临床护士不良事件风险感知调查及影响因素分析

Investigation on clinical nurses' perception of adverse events and analysis of influencing factors

目的调查临床护士不良事件风险感知现状及其影响因素,探讨提高临床护士不良事件风险感知水平的应对措施。方法使用自行设计的一般资料调查问卷、临床护士不良事件风险感知结构维度量表,采用现场问卷调查的方式,于2015年4—8月对泰安市10所二、三级医院917名临床护士进行调查,分析影响临床护士不良事件风险感知的相关因素。收集数据主要运用SPSS 19.0和AMOS 17.0统计软件对各指标做统计描述分析。结果利用项目分析和探索性因素分析最终确定20个条目3个因子的模型;探索性和验证性因素分析证实,临床护士不良事件风险感知包括3个维度,分别为患者照护风险、系统流程风险和护士操作风险。临床护士不良事件风险感知得分为(16.48±3.79)分。各维度得分由高到低依次为:护士操作风险、系统流程风险和患者照护风险。影响临床护士不良事件风险感知的因素有工作年限、科室和医院级别。结论临床护士不良事件风险感知水平有待提高,护理管理者要注重提高护士不良事件风险感知能力;加强对二级医院临床护士系统与流程安全风险意识宣教;积极改善妇产科、门急诊等科室护士风险感知能力;通过主动上报不良事件与案例分析学习,更好地提高患者安全管理水平,减少不良事件的发生。

Objective To investigate the current situation and influential factors of clinical nurses＇ perception of adverse events, and discuss the corresponding measures for improving the risk awareness of nurses. Methods The on-site survey was conducted among 917 clinical nurses from ten hospitals in Taian city between April,2015 and August,2015 using a self-designed demographic questionnaire and Clinical Nurses Adverse Events Risk Perception Structure Scales to investigate the influential factors of clinical nurses＇ perception of adverse events. The data were analyzed with SPSS 19.0 and AMOS 17.0. Results A scale of three factors and 20 items was identified by using item analysis and exploratory factor analysis. Exploratory and confirmatory factor analysis revealed that there were three dimensions of adverse events risk perception： patient care risk, system process risk and nurse operation risk. The score of clinical nurses adverse events risk perception was 16.48± 3.79. The score of each dimension in descending order were： nurse operation risk, system process risk and patient care risk. Work experience, departments and hospital level were the significant influencing factors of cliniical nurses＇ risk perception of adverse events. Conclusion The level of clinical nurses＇ perception of adverse events need to be improved. The nurse managers should pay more attentions to improve nurse risk awareness and reporting adverse event in order to promote the management of the safety of patients and reduce occurrence of adverse event.