Kuosmanen Anssi, Tiihonen Jari, Repo-Tiihonen Eila, Eronen Markku, Turunen Hannele
Author Affiliations: 1Department of Forensic Psychiatry, University of Eastern Finland, Kuopio, Finland; 2Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; 3Research Professor, National Institute of Health and Welfare, Helsinki, Finland; 4Vanha Vaasa Hospital, Vaasa, Finland; 5Department of Nursing Science, University of Eastern Finland, Kuopio, Finland; 6Kuopio University Hospital, Kuopio, Finland.
J Forensic Nurs. 2013 Oct-Dec;9(4):207-16. doi: 10.1097/JFN.0b013e318281068c.
Safety culture refers to the way patient safety is regarded and implemented within an organization and the structures and procedures in place to support this. The aim of this study was to evaluate patient safety culture, identify areas for improvement, and establish a baseline for improving state hospitals in Finland. Cross-sectional design data were collected from two state-run forensic hospitals in Finland using an anonymous, Web-based survey targeted to hospital staff based on the Hospital Survey on Patient Safety Culture questionnaire. The response rate was 43% (n = 283). The overall patient safety level was rated as excellent or very good by 58% of respondents. The highest positive grade was for "teamwork within units" (72%). The lowest rating was for "nonpunitive response to errors" (26% positive). Good opportunities for supplementary education had a statistically significant (p ≤ 0.05) effect on 9 of 12 Hospital Survey on Patient Safety Culture dimensions. Statistically significant (p ≤ 0.05) differences in patient safety culture were also found in the staff's educational background, manager status, and between the two hospitals. These findings suggest there are a number of patient safety problems related to cultural dimensions. Supplementary education was shown to be a highly significant factor in transforming patient safety culture and should therefore be taken into account alongside sufficient resources.
安全文化是指一个组织内看待和实施患者安全的方式以及为支持这一点而建立的结构和程序。本研究的目的是评估患者安全文化，确定改进领域，并为芬兰国立医院的改进建立一个基线。采用横断面设计，基于患者安全文化医院调查问卷，通过针对医院工作人员的匿名网络调查，从芬兰两家国立法医医院收集数据。回复率为43%（n = 283）。58%的受访者将整体患者安全水平评为优秀或非常好。最高的积极评分是“科室内部团队合作”（72%）。最低评分是“对错误的无惩罚性反应”（26%为积极）。良好的补充教育机会对患者安全文化医院调查问卷的12个维度中的9个维度具有统计学意义（p≤0.05）的影响。在工作人员的教育背景、管理者身份以及两家医院之间，患者安全文化也存在统计学意义（p≤0.05）的差异。这些发现表明存在一些与文化维度相关的患者安全问题。补充教育被证明是转变患者安全文化的一个非常重要的因素，因此应与充足的资源一起加以考虑。
