护士对组织文化的认知及其与错误报告文化的关联：以巴基斯坦公立部门医院为例
Nurse perceptions of organizational culture and its association with the culture of error reporting: a case of public sector hospitals in Pakistan.
作者信息
Jafree Sara Rizvi, Zakar Rubeena, Zakar Muhammad Zakria, Fischer Florian
机构信息
Institute of Social and Cultural Studies, Sociology Department, University of the Punjab, Lahore, Pakistan.
Institute of Social and Cultural Studies, University of the Punjab, New Campus, University of the Punjab, Lahore, Pakistan.
出版信息
BMC Health Serv Res. 2016 Jan 5;16:3. doi: 10.1186/s12913-015-1252-y.
BACKGROUND
There is an absence of formal error tracking systems in public sector hospitals of Pakistan and also a lack of literature concerning error reporting culture in the health care sector. Nurse practitioners have front-line knowledge and rich exposure about both the organizational culture and error sharing in hospital settings. The aim of this paper was to investigate the association between organizational culture and the culture of error reporting, as perceived by nurses.
METHODS
The authors used the "Practice Environment Scale-Nurse Work Index Revised" to measure the six dimensions of organizational culture. Seven questions were used from the "Survey to Solicit Information about the Culture of Reporting" to measure error reporting culture in the region. Overall, 309 nurses participated in the survey, including female nurses from all designations such as supervisors, instructors, ward-heads, staff nurses and student nurses. We used SPSS 17.0 to perform a factor analysis. Furthermore, descriptive statistics, mean scores and multivariable logistic regression were used for the analysis.
RESULTS
Three areas were ranked unfavorably by nurse respondents, including: (i) the error reporting culture, (ii) staffing and resource adequacy, and (iii) nurse foundations for quality of care. Multivariable regression results revealed that all six categories of organizational culture, including: (1) nurse manager ability, leadership and support, (2) nurse participation in hospital affairs, (3) nurse participation in governance, (4) nurse foundations of quality care, (5) nurse-coworkers relations, and (6) nurse staffing and resource adequacy, were positively associated with higher odds of error reporting culture. In addition, it was found that married nurses and nurses on permanent contract were more likely to report errors at the workplace.
CONCLUSION
Public healthcare services of Pakistan can be improved through the promotion of an error reporting culture, reducing staffing and resource shortages and the development of nursing care plans.
背景
巴基斯坦公共部门医院缺乏正式的差错追踪系统，且医疗保健领域关于差错报告文化的文献也很匮乏。执业护士对医院环境中的组织文化和差错共享有着一线知识和丰富经验。本文旨在调查护士所感知的组织文化与差错报告文化之间的关联。
方法
作者使用“修订版护士工作指数实践环境量表”来衡量组织文化的六个维度。从“差错报告文化信息征集调查”中选取七个问题来衡量该地区的差错报告文化。共有309名护士参与了调查，包括来自所有职位的女性护士，如主管、教员、病房护士长、普通护士和实习护士。我们使用SPSS 17.0进行因子分析。此外，还使用描述性统计、平均得分和多变量逻辑回归进行分析。
结果
护士受访者对三个方面评价不佳，包括：（i）差错报告文化，（ii）人员配备和资源充足性，以及（iii）护理质量的护士基础。多变量回归结果显示，组织文化的所有六个类别，包括：（1）护士长能力、领导能力和支持，（2）护士参与医院事务，（3）护士参与管理，（4）护理质量的护士基础，（5）护士与同事的关系，以及（6）护士人员配备和资源充足性，都与更高的差错报告文化几率呈正相关。此外，还发现已婚护士和签订长期合同的护士在工作场所更有可能报告差错。
结论
巴基斯坦的公共医疗服务可以通过促进差错报告文化、减少人员配备和资源短缺以及制定护理计划来得到改善。
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