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养老院患者安全文化与不良事件报告障碍。

Patient safety culture and obstacles to adverse event reporting in nursing homes.

机构信息

Xiangya International Medical Centre, Xiangya Hospital, Central South University, Changsha, China.

Xiangya Nursing School, Central South University, Changsha, China.

出版信息

J Nurs Manag. 2020 Oct;28(7):1536-1544. doi: 10.1111/jonm.13098. Epub 2020 Aug 26.

Abstract

AIMS

To investigate patient safety culture and its relationship with obstacles to adverse event reporting in Chinese nursing homes.

BACKGROUND

Reporting obstacles are related to high incidences and unreported rates of adverse events. Patient safety culture is also associated with adverse events. However, the relationship between reporting obstacles and patient safety culture in nursing homes is unclear.

METHODS

A cross-sectional survey was conducted with a random sampling method among 549 staff members in six nursing homes using instruments of the Nursing Home Survey on Patient Safety Culture and the Adverse Event Reporting Obstacle Scale. The Pearson correlation coefficient, independent t tests, ANOVA tests and multivariate regression analysis were used.

RESULTS

Patient safety culture in nursing homes was associated with facility ownership (p < .001), facility scale (p < .001), reporting management (p < .001), whether it was an integrated care institution (p = .006), frequency of concern about patient safety (p = .001), occurrence of adverse events in departments (p = .001) and a punitive atmosphere (p = .044). Adverse event reporting obstacles were negatively correlated with patient safety culture (p < .05).

CONCLUSION

An improvement in patient safety culture was associated with a reduction in reporting obstacles in nursing homes.

IMPLICATIONS FOR NURSING MANAGEMENT

A barrier-free adverse event reporting system should be built to reduce reporting obstacles and create a non-punitive patient safety culture in nursing homes.

摘要

目的

调查中国养老院患者安全文化及其与不良事件报告障碍的关系。

背景

报告障碍与不良事件的高发生率和未报告率有关。患者安全文化也与不良事件有关。然而,养老院报告障碍与患者安全文化之间的关系尚不清楚。

方法

采用横断面调查方法,对 6 家养老院的 549 名工作人员进行随机抽样,使用养老院患者安全文化调查工具和不良事件报告障碍量表。采用 Pearson 相关系数、独立 t 检验、方差分析和多元回归分析。

结果

养老院的患者安全文化与机构所有权(p<0.001)、机构规模(p<0.001)、报告管理(p<0.001)、是否为综合护理机构(p=0.006)、对患者安全的关注频率(p=0.001)、科室不良事件发生情况(p=0.001)和惩罚氛围(p=0.044)有关。不良事件报告障碍与患者安全文化呈负相关(p<0.05)。

结论

提高患者安全文化与减少养老院报告障碍有关。

对护理管理的启示

应建立无阻碍的不良事件报告系统,以减少养老院的报告障碍,并营造非惩罚性的患者安全文化。

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