河南省某三级综合性中医院护理人员对患者安全文化认知现状调查
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摘要
目的:了解河南省某三级综合性中医院护理人员对患者安全文化认知情况,为提高患者安全管理质量指明方向。方法:随机选取河南省某三级综合性中医院600名临床护理人员,采用中文版医院患者安全文化调查表(HSOPS)进行调查。对研究结果进行描述性统计分析、卡方检验、Logistic回归分析及等级相关检验(Spearman)。结果:本组护理人员组织学习与持续改进、管理者促进安全的期望与行动、科室团队合作、对患者安全的管理支持、科室间协作、对错误的反馈与沟通6个维度积极反应率均>70%,为患者安全文化优势领域;事件报告频率、沟通的公开性、人员配置、对错误的非惩罚性反应4个维度积极反应率均<50%,为患者安全文化劣势领域即待改进领域;86.4%的护理人员对所在科室患者安全总体评价为优秀或良好。不同科室之间不良事件报告数量有统计学差异(P<0.01),是否与患者直接接触与患者安全总体评价有关,每周工作时间与患者安全总体评价有关(P<0.01)。结论:护理人员对于患者安全文化总体较好,但非惩罚性文化、不良事件报告频率、人员配置方面仍需改进。
Objective: To understand the status of safety culture cognition of the nursing staff in a top level comprehensive Chinese medicine hospital in Henan Province,so as to provide reference for effective patient safety management. Methods: A total of 600 clinical nurses in a top level comprehensive Chinese medicine hospital in Henan Province were randomly selected. Descriptive statistical analysis,chi square test,Logistic regression analysis and grade correlation test( Spearman) were carried out. Results: This group of nursing staff' s positive reaction rate of 6 dimensions including organizational learning and continuous improvement and management,promotion on safety expectations and actions,group cooperation,the management of patient safety support,collaboration between departments,the error feedback and communication was over 70%,with advantages in the field of safety culture. The 4 dimensions' positive reaction rate was less than50%,including the incident frequency,the openness of communication,personnel allocation,non-punitive response to errors,that means it need to be improved,called the inferior field. 86. 4% of the nurses were excellent or good at the overall evaluation of the safety of the patients in the department. The number of adverse events reported by different departments was statistically different( P < 0. 01). Whether he direct contact with patients is related to the overall assessment of patient safety and the working time per week is related to the overall assessment of patient safety( P < 0. 01). Conclusion: The nursing staff has a good overall safety culture,but the non-punitive culture,the frequency of adverse event report,and the staffing need to be improved.
Objective: To understand the status of safety culture cognition of the nursing staff in a top level comprehensive Chinese medicine hospital in Henan Province,so as to provide reference for effective patient safety management. Methods: A total of 600 clinical nurses in a top level comprehensive Chinese medicine hospital in Henan Province were randomly selected. Descriptive statistical analysis,chi square test,Logistic regression analysis and grade correlation test( Spearman) were carried out. Results: This group of nursing staff' s positive reaction rate of 6 dimensions including organizational learning and continuous improvement and management,promotion on safety expectations and actions,group cooperation,the management of patient safety support,collaboration between departments,the error feedback and communication was over 70%,with advantages in the field of safety culture. The 4 dimensions' positive reaction rate was less than50%,including the incident frequency,the openness of communication,personnel allocation,non-punitive response to errors,that means it need to be improved,called the inferior field. 86. 4% of the nurses were excellent or good at the overall evaluation of the safety of the patients in the department. The number of adverse events reported by different departments was statistically different( P < 0. 01). Whether he direct contact with patients is related to the overall assessment of patient safety and the working time per week is related to the overall assessment of patient safety( P < 0. 01). Conclusion: The nursing staff has a good overall safety culture,but the non-punitive culture,the frequency of adverse event report,and the staffing need to be improved.
引文
[1]陈雪.患者安全重落实护理人员承重任——访中国医院协会常务副会长兼秘书长薛晓林[J].中国护理管理,2017,17(3):317-318.
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[5]AHRQ.2012 User Comparative Database Report.[2011-11-25].http://www.ahrq.gov/professionals/quality-patient safety/patientsafetyculture/hospital/2012/index.html.
[6]黄颖,张雪梅,袁欣,等.医疗不良事件发生与上报情况差异性分析[J].中国卫生事业管理,2016,33(8):575-577.
[7]Karen L,Hannah MBA,Charles P,et al.Hospital administrative staff vs.nursing staff responses to the AHRQ hospital survey on patient safety culture[J].Chapter,2008,7(20):56.
[8]崔颖,席修明,张进生,等.医疗安全不良事件报告的现状调查及影响因素分析[J].中国医院管理,2013,33(10):13-15.
[9]Dalton GD,Xanthia F,Samaropoulos,et al.Improvements in the safety of patient care can help end the medical malpractice crisis in the United States[J].Health Policy,2008,86(2):153-162.
[2]舒琴,陈东风,班博,等.国内外患者安全文化测评及安全文化构建策略分析[J].中国医院,2015,19(4):43-45.
[3]潘宇,李洋,梁超,等.某医院安全文化测评现状分析及对策[J].中国医院管理,2016,36(8):53-54.
[4]李伦兰,胡少华,刘安琪,等.安徽省某“三甲”医院护理人员对患者安全文化认知的调查研究[J].中国护理管理,2014,14(7):740-744.
[5]AHRQ.2012 User Comparative Database Report.[2011-11-25].http://www.ahrq.gov/professionals/quality-patient safety/patientsafetyculture/hospital/2012/index.html.
[6]黄颖,张雪梅,袁欣,等.医疗不良事件发生与上报情况差异性分析[J].中国卫生事业管理,2016,33(8):575-577.
[7]Karen L,Hannah MBA,Charles P,et al.Hospital administrative staff vs.nursing staff responses to the AHRQ hospital survey on patient safety culture[J].Chapter,2008,7(20):56.
[8]崔颖,席修明,张进生,等.医疗安全不良事件报告的现状调查及影响因素分析[J].中国医院管理,2013,33(10):13-15.
[9]Dalton GD,Xanthia F,Samaropoulos,et al.Improvements in the safety of patient care can help end the medical malpractice crisis in the United States[J].Health Policy,2008,86(2):153-162.