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伊朗基层医疗中心患者安全文化的首次研究。

The first study of patient safety culture in Iranian primary health centers.

作者信息

Tabrizchi Narges, Sedaghat Mojtaba

机构信息

Department of Community Medicine, School of Medicine, Tehran University of Medical Sciences, Iran.

出版信息

Acta Med Iran. 2012;50(7):505-10.

Abstract

Although the error in health care has received attention recently, patient safety culture in health centers has been relatively neglected. To measure the patient safety culture in primary health centers. A cross-sectional study, utilizing the modified version of the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ) and a demographic questionnaire. Healthcare staffs from health centers were participated in the survey. The patient safety culture score including subscores on 11 dimensions and 39 items; patient safety grade and number of events reported. The overall positive response rate of patient safety culture was 57 ± 16.8 (CI (95)55%-59%). The dimensions that received higher positive response rate were "Teamwork across units of health center", "Teamwork within units", "Head of center support for patient safety". The lowest percentage of positive responses was "Non punitive response to error". There were no relationship between working years and patients safely culture score. Similarly, no relationship was found between professional, gender and total patients safely culture score. Statistical analysis showed discrepancies between Iranian health centers and the US hospitals in three dimensions. For improving patient safety culture in health centers, it is necessary to have enough staff and establish an environment to be open and fair with staff which helps report errors spontaneously and without any fear. The findings of this study could be used to measure changes in patient safety culture over the time.

摘要

尽管医疗保健中的错误问题近来受到了关注,但健康中心的患者安全文化却相对被忽视了。为了衡量初级健康中心的患者安全文化,开展了一项横断面研究,采用了美国医疗保健研究与质量局(AHRQ)开发的《医院患者安全文化调查》(HSOPSC)的修改版以及一份人口统计学调查问卷。健康中心的医护人员参与了此次调查。患者安全文化得分包括11个维度和39个项目的子得分;患者安全等级以及报告的事件数量。患者安全文化的总体积极回应率为57±16.8(95%置信区间为55%-59%)。获得较高积极回应率的维度是“健康中心各单位间的团队合作”“单位内部的团队合作”“中心负责人对患者安全的支持”。积极回应率最低的是“对错误的无惩罚性回应”。工作年限与患者安全文化得分之间没有关系。同样,在专业、性别与患者安全文化总得分之间也未发现关系。统计分析表明,伊朗健康中心与美国医院在三个维度上存在差异。为了改善健康中心的患者安全文化,有必要配备足够的工作人员,并营造一个对员工开放且公平的环境,这有助于员工自发且毫无畏惧地报告错误。本研究的结果可用于衡量患者安全文化随时间的变化。

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