Bondevik Gunnar Tschudi, Hofoss Dag, Husebø Bettina Sandgathe, Deilkås Ellen Catharina Tveter
Research Group for General Practice, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway.
BMC Health Serv Res. 2017 Jun 20;17(1):424. doi: 10.1186/s12913-017-2387-9.
Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue.
In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values <0.05 were considered to be significant.
Out of the 463 employees invited, 288 (62.2%) answered the questionnaire. Response rates varied between 56.9% and 72.2% across the five nursing homes. In multiple linear regression analysis, we found that increasing age and job position among the healthcare providers were associated with significantly increased mean scores for the patient safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor.
Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the occurrence of adverse events in nursing homes.
患者安全文化涉及领导者与员工之间的互动、态度、日常工作、意识以及对患者不良事件风险产生影响的行为。由于养老院患者患有多种复杂疾病，他们发生不良事件的风险特别高。研究发现患者安全文化与不良事件风险之间存在关联。本研究旨在使用《安全态度问卷 - 门诊版》（SAQ - AV）调查挪威养老院医护人员的安全态度。我们研究了安全态度的差异是否与专业背景、年龄、工作经验和母语有关。
2016年2月，邀请了挪威滕斯贝格五家养老院的463名医护人员回答经翻译并适用于挪威养老院环境的SAQ - AV。此前对挪威养老院SAQ - AV的验证确定了五个患者安全因素：团队合作氛围、安全氛围、工作满意度、工作条件和压力认知。使用SPSS v.22进行统计分析，包括均值、标准差估计和多元线性回归。P值<0.05被认为具有统计学意义。
在邀请的463名员工中，288人（62.2%）回答了问卷。五家养老院的回复率在56.9%至72.2%之间。在多元线性回归分析中，我们发现医护人员年龄的增长和职位的提升与患者安全因素团队合作氛围、安全氛围、工作满意度和工作条件的平均得分显著增加相关。非挪威母语者的工作满意度平均得分显著更高，压力认知平均得分显著更低。专业背景和工作经验均与任何患者安全因素的平均得分无显著关联。
养老院患者安全因素得分低于此前挪威普通诊所的得分，但与非工作时间基层医疗诊所的结果相似。患者安全文化评估可能有助于养老院领导者启动有针对性的质量改进干预措施。进一步的研究应调查患者安全文化与养老院不良事件发生之间的关联。
