Ginsburg Liane R, Tregunno Deborah, Norton Peter G
School of Health Policy and Management, York University, 4700 Keele Street, Toronto, Ontario, Canada.
BMJ Qual Saf. 2013 Feb;22(2):147-54. doi: 10.1136/bmjqs-2012-001308. Epub 2012 Nov 23.
As efforts to address patient safety (PS) in health professional (HP) education increase, it is important to understand new HPs' perspectives on their own PS competence at entry to practice. This study examines the self-reported PS competence of newly registered nurses, pharmacists and physicians.
A cross-sectional survey of 4496 new graduates in medicine (1779), nursing (2196) and pharmacy (521) using the HP Education in PS Survey (H-PEPSS). The H-PEPSS measures HPs' self-reported PS competence on six socio-cultural dimensions of PS, including culture, teamwork, communication, managing risk, responding to risk and understanding human factors. The H-PEPSS asks about confidence in PS learning in classroom and clinical settings.
All HP groups reported feeling more confident in the dimension of PS learning related to effective communication with patients and other providers. Greater confidence in PS learning was reported for learning experiences in the clinical setting compared with the class setting with one exception-nurses' confidence in learning about working in teams with other HPs deteriorated as they moved from thinking about learning in the classroom setting to thinking about learning in the clinical setting.
Large-scale efforts are required to more deeply and consistently embed PS learning into HP education. However, efforts to embed PS learning in HP education seem to be hampered by deficiencies that persist in the culture of the clinical training environments in which we educate and acculturate new HPs.
随着在卫生专业人员(HP)教育中解决患者安全(PS)问题的努力不断增加,了解新入职的卫生专业人员对其自身进入实践时的患者安全能力的看法非常重要。本研究调查了新注册护士、药剂师和医生自我报告的患者安全能力。
使用卫生专业人员患者安全教育调查(H-PEPSS)对4496名医学(1779名)、护理(2196名)和药学(521名)专业的新毕业生进行横断面调查。H-PEPSS从患者安全的六个社会文化维度衡量卫生专业人员自我报告的患者安全能力,包括文化、团队合作、沟通、风险管理、应对风险和理解人为因素。H-PEPSS询问在课堂和临床环境中对患者安全学习的信心。
所有卫生专业人员群体都表示,在与患者和其他提供者进行有效沟通相关的患者安全学习维度上更有信心。与课堂环境相比,临床环境中的学习经历让卫生专业人员对患者安全学习更有信心,但有一个例外——护士在从考虑课堂环境中的学习转向考虑临床环境中的学习时,对与其他卫生专业人员团队合作学习的信心下降。
需要做出大规模努力,将患者安全学习更深入、持续地融入卫生专业人员教育。然而,将患者安全学习融入卫生专业人员教育的努力似乎受到临床培训环境文化中持续存在的缺陷的阻碍,我们在这些环境中培养和使新的卫生专业人员适应文化。