Nelson Shanelle, Stone Patricia W, Jordan Sarah, Pogorzelska Monika, Halpin Helen, Vanneman Megan, Larson Elaine
Center for Health Policy, Columbia University School of Nursing, New York, NY 10032, USA.
Interdiscip Perspect Infect Dis. 2011;2011:357121. doi: 10.1155/2011/357121. Epub 2011 Aug 4.
Background. Healthcare-associated infections (HAIs) are an important patient safety issue, and safety climate is an important organizational factor. This study explores perceptions of infection preventionists (IPs) and quality directors (QDs) regarding two safety microclimates, Senior Management Engagement (SME) and Leadership on Patient Safety (LOPS), across California hospitals. Methods. This was an analysis of two cross-sectional surveys. We conducted Wilcoxon signed-rank test, univariate analyses, and a multivariate ordinary least square regression. Results. There were 322 eligible hospitals; 149 hospitals (46.3%) responded to both surveys. The IP response rate was 59%, and the QD response rate was 79.5%. We found IPs perceived SME more positively than did QDs (21.4 vs. 20.4, P < 0.01). No setting characteristics predicted variation in perceptions. Presence of an independent budget predicted more positive perceptions of microclimates across personnel types (P < 0.01). Conclusions. Differences in perceptions continue to exist between essential leaders in acute health care settings which could have critical effects on outcomes such as HAIs. Having an independent budget for the infection prevention and control department may enhance the overall safety climate and in turn patient care.
背景。医疗保健相关感染(HAIs)是一个重要的患者安全问题,而安全氛围是一个重要的组织因素。本研究探讨了加利福尼亚州各医院的感染预防人员(IPs)和质量主管(QDs)对两种安全微气候的看法,即高级管理层参与度(SME)和患者安全领导力(LOPS)。方法。这是对两项横断面调查的分析。我们进行了Wilcoxon符号秩检验、单变量分析和多元普通最小二乘回归。结果。有322家符合条件的医院;149家医院(46.3%)对两项调查都做出了回应。IPs的回应率为59%,QDs的回应率为79.5%。我们发现,IPs对SME的看法比QDs更积极(21.4对20.4,P < 0.01)。没有任何环境特征能够预测看法的差异。拥有独立预算预示着各类人员对微气候的看法更积极(P < 0.01)。结论。急性医疗环境中的关键领导者之间在看法上仍存在差异,这可能对诸如医疗保健相关感染等结果产生关键影响。为感染预防与控制部门设立独立预算可能会改善整体安全氛围,进而提升患者护理水平。