護理業務的高壓力、多衝突及頻繁的人員流動，一直是護理行政者所關注的議題。本研究的目的為探討護理人員護理業務糾紛之經驗，包括：護理人員護理業務糾紛的發生頻次及困擾程度、對糾紛的感受，及糾紛經驗對護理人員留任或離職的影響。本研究將護理人員照護病人相關的工作活動內容，分成：行政作業相關業務、護理處置業務、醫療處置業務、及護病溝通等四個構面，並整理出27項常見護理業務糾紛項目。採問卷調查法，以中部某醫學中心13個內外科病房，任職滿3個月的護理人員為收案對象，共得有效問卷275份。研究發現：四個構面中，發生頻次最高及最困擾護理人員的是 “行政作相關業務”。其他構面中，以影響病人病情及安全的糾紛項目，對護理人員的困擾會比較大。而護理人員護理業務糾紛發生的頻次、困擾程度及對糾紛的感受等，均和離職的想法呈顯著相關。因此建議：加強病人醫療業務相關的行政作業流程之改善、持續推動以病人安全為中心的護理業務、糾紛處理過程應傾聽護理人員的心聲，以減少護理業務糾紛的發生，降低護理人員離職的想法。 Nursing staff always work under pressure and in conditions of frictional disputes; the unstable personnel are also a major concern for the Nursing administration. This research probes into the medical disputes related to nursing practice including the frequency of disputes, the bothering degree of the disputes, and the feeling of staff. Furthermore, the experience of handling the disputes causing nursing staff demission of personnel is also lined up in the discussion of this research. This research sorted out 27 items of nursing practice disputes and grouped them into four major categories: nursing administration affair, nursing intervention practice, medical intervention practice, and nurse?patient relationship. In this research, a total of 275 valid samples were collected from the nursing staff who have worked in the medicine and surgical wards for at least 3 months (samples were from 13 medicine wards in a medical center located centrally within Taiwan). Results showed that the nursing administration affair is the most tormented area where the frequency of disputes within the nursing staff was very high. The medical disputes of nursing practice caused due to safety consideration and of patients’ condition were the biggest concern. This research also found that the frequency of disputes, the degree of botheration due to medical disputes, and the feeling of nursing staff all are strongly related to unstable personnel. Therefore, to combat such situations of medical disputes in nursing practice, this research recommends the following major action items: improve the work flow of the nursing administration affair; carry out necessary nursing intervention practices for patients’ safety centered; and listen to the concerns of nursing staff who encounter difficult situation to help increase the stability of the personnel.
