Madsen Marlene Dyrløv, Østergaard Doris, Andersen Henning Boje, Hermann Niels, Schiøler Thomas, Freil Morten
Forskningscenter Risø, Afdeling for Systemanalyse, Amtssygehuset i Herlev, DIMS-Dansk Institut for Medicinsk Simulation, Herlev.
Ugeskr Laeger. 2006 Nov 27;168(48):4195-200.
Few studies have been published about the attitudes of doctors and nurses towards reporting and handling adverse events. However, knowledge about staff attitudes is relevant and may be essential to dealing with potential problems and barriers that staff might have, as well as to supporting cultural change in relation to reporting and learning.
From February to March 2002, a questionnaire comprising 133 questions was distributed to 4019 doctors and nurses in four counties in Denmark. This paper deals with only a subset of the results of the survey.
Responses were obtained from 703 doctors and 881 nurses, yielding an overall response rate of 51%. Statistical analysis was performed with non-parametric tests (Mann-Whitney, Kruskal-Wallis). The survey shows large differences in attitudes among different staff groups towards reporting adverse events, and errors, in their reasons for not reporting and their degree of distress at the prospect of making mistakes. Doctors are more reluctant (34%) than nurses (21%) to bring up adverse events and errors, indicating as their main reasons: lack of tradition, fear of the press, and the risk of being reprimanded. In contrast to consultants, "non-consultants" (staff specialists and junior doctors), and especially the female members of this group, show a greater agreement with each of the proposed reasons. The thought that one may cause injury to a patient induces 35% of "non-consultants" to consider giving up their job "now and then/often".
Efforts to improve patient safety culture can become more effective via knowledge about similarities and differences among staff groups that have been uncovered in this survey.
关于医生和护士对不良事件报告与处理的态度,已发表的研究较少。然而,了解员工态度是相关的,对于应对员工可能存在的潜在问题和障碍,以及支持报告和学习方面的文化变革可能至关重要。
2002年2月至3月,向丹麦四个县的4019名医生和护士发放了一份包含133个问题的问卷。本文仅涉及该调查结果的一个子集。
共收到703名医生和881名护士的回复,总体回复率为51%。采用非参数检验(曼-惠特尼检验、克鲁斯卡尔-沃利斯检验)进行统计分析。调查显示,不同员工群体在报告不良事件和错误的态度、不报告的原因以及对犯错可能性的苦恼程度方面存在很大差异。医生比护士更不愿意(34%对21%)提及不良事件和错误,主要原因包括:缺乏传统、害怕媒体以及有被斥责的风险。与顾问相比,“非顾问”( staff specialists和初级医生),尤其是该群体中的女性成员,对每个提出的原因的认同度更高。想到可能会给患者造成伤害,35%的“非顾问”会“偶尔/经常”考虑放弃工作。
通过了解本调查中发现的员工群体之间的异同,改善患者安全文化的努力可能会更有效。