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关注急诊体外膜肺氧合(ECMO)团队的患者安全文化:一项横断面调查。

Concern for Patient Safety Culture of ECMO Team in Emergency Department: A Cross-Sectional Survey.

机构信息

Central South University, Changsha, China.

出版信息

Inquiry. 2022 Jan-Dec;59:469580221129168. doi: 10.1177/00469580221129168.

Abstract

To evaluate the patient safety culture status of the ECMO team in the emergency department of a tertiary care hospital. A cross-sectional survey was conducted in the emergency department of Xiangya Hospital from September 1st to 30th, 2021. The Chinese version of HSOPSC electronic questionnaire was administered to all staff involved in ECMO management and initiation. A total of 152 ECMO team members completed the survey. Among the 12 dimensions of patient safety culture, 4 dimensions recorded relatively high positive response rates (>50%): organizational learning-continuous improvement (87.1%), teamwork within units (86.8%), feedback and communication about errors (58.5%), and supervisor/manager expectations and actions promoting patient safety (55.6%). 8 dimensions recorded relatively low positive response rates (<50%): nonpunitive responses to errors (24.1%), hospital handoffs and transitions (27.1%), staffing (28.6%), the frequency of event reporting (32.4%), teamwork across units (33.2%), communication openness (39.7%), management support for patient safety (48.7%), and overall perceptions of patient safety (49.3%). The overall level of patient safety culture was measured at 47.6%. The ECMO team should immediately address issues of nonpunitive responses to errors, hospital handoffs and transitions, and staffing to improve the safety of ECMO. Going forward, the head of the ECMO team should regard patient safety culture as a top priority, improve staff satisfaction, standardize the transfer and handover process, and create a blame-free environment to facilitate event reporting.

摘要

评估一家三级医院急诊科 ECMO 团队的患者安全文化状况。2021 年 9 月 1 日至 30 日,在湘雅医院急诊科进行了横断面调查。采用 HSOPSC 电子问卷中文版对所有参与 ECMO 管理和启动的工作人员进行了问卷调查。共有 152 名 ECMO 团队成员完成了调查。在患者安全文化的 12 个维度中,有 4 个维度记录了较高的积极响应率(>50%):组织学习-持续改进(87.1%)、单位内团队合作(86.8%)、错误反馈和沟通(58.5%)以及主管/经理期望和促进患者安全的行动(55.6%)。8 个维度记录了较低的积极响应率(<50%):对错误的非惩罚性反应(24.1%)、医院交接和过渡(27.1%)、人员配备(28.6%)、事件报告频率(32.4%)、跨单位团队合作(33.2%)、沟通开放性(39.7%)、管理层对患者安全的支持(48.7%)和整体患者安全感知(49.3%)。患者安全文化的总体水平为 47.6%。ECMO 团队应立即解决对错误的非惩罚性反应、医院交接和过渡以及人员配备等问题,以提高 ECMO 的安全性。今后,ECMO 团队负责人应将患者安全文化作为重中之重,提高员工满意度,规范交接流程,营造无责环境,促进事件报告。

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