医疗不良事件后临床护士第二受害者经历与支持对工作不安全感的影响

Experience and support of secondary victims of clinical nurses after adverse medical events and the impact on job insecurity

目的探讨医疗不良事件后临床护士作为第二受害者的经历与支持现状,及其对护士工作不安全感的影响。方法2022年6月至8月采用便利抽样方法,选取某市3所三甲医院283例第二受害者临床护士作为研究对象。使用基本资料调查表、中文版第二受害者经历与支持测评量表和工作不安全感量表进行问卷调查。结果第二受害者经历与支持均分(73.35±16.49),其中困扰分量表均分(41.42±11.12),支持分量表均分(31.38±6.35)。工作不安全感条目均分(2.98±0.77),其中工作质量不安全感条目均分(3.21±0.82),工作数量不安全感条目均分(2.68±0.70)。多元线性回归分析结果显示,性别和第二受害者困扰影响临床护士的工作质量不安全感;聘用方式影响临床护士的工作数量不安全感;第二受害者经历与支持影响临床护士的总体工作不安全感。结论护理管理者应重视不良事件对第二受害者护士,尤其是男护士的影响,从风险管理、组织支持、情绪疏导等多个层面制定支持和管理方案,消除不良事件对职业发展影响的顾虑,降低其工作不安全感。

Objective To explore the second victim experiences of nurses in medical adverse events and its impact on job insecurity.Methods There were 283 second victim nurses selected from 3 tertiary hospitals from a city from June to August 2022 with convenience sampling method.The basic information questionnaire,Chinese version of the Second Victim Experience and Support Tool and Job Insecurity Scale were used in the investigation.Results The average score of the second victim's experience and support was(73.35±16.49),among which the average score of distress subscale was(41.42±11.12)and that of support subscale was(31.38±6.35).The average score of job insecurity items was(2.98±0.77),among which the average score of job quality insecurity items was(3.21±0.82),and the average score of job quantity insecurity items was(2.68±0.70).Multiple linear regression analysis showed that gender and second-victim distress affected the job insecurity of clinical nurses.The way of employment affected the job quantity insecurity of clinical nurses.Second victim experience and support influenced overall job insecurity of clinical nurses.Conclusion Nursing managers should pay attention to the influence of adverse events on the second victim nurses,especially male nurses,and formulate support and management programs from the risk management,organizational support,emotional guidance and other levels,eliminate the concerns about influence of adverse events on career development,and reduce their job insecurity.