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加沙地带医生和护士对医疗实践中患者安全和错误的态度:一项横断面研究。

Attitudes of doctors and nurses to patient safety and errors in medical practice in the Gaza-Strip: a cross-sectional study.

机构信息

Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine

Islamic University of Gaza Faculty of Nursing, Gaza, State of Palestine.

出版信息

BMJ Open. 2019 Aug 5;9(8):e026788. doi: 10.1136/bmjopen-2018-026788.

Abstract

OBJECTIVES

This study examined the attitudes of nurses and doctors to key patient safety concepts, evaluated differences and similarities between professional groups and assessed positive and negative attitudes to identify target areas for future training.

SETTING

Four major governmental hospitals in the Gaza-Strip.

PARTICIPANTS

A convenience sample of 424 nurses and 150 physicians working for at least 6 months in the study hospitals.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures were mean scores with SD as measured for individual items and nine main patient safety domains assessed by the Attitudes to Patient Safety Questionnaire. Secondary outcome measures were the proportions of doctors and nurses, that gave a positive response to each item, represented as percentage of each group.

RESULTS

Nurses and doctors held moderately positive attitudes towards patient safety with five out of nine domain scores >3.5 of 5. Doctors showed slightly more positive attitudes than nurses, despite a smaller proportion of doctors having received patient safety training with 37.5% compared with 41.9% of nurses. Both professions displayed their most positive patient safety attitudes in the same domains ('team functioning' and 'working hours as a cause for error'), as well as their two most negative attitudes ('importance of patient safety in the curriculum' and 'professional incompetence as a cause of error'), demonstrating significant deficits in understanding medical errors. A specific challenge will be the negative attitudes of both professions towards patient safety training for wider dissemination of this content in the postgraduate curriculum.

CONCLUSION

Patient safety attitudes were moderately positive in both professional groups. Target of future patient safety training should be enhancing the understanding of error in medicine. Any training has to be motivating and relevant for clinicians, demonstrating its importance in ongoing professional learning.

摘要

目的

本研究考察了护士和医生对关键患者安全概念的态度,评估了专业群体之间的差异和相似之处,并评估了积极和消极态度,以确定未来培训的目标领域。

地点

加沙地带的四家主要政府医院。

参与者

在研究医院工作至少 6 个月的 424 名护士和 150 名医生的便利样本。

主要和次要结果测量

主要结果测量是个体项目的平均得分和标准差,以及通过患者安全态度问卷评估的九个主要患者安全领域的得分。次要结果测量是对每个项目给予积极回应的医生和护士的比例,以每组的百分比表示。

结果

护士和医生对患者安全持有较为积极的态度,九个领域中有五个领域的得分>3.5 分(满分为 5 分)。尽管接受患者安全培训的医生比例较小(37.5%对 41.9%),但医生的态度比护士略为积极。两个专业在相同的领域(“团队功能”和“工作时间是错误的原因”)表现出最积极的患者安全态度,以及他们两个最消极的态度(“患者安全在课程中的重要性”和“专业能力不足是错误的原因”),表明他们对医疗错误的理解存在显著缺陷。一个特殊的挑战将是两个专业对更广泛传播这种内容的患者安全培训的负面态度。

结论

两个专业群体的患者安全态度均为中度积极。未来患者安全培训的目标应该是增强对医学错误的理解。任何培训都必须对临床医生具有激励性和相关性,展示其在持续专业学习中的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49bb/6687030/67ef7ee8c1f6/bmjopen-2018-026788f01.jpg

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