日本医护人员的患者安全文化与影响工作环境的因素（如工作时间、夜班次数和休息日数量）之间的关系：一项横断面研究。
Relationship of patient safety culture with factors influencing working environment such as working hours, the number of night shifts, and the number of days off among healthcare workers in Japan: a cross-sectional study.
机构信息
Toho University Graduate School of Medicine, Tokyo, Japan.
Department of Social Medicine, Toho University School of Medicine, Tokyo, Japan.
出版信息
BMC Health Serv Res. 2020 Apr 15;20(1):310. doi: 10.1186/s12913-020-05114-8.
BACKGROUND
Patient safety culture is defined as a product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization's health and safety management. Factors influencing healthcare workers' working environment such as working hours, the number of night shifts, and the number of days off may be associated with patient safety culture, and the association pattern may differ by profession. This study aimed to examine the relationship between patient safety culture and working environment.
METHODS
Questionnaire surveys were conducted in 2015 and 2016. The first survey was conducted in hospitals in Japan to investigate their patient safety management system and activities and intention to participate in the second survey. The second survey was conducted in 40 hospitals; 100 healthcare workers from each hospital answered a questionnaire that was the Japanese version of the Hospital Survey on Patient Safety Culture for measuring patient safety culture. The relationship of patient safety culture with working hours in a week, the number of night shifts in a month, and the number of days off in a month was analyzed.
RESULTS
Response rates for the first and second surveys were 22.4% (731/3270) and 94.2% (3768/4000), respectively. Long working hours, numerous night shifts, and few days off were associated with low patient safety culture. Despite adjusting the working hours, the number of event reports increased with an increase in the number of night shifts. Physicians worked longer and had fewer days off than nurses. However, physicians had fewer composites of patient safety culture score related to working hours, the number of night shifts, and the number of days off than nurses.
CONCLUSIONS
This study suggested a possibility of improving the patient safety culture by managing the working environment of healthcare workers. High number of night shifts may lead to high number of event reports. Working hours, the number of night shifts, and the number of days off may differently influence patient safety culture in physicians and nurses.
背景
患者安全文化定义为个体和群体价值观、态度、认知、能力和行为模式的产物，这些因素决定了组织对健康和安全管理的承诺、风格和熟练程度。影响医疗保健工作者工作环境的因素，如工作时间、夜班次数和休息日天数，可能与患者安全文化有关，其关联模式可能因职业而异。本研究旨在探讨患者安全文化与工作环境之间的关系。
方法
2015 年和 2016 年进行了问卷调查。第一次调查在日本的医院进行，旨在调查其患者安全管理系统和活动以及参与第二次调查的意愿。第二次调查在 40 家医院进行；每家医院的 100 名医护人员回答了一份问卷，该问卷是用于衡量患者安全文化的《医院患者安全文化调查》的日语版。分析了患者安全文化与每周工作时间、每月夜班次数和每月休息日天数的关系。
结果
第一次和第二次调查的回复率分别为 22.4%（731/3270）和 94.2%（3768/4000）。工作时间长、夜班多、休息日少与患者安全文化水平低有关。尽管调整了工作时间，但随着夜班次数的增加，事件报告的数量也会增加。医生的工作时间比护士长，休息日也比护士少。然而，与护士相比，医生在与工作时间、夜班次数和休息日天数相关的患者安全文化评分组合方面得分较低。
结论
本研究表明，通过管理医疗保健工作者的工作环境，有可能改善患者安全文化。夜班次数多可能导致事件报告数量增加。工作时间、夜班次数和休息日天数可能会对医生和护士的患者安全文化产生不同的影响。
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