Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
Center for Implementation Science, Health Service, and Population Research Department, King's College London, London, United Kingdom.
BMJ Open Qual. 2020 Jul;9(3). doi: 10.1136/bmjoq-2020-000966.
Our primary objective was to study the impact of the Norwegian National Patient Safety Campaign and Program on Surgical Safety Checklist (SSC) implementation and on safety culture. Secondary objective was associations between SSC fidelity and safety culture. We hypothesised that the programme influenced on SSC use and operating theatre personnel's safety culture perceptions.
A longitudinal cross-sectional study was conducted in a large Norwegian tertiary teaching hospital.
We invited 1754 operating theatre personnel to participate in the study, of which 920 responded to the surveys at three time points in 2009, 2010 and 2017.
Primary outcome was the results of the patient safety culture measured by the culturally adapted Norwegian version of the Hospital Survey on Patient Safety Culture. Our previously published results from 2009/2010 were compared with new data collected in 2017. Secondary outcome was correlation between SSC fidelity and safety culture. Fidelity was electronically recorded.
Survey response rates were 61% (349/575), 51% (292/569) and 46% (279/610) in 2009, 2010 and 2017, respectively. Eight of the 12 safety culture dimensions significantly improved over time with the largest increase being '' from a mean score of 2.82 at baseline in 2009 to 3.15 in 2017 (mean change: 0.33, 95% CI 0.21 to 0.44). Fidelity in use of the SSC averaged 88% (26 741/30 426) in 2017. Perceptions of safety culture dimensions in 2009 and in 2017 correlated significantly though weakly with fidelity (r=0.07-0.21).
The National Patient Safety Program, fostering engagement from trust boards, hospital managers and frontline operating theatre personnel enabled effective implementation of the SSC. As part of a wider strategic safety initiative, implementation of SSC coincided with an improved safety culture.
我们的主要目的是研究挪威国家患者安全运动和计划对手术安全检查表（SSC）实施和安全文化的影响。次要目的是 SSC 保真度与安全文化之间的关系。我们假设该计划影响 SSC 的使用和手术室人员对安全文化的认知。
一项大型挪威三级教学医院的纵向横断面研究。
我们邀请了 1754 名手术室工作人员参与研究，其中 920 名工作人员在 2009 年、2010 年和 2017 年三个时间点对调查做出了回应。
主要结果是通过文化适应的挪威版医院患者安全文化调查测量的患者安全文化结果。我们之前发表的 2009/2010 年的结果与 2017 年新收集的数据进行了比较。次要结果是 SSC 保真度与安全文化之间的相关性。保真度是通过电子方式记录的。
2009 年、2010 年和 2017 年的调查回复率分别为 61%（349/575）、51%（292/569）和 46%（279/610）。12 个安全文化维度中有 8 个随着时间的推移显著改善，其中“管理层对安全的承诺”的改善幅度最大，从 2009 年基线时的平均得分为 2.82 提高到 2017 年的 3.15（平均变化：0.33，95%CI 0.21-0.44）。2017 年 SSC 的使用保真度平均为 88%（26741/30426）。2009 年和 2017 年的安全文化维度认知与保真度显著相关，尽管相关性较弱（r=0.07-0.21）。
国家患者安全计划通过信任委员会、医院管理人员和一线手术室工作人员的参与，促进了 SSC 的有效实施。作为更广泛的战略安全举措的一部分，SSC 的实施恰逢安全文化的改善。
