二、三级医院护理安全文化现状的比较

Comparative Study on Patient Safety Culture in Grade Ⅱ & Ⅲ Hospitals

目的了解上海二、三级医院护理的安全文化现状。方法采用医院安全文化问卷,对上海二、三级医院护士共514名开展问卷调查。结果三级医院有19.7%的护士认为就职医院总体安全为极好、有59.1%的护士认为总体安全为很好,其中有87.9%的护士在过去一年内未报告意外事件。二级医院有8.7%的护士认为就职医院总体安全为极好、有51.1%的护士认为就职医院总体安全为很好,其中有85.3%的护士在过去一年内未报告意外事件(P<0.05)。不同等级医院均在科室内团队合作、对于差错的反馈和交流、管理者促进患者安全的意愿和行动以及组织的学习与持续改进这4方面有优势,劣势则在人员配置和对差错的非惩罚性反应。结论应根据不同背景护士呈现的安全文化优劣势,在护理管理工作中采取相应措施,保持优势,改进劣势,切实保证患者安全。

Objective To explore patient safety culture in hospitals of grade-Ⅱand grade-Ⅲ. Methods Questionnaire survey on patient safety culture was used on 514 nurses in hospitals of grade-Ⅱ and grade-Ⅲin Shanghai. Results It showed 19. 7% and 59. 1% of the nurses from grade-Ⅲhospitals considered their work units excellent and very good respectively on patient safety, and 87.9% of them reported no events in the past 12 months. While in grade-Ⅱ hospitals, 8.7%, 51.1% of the nurses considered their work units excellent and very good respectively on patient safety and 85.3% of them reported no events in the past 12 months（P〈0.05）. Feedback and communication about error ＇ teamwork within hospital units,supervisor expectation ＆ actions promoting patient safety and organizational continuous-learning and improving were areas of strength for the hospitals, while staffing and non-punitive response to error were areas with potential for improvement. Conclusion Corresponding measures should be taken to keep these strengths difference and improve other areas with potential to guarantee patient safety according to nurses＇ backgrounds.