| Abstract: | 本研究主旨在探討外勤消防人員面對不同輪班制度與救護案件數量時，對到院前救護品質之影響，以全臺外勤消防人員為研究對象，取共121名進行問卷調查研究，有效樣本為119份。調查所得資訊以描述性統計、信度分析、平均數與標準差、獨立樣本t檢與單因子異變數分析進行分析，本研究獲得以下結果：
一、到院前救護品質方面，以「運送病患過程中，會隨時注意患者情形變化」項目（5點尺度，平均值為4.61）為最高分。
二、到院前救護品質方面，「對有呼吸雜音的患者進行抽吸」項目（5點尺度，平均值為2.73）為最低分。
三、救護勤務輪班方式中，輪值時數不同之救護副班，對到院前救護品質之「以傷病患感覺較舒服的姿勢後送」及「確認患者末梢循環是否良好，並給予相對應處置」二項目有顯著差異性之影響，其中特定較長時數表現比短時數排班優異。
四、救護勤務輪班方式中，不同出勤救護車數量在「移動傷病患到上車過程中，常忽略環境安全條件變化」項目中達顯著差異性之影響，2臺以上救護車出勤分隊表現較一臺優異。
五、救護勤務案件數量方面，經統計分析後，未發現有顯著變異性之影響。
六、救護人員對於傷患處置及送醫地點遠近選擇，會被救護案件數量及鄰近換班時間影響，且呈現顯著負相關。
七、人口學變項方面，不同消防工作年資在「對有呼吸雜音的患者進行抽吸」項目達顯著差異性之影響，其中特定較長年資表現比新進人員優異。
本研究結論，如下：
一、將每日24小時救護班勤務分成3-4時段執行，當天正班人員固定深夜勤時段，其餘時段由固定人員輪流執行，且將每月勤務編排表先行公告同仁知曉。
二、在分隊每月定期編排的救護訓練中實際操作器材及情境流程，針對不熟練之步驟加以練習，並且不分年資多寡每人均須輪流操作。
三、對於不常見之救護情境增加演練次數，並請實際執行過類似案例同仁分享經驗，並說明該項救護處置原由或如何發現傷病患異狀。
The main purpose of this study is to investigate the effect of ambulance service shift mode and number of ambulance cases on the quality of emergency ambulance. This thesis regard firefighter of Taiwan as research object. A total of 121 questionnaires were randomly selected for questionnaire survey, and the effective sample was 119. The surveyed information was analyzed by descriptive statistics, reliability analysis, mean and standard deviation, independent sample t-test and single factor-variable analysis. The study obtained the following conclusions:
1. In terms of the quality of pre-hospital care, the item “5 points, average value 4.61” is the highest score in the “EMT well keep the patient under observation on the way to emergency room”.
2. In terms of the quality of pre-hospital care, the item “5 points, average value 2.73” is the lowest score in the “suctioning of patients with respiratory noise”.
3. In the ambulance service shift mode, the ambulance deputy classes with different number of rotation hours are sent to the pre-hospital ambulance quality to "send a comfortable posture to the patient" and "confirm whether the patient's peripheral circulation is good and give corresponding treatment" There is a significant difference between the two, where a particular longer time performance is better than a short time schedule.
4. In the ambulance service shift mode, the number of different attendance ambulances is significantly different in the project of “moving patients to the ambulance, often overlooking changes in environmental safety conditions”. More than two ambulance attendance units perform better than single unit.
5. Through statistical analysis, there was no significant variability in the number of ambulance service cases.
6. The choice of ambulance personnel for the location of the injured and the location of the medical treatment will be affected by the number of ambulance cases and the time of the nearby shift, and there is a significant negative correlation.
7. In terms of personal background context, different firefighting seniority have a significant difference in the “suctioning of patients with respiratory noise”, and the specific long-term performance is better than that of new recruits.
Based on the statistical analysis results, the conclusions of this study are as follows:
1. The daily 24-hour ambulance service is divided into 3-4 time slots. The regular staff on the day is fixed for the late-night service hours. The rest of the time is executed by the fixed personnel in turn, and the monthly service schedule is announced first.
2. In the ambulance training that is regularly scheduled monthly, the actual operation equipment and situational processes are practiced, and the unskilled steps are practiced, and each person is required to take turns in rotation regardless of the amount of seniority.
3. For the special ambulance situation, increase the number of exercises, and please actually share the experience of colleagues in similar cases, and explain the cause of the ambulance or how to find the abnormality of the patient. |
