Singer Sara J, Jiang Wei, Huang Lyen C, Gibbons Lorri, Kiang Mathew V, Edmondson Lizabeth, Gawande Atul A, Berry William R
Harvard T. H. Chan School of Public Health, Boston, MA, USA Harvard Medical School, Boston, MA, USA Massachusetts General Hospital, Boston, MA, USA Stanford University School of Medicine, Stanford, CA, USA
Brigham and Women's Hospital, Boston, MA, USA.
Med Care Res Rev. 2015 Jun;72(3):298-323. doi: 10.1177/1077558715577479. Epub 2015 Mar 31.
We assessed surgical team member perceptions of multiple dimensions of safe surgical practice in 38 South Carolina hospitals participating in a statewide initiative to implement surgical safety checklists. Primary data were collected using a novel 35-item survey. We calculated the percentage of 1,852 respondents with strongly positive, positive, and neutral/negative responses about the safety of surgical practice, compared results by hospital and professional discipline, and examined how readiness, teamwork, and adherence related to staff perception of care quality. Overall, 78% of responses were positive about surgical safety at respondent's hospitals, but in each survey dimension, from 16% to 40% of responses were neutral/negative, suggesting significant opportunity to improve surgical safety. Respondents not reporting they would feel safe being treated in their operating rooms varied from 0% to 57% among hospitals. Surgeons responded more positively than nonsurgeons. Readiness, teamwork, and practice adherence related directly to staff perceptions of patient safety (p < .001).
我们评估了参与南卡罗来纳州一项实施手术安全检查表的全州性倡议的38家医院中,手术团队成员对安全手术实践多个维度的认知。使用一份全新的包含35个条目的调查问卷收集原始数据。我们计算了1852名受访者中对手术实践安全性给出强烈肯定、肯定以及中立/否定回答的百分比,按医院和专业学科比较结果,并研究准备情况、团队协作和依从性如何与工作人员对护理质量的认知相关。总体而言,78%的受访者对其所在医院的手术安全性给出肯定回答,但在每个调查维度中,16%至40%的回答为中立/否定,这表明改善手术安全性有很大空间。各医院中,未表示在自己医院手术室接受治疗会感到安全的受访者比例从0%到57%不等。外科医生的回答比非外科医生更积极。准备情况、团队协作和实践依从性与工作人员对患者安全的认知直接相关(p < .001)。