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埃塞俄比亚西北部阿姆哈拉地区转诊医院护士的医疗事故披露行为及相关因素:一项横断面研究

Critical Incident Disclosing Behaviors and Associated Factors among Nurses Working in Amhara Region Referral Hospitals, Northwest Ethiopia: A Cross-Sectional Study.

作者信息

Eshete Yeshiambew, Tesfaye Bekele, Dagnew Zewdu, Kefale Demewoz, Mesfin Belay Demke, Minuye Binyam

机构信息

Department of Nursing, College of Health Sciences, Debretabor University, Debretabor, Ethiopia.

College of Health Sciences, Debremarkos University, Debremarkos, Ethiopia.

出版信息

Crit Care Res Pract. 2021 Jan 11;2021:8813368. doi: 10.1155/2021/8813368. eCollection 2021.

Abstract

BACKGROUND

Though the goal of healthcare institutions is patient safety, errors have been committed by healthcare providers. Incident reporting behavior enhances patient safety by reducing the repeated occurrence of errors in the health facility. Therefore, this study aims to identify incident disclosing behaviors and associated factors among nurses working in referral hospitals, Northwest Ethiopia.

METHODS

Institution-based cross-sectional study design was conducted among randomly selected 319 nurses working in referral hospitals of Amhara region from March 1-30, 2019. Data were collected using a self-administered structured questionnaire. Data were coded and entered into EpiData 4.2 software and exported to Statistical Package for Social Sciences version 25 for analysis. All variables with value <0.25 during bivariable binary logistic regression analysis were considered for multivariable binary logistic regression analysis. Odds ratio along with 95% CI was estimated to measure the strength of the association. Level of statistical significance was declared at value ≤0.05.

RESULTS

The proportion of nurses who reported incidents was 31.9% (95% confidence interval (CI), 27, 3)). Fear of administrative sanctions (adjusted odd ratio (AOR) = 0.45; 95% CI, 0.22, 0.90), fear of legal penalty (AOR = 0.27; 95% CI, 0.14, 0.50), lack of feedback (AOR = 0.29; 95% CI, 0.13, 0.66), nonsupportive environment (AOR = 0.27; 95% CI, 0.14, 0.52), and feel that reporting to colleague is easier (AOR = 2.65; 95% CI, 1.35, 5.20) were all found to be significant factors.

CONCLUSIONS

The proportion of nurses who reported incidents was low. Fear of administrative sanctions, fear of legal penalty, lack of feedback, nonsupportive environment, and felling that reporting to colleagues was easier are found to be significant factors. Developing a system that encourages critical incident reporting behavior and provide protection from penalties for nurses to report incidents for the enhancement of patient safety and quality of care at each health facility and regional level is crucial.

摘要

背景

尽管医疗机构的目标是确保患者安全,但医护人员仍会犯错。事件报告行为通过减少医疗机构中错误的重复发生来提高患者安全。因此,本研究旨在确定埃塞俄比亚西北部转诊医院护士的事件披露行为及相关因素。

方法

2019年3月1日至30日,在阿姆哈拉地区转诊医院随机抽取319名护士进行基于机构的横断面研究设计。使用自填式结构化问卷收集数据。数据进行编码后录入EpiData 4.2软件,并导出到社会科学统计软件包第25版进行分析。在双变量二元逻辑回归分析中,所有P值<0.25的变量都被纳入多变量二元逻辑回归分析。估计比值比及95%置信区间以衡量关联强度。当P值≤0.05时宣布具有统计学意义。

结果

报告事件的护士比例为31.9%(95%置信区间(CI),27,3))。害怕行政制裁(调整后比值比(AOR)=0.45;95%CI,0.22,0.90)、害怕法律处罚(AOR=0.27;95%CI,0.14,0.50)、缺乏反馈(AOR=0.29;95%CI,0.13,0.66)、不支持的环境(AOR=0.27;95%CI,0.14,0.52)以及感觉向同事报告更容易(AOR=2.65;95%CI,1.35,5.20)均被发现是重要因素。

结论

报告事件的护士比例较低。害怕行政制裁、害怕法律处罚、缺乏反馈、不支持的环境以及感觉向同事报告更容易被发现是重要因素。建立一个鼓励关键事件报告行为并为护士提供免受处罚保护的系统,以便他们能够报告事件,从而在每个医疗机构和地区层面提高患者安全和护理质量至关重要。

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