手术室和麻醉后护理单元的患者安全文化与医院其他部门相比如何？

How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital?

作者信息

Kaafarani Haytham M A, Itani Kamal M F, Rosen Amy K, Zhao Shibei, Hartmann Christine W, Gaba David M

机构信息

Department of Surgery, Boston, VA Healthcare System, West Roxbury, MA, USA.

出版信息

Am J Surg. 2009 Jul;198(1):70-5. doi: 10.1016/j.amjsurg.2008.09.017. Epub 2009 Mar 6.

DOI:10.1016/j.amjsurg.2008.09.017

PMID:19268901

Abstract

BACKGROUND

A strong patient safety culture in the operating room (OR) and post-anesthesia care unit (PACU) is essential to promote safe care.

METHODS

The Patient Safety Climate in Healthcare Organizations (PSCHO) survey was administered to employees at 30 Veterans Affairs (VA) hospitals. The survey consisted of 42 close-ended items representing 12 different dimensions of safety. We measured percent problematic response (PPR); higher PPR values reflect weaker safety culture. The "OR/PACU" and the "Other Work Areas" groups' item-specific, dimension-specific, and overall problematic responses were compared.

RESULTS

The overall and dimension-specific PPRs were similar between the OR/PACU and the Other Work Areas group (overall: 20.2% and 18.1%, respectively; P = .41). When the 2 groups were compared on an item-by-item level, the OR/PACU staff reported more frequent witnessing of unsafe patient care (PPR 55.1% vs 43.2%; P = .01), and perceived less understanding by senior leadership of clinical care (PPR 28.3% vs 17.1%; P = .01) and less hospital interest in quality of care (PPR 20.4% vs 12.5%; P = .03).

CONCLUSIONS

Specific areas of safety culture in the OR/PACU were found that should be targeted for improvement.

摘要

背景

手术室（OR）和麻醉后护理单元（PACU）中强大的患者安全文化对于促进安全护理至关重要。

方法

对30家退伍军人事务（VA）医院的员工进行了医疗保健组织中的患者安全氛围（PSCHO）调查。该调查由42个封闭式项目组成，代表12个不同的安全维度。我们测量了问题反应百分比（PPR）；较高的PPR值反映出较弱的安全文化。比较了“OR/PACU”组和“其他工作区域”组在项目特定、维度特定和整体问题反应方面的情况。

结果

OR/PACU组和其他工作区域组在总体和维度特定的PPR方面相似（总体分别为20.2%和18.1%；P = 0.41）。当在逐个项目层面比较两组时，OR/PACU的工作人员报告更频繁目睹不安全的患者护理情况（PPR为55.1%对43.2%；P = 0.01），并且认为高级领导层对临床护理的理解较少（PPR为28.3%对17.1%；P = 0.01），以及医院对护理质量的关注较少（PPR为20.4%对12.5%；P = 0.03）。