从重症护理护士的角度对患者安全文化及其相关因素进行的基线评估：来自10家医院的结果。

A baseline assessment of patient safety culture and its associated factors from the perspective of critical care nurses: Results from 10 hospitals.

作者信息

Tlili Mohamed Ayoub, Aouicha Wiem, Sahli Jihene, Zedini Chekib, Ben Dhiab Mohamed, Chelbi Souad, Mtiraoui Ali, Said Latiri Houyem, Ajmi Thouraya, Ben Rejeb Mohamed, Mallouli Manel

机构信息

University of Sousse, Faculty of Medicine of Sousse (Tunisia), Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle» - University of Sousse, Higher School of Health Sciences and Techniques of Sousse, Tunisia.

出版信息

Aust Crit Care. 2021 Jul;34(4):363-369. doi: 10.1016/j.aucc.2020.09.004. Epub 2020 Oct 26.

DOI:10.1016/j.aucc.2020.09.004

PMID:33121872

Abstract

INTRODUCTION

Critical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings.

OBJECTIVES

This study aimed to assess critical care nurses' perception of PSC and to determine its associated factors.

METHODS

This cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items.

RESULTS

A total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension "frequency of events reported" and 50.1% for the dimension "teamwork within units". Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92-6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02-1.12]; p = 0.018).

CONCLUSION

This study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.

摘要

引言

重症监护护士被视为改善患者安全的关键，在重症监护病房（ICU）提高护理质量方面发挥着至关重要的作用，在这些病房中不良事件频发且后果严重。此外，人们认识到评估和发展患者安全文化（PSC）作为改善患者安全和医疗质量的战略重点的重要性，尤其是在重症监护环境中。

目的

本研究旨在评估重症监护护士对PSC的认知，并确定其相关因素。

方法

这项横断面研究在突尼斯中心（六个突尼斯省份）的ICU工作的护士中进行。研究工具是经过法语验证的《医院患者安全文化调查问卷》版本，包括10个维度，共50个项目。

结果

来自18个ICU的249名护士参与了研究，参与率为87.36%。维度得分在“报告事件频率”维度的17.2%至“单位内团队合作”维度的50.1%之间。多变量逻辑回归表明，在私立医院工作的受访者拥有发达PSC的可能性是其他受访者的五倍（调整后的优势比[AOR]：5.34；95%置信区间[CI]，[2.28, 12.51]；p < 0.01）。同样，在认证医院工作的参与者拥有更发达PSC的可能性是在非认证医院工作的受访者的两倍（AOR：2.51；95% CI，[0.92 - 6.82]；p = 0.041）。此外，护士与患者比例增加（即工作量减少）会提高PSC（AOR：1.10；95% CI，[1.02 - 1.12]；p = 0.018）。