長期照顧服務法律風險管理之研究

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Title:	長期照顧服務法律風險管理之研究
Other Titles:	A Study of the Legal Risk Management on Long Term Care service
Authors:	郭淑珍 Kuo, Shu-Chen
Contributors:	莊晏詞;施茂林 Chuang, Yen-Tzu;Shih, Mao-Lin 財經法律學系
Keywords:	法律風險管理;預防策略;長期照顧服務;長照人員;照顧訴訟 prevention strategy;legal risk management;long-term care personnel;long-term care service;care litigation
Date:	2023
Issue Date:	2023-11-22 01:17:07 (UTC+0)
Abstract:	由於接受長期照顧的人口迅速增加，照顧疏忽及其訴訟案件也隨之增加，近年來，長照服務訴訟案件層出不窮。本研究收集2002年至2021年164件法院判決文，採用量性與質性整合性研究方法，從長照接受者（即原告）的角度，分析照顧疏失類型及其風險因素。結果發現：1、照顧疏失以住宿型機構案例為多，而居家式、社區式自2017年起呈增加趨勢；2、提出訴訟者以子女和家屬最多(77.68%)；被告對象以機構雇主最多(98.17%)，其次是照服員、護理人員；受照顧者傷害嚴重度死亡(59.15%)最多；原告勝訴率33.54%；3、疏失類型前五項為：跌倒、哽咽、病情變化、感染、高處墜落；4、整體而言，技術性照顧疏失(64.02%)高於組織性照顧疏失(35.98%)；(1)技術性照顧實務(34.20%)，次類型：照顧處置、不適當的照顧干預、進食/餵食/管灌技術；(2)技術性照顧支援(29.82%)，次類型：專業警覺性不足、延誤送醫和溝通；(3)組織性照顧實務(6.29%)，次類型：照顧流程未落實、個人照顧衛生不良；(4)組織性照顧支援(29.69%)，次類型：人員管理、環境設施安全和清潔、照顧相關記錄等。研究結果可供長照機構管理者與長照人員警惕。建議(1)強化法律風險教育訓練；(2)施行強制性異常/意外事件報告制度；(3)機構應確實建立標準作業流程與管理，主管機關應列為評鑑必要項目；(4)應定期查核與修復設施與環境清潔，以提高長照服務安全和照顧品質。 Due to the rapid increase in the population receiving long-term care. so has the incidence of nursing negligence and its litigation. In recent years, long-term care service lawsuits have emerged in endlessly. The purpose of this study is to from the perspective of long-term care recipients (namely plaintiffs), analysis the types of neglect and their risk factors. with judgments for 164 cases spanning from 2002 to 2021 collected. This study adopts a integrative research method combining quantitative and qualitative methods. Finding:1. Long-term care failures are mostly cases of accommodation institutions. The home-based or community-based have increased since 2017; 2.The plaintiffs are mostly children and family members (77.68%); The majority of defendants are employers (agencies or institutions) (98.17%), secondly are nurse aid and nursing staff; The rate of plaintiffs obtaining satisfaction of a claim is 33.54%, 3. The top five primary types of negligence are: falls, choking, changes in medical conditions, infections, and fall from height (FFH). Overall, technical care negligence (64.02%) is higher than organizational care negligence (35.98%); 1.technical care negligence (34.20%), with subtypes neglect: care practices , inappropriate care interventions, feeding or tube-feeding technique neglect, 2.technical care support (29.82%), with subtypes : insufficient professional alertness, delayed hospitalization, and communication errors. 3.Organizational care negligence(6.29%), with subtypes like failure to implement care processes and poor hygiene; 4. Organizational Care Support (29.69%), with subtypes including personnel management, environmental facility safety and cleanliness, and omissions in care-related records. The findings can provide long-term care institutions as references in management and practices. This Study suggests the following conducts: (1) legal education and training shall be strengthened; (2) mandatory exception/incident reporting systems shall be implemented; establish their standard operation procedure and managements, and competent authorities shall include these establishments as items required under evaluations; and (4) regular inspections and immediate recovery of environmental cleanliness and facilities as well as caregiver alertness and sensitivity enhancement shall be conducted to improve the safety and quality of long- term care services.
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