Martowirono Kartinie, Wagner Cordula, Bijnen A Bart
Foreest Medical School, Medical Center Alkmaar, Alkmaar, The Netherlands.
J Eval Clin Pract. 2014 Apr;20(2):121-8. doi: 10.1111/jep.12096. Epub 2013 Nov 9.
RATIONALE, AIMS AND OBJECTIVES: Explicit attention to patient safety during surgical training is needed to improve patient safety. A positive safety climate is associated with greater patient safety and is a requisite for safety teaching at the workplace. The Safety Climate Survey (SCS) measures perceptions of safety climate. This study aims to take a first step in validating the SCS for use among surgical residents in the Netherlands and to highlight opportunities for safety climate improvement through changes in surgical training in the Netherlands. It therefore assesses (1) if the SCS can be used to assess surgical residents' perceptions of the safety climate in Dutch teaching hospitals; and (2) how, according to SCS results, these residents perceive the safety climate in Dutch teaching hospitals.
In a cross-sectional study conducted in February 2011, a Dutch translation of the SCS was administered to all general surgical residents in the Netherlands. Face validity and internal consistency were assessed, as were overall mean, means per item and significant differences in means between different groups of respondents.
In total, 306 of 390 (78%) residents completed the questionnaire. The SCS showed good face validity and internal consistency (Cronbach's alpha = 0.87). Residents reported an overall mean of 3.95 (standard deviation 0.51) out of a maximum score of 5.00, and 52% reported an overall mean of 4.00 or higher. Women and residents working in university hospitals gave significantly lower scores. Significant differences were also found among hospitals and among regions. Majority of the items scored less than 4.00.
The SCS is potentially useful to measure surgical residents' perceptions of the patient safety climate in Dutch teaching hospitals. There is considerable room for improvement of the patient safety climate. Surgical training should include better feedback, formal patient safety teaching sessions at the workplace and specific attention to patient safety during the introduction in a new hospital, and supervisors should encourage surgical residents to report any patient safety concern they may have.
原理、目的与目标：在外科培训期间明确关注患者安全对于提高患者安全至关重要。积极的安全氛围与更高的患者安全相关联，并且是工作场所安全教学的必要条件。安全氛围调查（SCS）用于衡量对安全氛围的认知。本研究旨在迈出验证SCS在荷兰外科住院医师中使用的第一步，并通过荷兰外科培训的变革突出改善安全氛围的机会。因此，它评估（1）SCS是否可用于评估荷兰教学医院外科住院医师对安全氛围的认知；以及（2）根据SCS结果，这些住院医师如何看待荷兰教学医院的安全氛围。
在2011年2月进行的一项横断面研究中，将SCS的荷兰语译本发放给荷兰所有普通外科住院医师。评估了表面效度和内部一致性，以及总体均值、各项目均值和不同受访者组之间均值的显著差异。
390名住院医师中有306名（78%）完成了问卷。SCS显示出良好的表面效度和内部一致性（克朗巴哈系数α = 0.87）。住院医师报告的总体均值为3.95（标准差0.51），满分5.00，52%的人报告总体均值为4.00或更高。在大学医院工作的女性和住院医师给出的分数显著更低。在医院之间和地区之间也发现了显著差异。大多数项目得分低于4.00。
SCS可能有助于衡量荷兰教学医院外科住院医师对患者安全氛围的认知。患者安全氛围有很大的改善空间。外科培训应包括更好的反馈、在工作场所进行正式的患者安全教育课程，以及在新医院入职期间特别关注患者安全，并且上级应鼓励外科住院医师报告他们可能有的任何患者安全问题。
