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印度尼西亚公立医院医护人员上报事件的实际与文化障碍

Practical and Cultural Barriers to Reporting Incidents Among Health Workers in Indonesian Public Hospitals.

作者信息

Dhamanti Inge, Leggat Sandra, Barraclough Simon

机构信息

Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.

Center for Patient Safety Research, Universitas Airlangga, Surabaya, Indonesia.

出版信息

J Multidiscip Healthc. 2020 Apr 3;13:351-359. doi: 10.2147/JMDH.S240124. eCollection 2020.

Abstract

PURPOSE

This study investigated the practical and cultural barriers of reporting patient safety incidents in three accredited public hospitals in East Java, Indonesia.

METHODS

This study employed a mixed methods approach using a convergent parallel design. We surveyed 1121 health workers and interviewed 27 managerial staff members from the sampled hospitals. A chi-square analysis was performed to evaluate differences in demographic factors, barriers to reporting, and practices of reporting between those who had reported an incident and those who had witnessed an incident but had not reported it. NVivo 11 software was used to perform the qualitative data analysis.

RESULTS

This study had a 76.53% response rate. The quantitative evaluation identified significant differences in professions and work units and in participation in quality and safety training between the reporting group and the non-reporting group. The analysis of practical barriers displayed significant differences between the groups with the following responses: "did not know how to report," "did not know where to report," and "lack of feedback". For cultural barriers, a significant difference was shown only for the response "did not want conflict." In the qualitative assessment, most of the interview participants reported lack of knowledge and lack of socialization or training as practical barriers in reporting incidents. Furthermore, reluctance and fear to report were mentioned as cultural barriers by most of the interviewees.

CONCLUSION

Because there were conflicting findings in the barriers of reporting incidents, these barriers must be identified, discussed, and resolved by health workers and their managers or supervisors to improve incident reporting. Managers must foster open communication and build positive connections with health workers. Further research is necessary to focus on possible ways of addressing the barriers to reporting.

摘要

目的

本研究调查了印度尼西亚东爪哇省三家经认可的公立医院在报告患者安全事件方面的实际和文化障碍。

方法

本研究采用混合方法,采用收敛平行设计。我们对1121名卫生工作者进行了调查,并采访了抽样医院的27名管理人员。进行卡方分析以评估报告事件者与目睹事件但未报告者在人口统计学因素、报告障碍和报告实践方面的差异。使用NVivo 11软件进行定性数据分析。

结果

本研究的回复率为76.53%。定量评估发现报告组和非报告组在职业、工作单位以及参与质量和安全培训方面存在显著差异。对实际障碍的分析显示,两组在以下回复方面存在显著差异:“不知道如何报告”、“不知道向何处报告”以及“缺乏反馈”。对于文化障碍,仅在“不想引发冲突”这一回复上显示出显著差异。在定性评估中,大多数访谈参与者报告称缺乏知识以及缺乏社交或培训是报告事件的实际障碍。此外,大多数受访者提到不愿报告和害怕报告是文化障碍。

结论

由于在报告事件的障碍方面存在相互矛盾的发现,卫生工作者及其管理人员或上级必须识别、讨论并解决这些障碍,以改善事件报告。管理人员必须促进开放沟通,并与卫生工作者建立积极的联系。有必要进行进一步研究,重点关注解决报告障碍的可能方法。

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