary: | 碩士 === 國立臺灣大學 === 醫療機構管理研究所 === 93 === The World Aliance for Patient Safety created in 2004 ensured that the drive for safer health care is now becoming a worldwide endeavour that can bring significant benefits to patients in countries rich and poor, developed and developing, in all corners of the globe. It provides a mechanism to build capacity, decrease duplication of investment and activities and benefit by economies of scale also. The Patient Safety issue becomes the most important one in 21 th century. There were about 66% cases from surgery who suffered from medical adverse events. But here in Taiwan, there is no knowing about the medical error distributions in surgery, nor do we know the factors which associated with the surgical medical errors.
The study takes surgeons selected out of the community-based level hospitals (including & upon) accredited with the Department of Health ( DOH) in 2003 as the samples. The questionnaire was designed to be aimed at the individual backgrounds, experiences accumulated, professionalism, work conditions, environment, these as the independent variables. The perceived categories of surgical medical error( include diagnosis, preoperative preparation, intra-operative manangement, postoperative monitoring, medicine, communication error) as the dependent variables. A total of 331 copies of the questionnaires were successfully retrieved. The rough estimate indicates a successful retrieval rate of 13.59 %.
The findings yielded through the study indicate that in personal professionalism , surgeons graduated with the degree of master or PHD. responded with fewer medical error than surgeons with MD. Surgeons of more interruptions during surgery responded with more medical errors than those who did not. Surgeons who received more abnormal data remind responded with fewer medical errors than those who did not. Otherwise, the most medical errors was found during postoperative caring & monitoring and diagnosis. And the causes were multifactorial; human engineering,(such as tired, stress, no enough experience) work conditions( such as poor communication with patient & family, poor professionalism, unavailable senior surgeon instrument), organizations factors or team work( such as substandard manpower, short of standard of procedures, administrative deficiency).
Comment: It’s necessary to set up standard taxonomy in surgical medical errors here in Taiwan. The ethical education programs for surgeon should be launched continually. The interruptions during surgery should be forbidden. The abnormal laboratory data should be reminded for surgeons in time.
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