Tereanu Carmen, Sampietro Giuseppe, Sarnataro Francesco, Siscanu Dumitru, Palaria Rodica, Savin Victor, Cliscovscaia Tatiana, Pislaru Valentina, Oglinda Valeriu, Capmare Larisa, Ghelase Mugurel Stefan, Turcanu Tamara
Department of Hygiene and Prevention, Agenzia di Tutela della Salute, Bergamo, Italy.
Epidemiology Service, Agenzia di Tutela della Salute, Bergamo, Italy.
Clujul Med. 2018;91(1):65-74. doi: 10.15386/cjmed-869. Epub 2018 Jan 15.
The Republic of Moldova is a small ex-soviet country in the Central Eastern European group of states, whose official language is Romanian. In countries with limited resources, quality improvement in healthcare and patient safety are very challenging. This study aims to identify which areas of the patient safety culture (PSC) need prompt intervention.
A cross-sectional study was conducted in three Moldovan healthcare settings, using the Romanian translation of the US Hospital Survey on Patient Safety Culture HSOPSC. Descriptive statistics were carried out, based on the responses from n. 929 staff. Percentages of positive responses (PPRs) by item (41 items) and composite (12 PSC areas) were computed.
Most respondents were nurses (53%), followed by doctors (35%). The main work areas were: primary care (27%), medical specialties (20%), gynecology and obstetrics (16%), and general surgery (11%). The highest composite PPRs were for: teamwork within units (80%), feedback & communication about error, organizational learning-continuous improvement and supervisor/manager expectations & actions promoting patient safety (78%), and management support for patient safety (75%). The lowest composites were for: frequency of events reported (57%), non-punitive response to errors (53%), communication openness (51%) and staffing (37%).
Our results suggest that staffing issues should be tackled to provide safe care. Staff avoid to openly report adverse events and/or discuss errors, likely because a poor understanding of the potential of these events for learning and because of fear of blame or punitive actions. Future research should check psychometrics of the Romanian version of the HSOPSC applied to Moldovan staff.
摩尔多瓦共和国是中东欧国家集团中的一个前苏联小国，其官方语言为罗马尼亚语。在资源有限的国家，改善医疗保健质量和患者安全极具挑战性。本研究旨在确定患者安全文化（PSC）的哪些领域需要立即干预。
在摩尔多瓦的三个医疗环境中进行了一项横断面研究，使用了美国医院患者安全文化调查（HSOPSC）的罗马尼亚语译本。基于929名工作人员的回复进行了描述性统计。计算了各项目（41项）和综合项（12个PSC领域）的积极回复百分比（PPRs）。
大多数受访者为护士（53%），其次是医生（35%）。主要工作领域为：初级保健（27%）、医学专科（20%）、妇产科（16%）和普通外科（11%）。综合PPRs最高的领域为：科室内部团队合作（80%）、差错反馈与沟通、组织学习 - 持续改进以及主管/经理对促进患者安全的期望与行动（78%），以及管理层对患者安全的支持（75%）。综合PPRs最低的领域为：事件报告频率（57%）、对差错的无惩罚性回应（53%）、沟通开放性（51%）和人员配备（37%）。
我们的结果表明，应解决人员配备问题以提供安全的护理。工作人员避免公开报告不良事件和/或讨论差错，可能是因为对这些事件的学习潜力理解不足，以及害怕受到指责或惩罚性行动。未来的研究应检验应用于摩尔多瓦工作人员的HSOPSC罗马尼亚语版本的心理测量学特性。
