Vogus Timothy J, Sutcliffe Kathleen M
Department of Management and Organization Studies, Owen Graduate School of Management, Vanderbilt University, Nashville, Tennessee 37203, USA.
Med Care. 2007 Oct;45(10):997-1002. doi: 10.1097/MLR.0b013e318053674f.
Prior research has found that safety organizing behaviors of registered nurses (RNs) positively impact patient safety. However, little research exists on the joint benefits of safety organizing and other contextual factors that help foster safety.
Although we know that organizational practices often have more powerful effects when combined with other mutually reinforcing practices, little research exists on the joint benefits of safety organizing and other contextual factors believed to foster safety. Specifically, we examined the benefits of bundling safety organizing with leadership (trust in manager) and design (use of care pathways) factors on reported medication errors.
A total of 1033 RNs and 78 nurse managers in 78 emergency, internal medicine, intensive care, and surgery nursing units in 10 acute-care hospitals in Indiana, Iowa, Maryland, Michigan, and Ohio who completed questionnaires between December 2003 and June 2004.
Cross-sectional analysis of medication errors reported to the hospital incident reporting system for the 6 months after the administration of the survey linked to survey data on safety organizing, trust in manager, use of care pathways, and RN characteristics and staffing.
Multilevel Poisson regression analyses indicated that the benefits of safety organizing on reported medication errors were amplified when paired with high levels of trust in manager or the use of care pathways.
Safety organizing plays a key role in improving patient safety on hospital nursing units especially when bundled with other organizational components of a safety supportive system.
先前的研究发现，注册护士的安全组织行为对患者安全有积极影响。然而，关于安全组织与其他有助于促进安全的背景因素的联合效益的研究很少。
虽然我们知道组织实践与其他相互强化的实践相结合时往往会产生更强大的效果，但关于安全组织与其他被认为能促进安全的背景因素的联合效益的研究很少。具体来说，我们研究了将安全组织与领导因素（对管理者的信任）和设计因素（护理路径的使用）相结合对报告的用药错误的效益。
印第安纳州、爱荷华州、马里兰州、密歇根州和俄亥俄州10家急症护理医院的78个急诊科、内科、重症监护室和外科护理单元的1033名注册护士和78名护士长，他们在2003年12月至2004年6月期间完成了问卷调查。
对调查后6个月向医院事件报告系统报告的用药错误进行横断面分析，并与关于安全组织、对管理者的信任、护理路径的使用以及注册护士特征和人员配备的调查数据相关联。
多层次泊松回归分析表明，当与对管理者的高度信任或护理路径的使用相结合时，安全组织对报告的用药错误的效益会放大。
安全组织在提高医院护理单元的患者安全方面起着关键作用，特别是当与安全支持系统的其他组织组成部分相结合时。
