昆明市三级甲等医院护士对患者安全文化评价的研究

The survey on perceptions of patient safety culture among nurses in tertiary hospitals in Kunming

目的调查昆明市三级甲等医院护士对患者安全文化的评价及不同特征的护士对患者安全文化评分的影响。方法 2015年7月—2016年1月,采用方便抽样法,使用美国联邦卫生保健研究和质量署研发的医院患者安全文化问卷,对昆明市7所三级甲等医院的2 629名护士进行横断面调查。结果患者安全文化的优势维度(积极同意率>75%)为:"组织学习与持续改进"(86.60%)"科室内部的团队合作"(83.34%)和"错误的反馈和交流"(75.98%);劣势维度(积极同意率<50%)为"差错的非惩罚性反应"(23.74%)"人员配置"(33.71%)和"医院各部门之间的协作"(49.45%)。不同学历、职称和每周工作时间的护士对患者安全文化部分条目评价的比较,差异存在统计学意义(P<0.05)。结论营造非惩罚性上报文化,合理安排人员配置和工作时间,发挥高学历、高职称护理人员在患者安全文化建设中的作用,是提高患者安全文化的重要举措。

Objective To investigate perceptions of patient safety eulture（PSC） among nurses in tertiary hospita]s in Kunming. Methods Totally 2629 nurses were recruited by convenience sampling method from 7 tertiary hospi- tals in Kunming between July 2015 to January 2016. Hospital Survey on Patient Safety Culture （HSOPS） was used to assess PSC. Results The top three superior dimensions of PSC were ＂Organizational Learning-Continuous Im- provement＂（86.60%）,＂Teamwork within Hospital Units＂（83.34%） and ＂Feedback and Communication about Error＂ （75.98%）. The last three inferior dimensions of PSC were＂Nonpunitive response to error＂（23.74%）, ＂Staffing＂（33.71%） and ＂Teamwork across hospital units＂（49.45%）. There were significant differences in certain items among nurses with different educational level,academic title,working hour per week（P〈0.05）. Conclusion Establishing nonpunitive re- sponse culture,reasonably arranging staffing and working hours,and encouraging nurses with high educational level and title to play their full role,are critical measures to improve patient safety culture in hospital.