救護技術員嗜睡程度與救護安全之相關性探討

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Title:	救護技術員嗜睡程度與救護安全之相關性探討 Association between Sleepiness and EMS Safety Outcome among EMS Providers in Taiwan
Authors:	黃尹俊;Jack Yin-Chun Huang
Contributors:	醫務管理學系碩士在職專班
Keywords:	緊急救護;救護技術員;救護安全;EMS;EMT;EMS Safety
Date:	2015-07-21
Issue Date:	2015-11-04 17:05:51 (UTC+8)
Publisher:	中國醫藥大學
Abstract:	目標：119救護技術員提供民眾遭遇緊急傷病時的及時的第一線緊急救護，但因備勤時間過長，研究指出約有70%具有睡眠不良情形。嗜睡為睡眠不良之具體生理現象，其不僅影響工作表現，更危害工作安全。本研究主要探討119救護技術員嗜睡程度與救護安全之相關性。方法：利用問卷調查法取得研究資料，抽樣方法採用便利抽樣。問卷含四大構面：人口學特徵、服勤狀況、愛普沃斯嗜睡量表、救護安全量表。受試者共500名，分別隸屬於台灣北中南東41隊專責救護隊之救護員，並依其2014年9至11月值勤實況匿名填答；所得資料使用複回歸及羅吉斯回歸進行分析。結果：問卷總計回收399份(回收率為79.8%)，有效問卷為347份(69.4%)。其中36.9%的受試者屬輕度嗜睡、39.2%屬過度嗜睡。多變量分析結果顯示，嗜睡程度越嚴重，救護安全表現越差：受傷構面(P<0.05)、異常事件構面(P<0.05)、安全忽視行為構面(P<0.01)。此外，相對於正常的受試者，過度嗜睡者具有2.2倍的受傷風險(OR = 1.95, 95% CI = 1.07-4.71)、2.4倍針紮風險(OR = 2.44, 95% CI = 1.08-5.52)、2.6倍未執行呼吸道處置風險(OR = 2.63, 95% CI = 1.05-6.57)。結論：本研究呈現台灣2014年9月至11月119救護員嗜睡程度與救護安全之相關，希望提供決策者有效資訊，做為未來制訂相關政策，提升救護安全之參酌。 Background: Prior research reported that sleepiness impaired staff's performance in various occupations and increased adversities in health care fields. However, the impact of daytime sleepiness on pre-hospital emergency medical service is still unknown. Objective: The aim of this study was to investigate association between sleepiness and self-reported EMS safety outcomes among EMTs in Taiwan. Methods: In this cross-sectional study, a convenience sampling design was used . Structured questionnaires were administrated in early Dec 2014, measuring respondent's status within the past 3 months. Sleepiness and EMS safety outcomes were measured with the Epworth Sleepiness Scales and a modified 25-item EMS Safety Inventory, respectively. Inferential statistic was calculated with Multiple regression and Logistic regression. Results: We received 399 surveys from 41 EMS squads located in northern, central, southern, and eastern Taiwan (79.8% response rate). 36.9% and 39.2% of respondents were identified as mild daytime sleepiness and excessive daytime sleepiness. Multivariate analysis showed the more sleepiness status, the worse safety outcome in main safety dimension: injury (P < 0.05), adverse event (P < 0.05), and safety compromised behaviors (P < 0.01). Compared to normal group, excessive sleepiness respondent had higher risk of injury (OR = 1.95, 95% CI = 1.07-4.71), needle stick (OR = 2.44, 95% CI = 1.08-5.52), and disestablished airway of OHCA (OR = 2.63, 95% CI = 1.05-6.57). Conclusion: The association between EMT's daytime sleepiness and EMS safety outcomes in Taiwan has been identified. It carries policy implications for EMS Safety.
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