Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan 48201, USA.
Gerontologist. 2011 Dec;51(6):739-49. doi: 10.1093/geront/gnr053. Epub 2011 Jun 27.
In recent years, there has been an increasing focus on the role of safety culture in preventing costly adverse events, such as medication errors and falls, among nursing home residents. However, little is known regarding critical organizational determinants of a positive safety culture in nursing homes. The aim of this study was to identify organizational climate predictors of specific aspects of the staff-rated resident safety culture (RSC) in a sample of nursing homes.
Staff at 4 Michigan nursing homes responded to a self-administered questionnaire measuring organizational climate and RSC. Multiple regression analyses were used to identify organizational climate factors that predicted the safety culture dimensions nonpunitive response to mistakes, communication about incidents, and compliance with procedures.
The organizational climate factors efficiency and work climate predicted nonpunitive response to mistakes (p < .001 for both scales) and compliance with procedures (p < .05 and p < .001 respectively). Work stress was an inverse predictor of compliance with procedures (p < .05). Goal clarity was the only significant predictor of communication about incidents (p < .05).
Efficiency, work climate, work stress, and goal clarity are all malleable organizational factors that could feasibly be the focus of interventions to improve RSC. Future studies will examine whether these results can be replicated with larger samples.
近年来，人们越来越关注安全文化在预防养老院居民昂贵的不良事件（如用药错误和跌倒）中的作用。然而，对于养老院积极安全文化的关键组织决定因素知之甚少。本研究旨在确定组织氛围对员工评定居民安全文化（RSC）特定方面的预测因素，该研究样本来自密歇根州的 4 家养老院。
4 家密歇根养老院的员工对一份自我管理的问卷做出了回应，该问卷衡量了组织氛围和 RSC。采用多元回归分析来确定组织氛围因素，这些因素可以预测安全文化的各个维度，包括对错误的非惩罚性反应、事件沟通和程序遵守。
效率和工作氛围这两个组织氛围因素预测了对错误的非惩罚性反应（两个量表均为 p <.001）和程序遵守（分别为 p <.05 和 p <.001）。工作压力是程序遵守的反向预测因素（p <.05）。目标明确度是事件沟通的唯一显著预测因素（p <.05）。
效率、工作氛围、工作压力和目标明确度都是可以改变的组织因素，它们可能是改善 RSC 的干预措施的重点。未来的研究将检验这些结果是否可以在更大的样本中得到复制。
