护理一般差错瞒报情况调查与分析

Investigation and analysis on nursing error concealment

目的:了解护理人员发生护理差错后的瞒报情况及影响瞒报的因素,为建立护理安全管理文化提供依据。方法:自制调查问卷对广东省67家医院402个科室的护理人员进行调查,内容包括护理差错的发生情况、发生原因、瞒报情况、所在科室的责罚情况、影响主动上报的因素等。结果:71.1%的护理人员曾经发生过护理差错,主动上报的只有42.3%;其压力源主要来自"怕病人及家属知道后提意见或投诉"、"怕领导知道了批评,扣奖金"、"担心自己失面子"等。当发生一般差错时,50.5%的科室只批评不扣奖金,41.3%的科室又批评又扣奖金;当发生严重差错时,不管是否主动报告,85.3%的科室均有所责罚。结论:护理管理者应摒弃基于"个体认识观"的"苛责文化",根除护理人员担心"失面子"等心理障碍,建立无惩罚性的护理差错自愿报告系统,减少瞒报现象的发生。

Objective：To explore nursing error concealment condition and influencing factors.Methods：Nurses from 402 nursing departments in 67 hospitals in Guangdong Province were investigated about the occurrences of nursing errors,causes,concealment conditions,punishment,and influencing factors.Results：71.1% nurses made errors but only 42.3% reported errors voluntarily.The influencing factors were ＂fear of complaints from patients and their families after they knowing errors ＂,＂ worrying about criticism from the managers and bonus deduction ＂,＂ humiliation＂ and so on.When errors occurred,nurses from 50.5% departments were under criticism but had no money deduction,nurses from 41.3% departments were both under criticism and had their money deducted;when severe errors happened,nurses from 85.3% departments were punished whether they reported voluntarily or not.Conclusion：Nursing managers should abandon the ＂blame culture＂,eliminate psychological obstacles like worrying about ＂losing face＂ and other mental obstacles,establish a non-punishment voluntary reporting system to reduce error concealment phenomena.