Monash Nursing and Midwifery, Monash University, PO Box 527, Frankston, VIC 3199, Australia.
School of Nursing and Health Professions, Federation University, Gippsland Campus, Churchill, VIC 3842, Australia.
Int Emerg Nurs. 2021 Sep;58:101048. doi: 10.1016/j.ienj.2021.101048. Epub 2021 Sep 1.
There are numerous intricate human, system and cultural factors that can impact upon the safe and effective implementation of patient safety systems (e.g. rapid response systems). Safety climate is one of these factors and is a measure of frontline healthcare workers' shared perceptions, behaviours, beliefs and attitudes towards the organisation's culture of safety. Safety climate scores are also associated with the frequency of errors and adverse events in the healthcare setting. However, there is little evidence regarding the relationships between attitudes to patient safety and staff characteristics such as emergency care expertise and experience. The aims of this study were to measure perceptions of the safety climate in an Australian metropolitan Emergency Department and examine relationships between safety climate perceptions and staff characteristics.
The Victorian Managed Insurance Authority Safety Climate Survey was administered to all doctors (n = 44) and nurses (n = 119) at an Australian emergency department.
Completed surveys were received from 127 (78%) respondents, 25 (52%) doctors and 100 (84%) nurses. Reliability analysis showed very good internal consistency of all 43-items of the survey (α = 0.94). With the exception of stress recognition, nurses rated the organisation's commitment to patient safety higher than doctors in all remaining attitudinal domains (p < 0.05). Both groups acknowledge that fatigue, increased workload and stress recognition negatively impacts upon patient safety. There was a significant trend for declining safety climate ratings related to participants' clinical competence level and experience across all domains except stress recognition (p < 0.05).
The Safety Climate Survey appears to be a reliable measure of patient safety climate for use in Emergency Departments. Emergency doctors and nurses did not perceive there to be a strong organisational commitment to patient safety in an Australian Emergency Department. Emergency Departments can provide a safer environment through genuine commitment to safety culture improvement which capitalises on the insights, intrinsic strengths and behaviours characteristic of the ED team's expertise and experience. This kind of commitment can positively influence the effectiveness of actions taken to minimise risk to patient safety and improve ED staff job satisfaction and effectiveness.
有许多复杂的人为、系统和文化因素会影响患者安全系统（例如快速反应系统）的安全有效实施。安全氛围是其中一个因素，是衡量一线医护人员对组织安全文化的共同看法、行为、信念和态度的指标。安全氛围得分也与医疗保健环境中的错误和不良事件的频率有关。然而，关于对患者安全的态度与员工特征（如紧急护理专业知识和经验）之间的关系，证据很少。本研究的目的是测量澳大利亚大都市急诊部的安全氛围感知，并研究安全氛围感知与员工特征之间的关系。
在澳大利亚一家急诊部向所有医生（n=44）和护士（n=119）管理维多利亚州管理保险局安全氛围调查。
共收到 127 名（78%）应答者的完整调查，其中 25 名（52%）医生和 100 名（84%）护士。可靠性分析显示，调查的所有 43 项都具有非常好的内部一致性（α=0.94）。除了压力识别外，护士在所有剩余态度领域的组织对患者安全的承诺评价都高于医生（p<0.05）。两组都承认疲劳、工作量增加和压力识别会对患者安全产生负面影响。在除压力识别外的所有领域，参与者的临床能力水平和经验与安全氛围评分的下降趋势显著相关（p<0.05）。
安全氛围调查似乎是急诊部患者安全氛围的可靠测量工具。澳大利亚急诊部的急诊医生和护士并不认为组织对患者安全有强烈的承诺。通过真正致力于安全文化的改善，利用 ED 团队的专业知识和经验的特点、内在优势和行为，可以使急诊部提供更安全的环境。这种承诺可以积极影响为最大限度降低患者安全风险和提高 ED 员工工作满意度和效率而采取的行动的效果。
