He Haiyan, Chen Xi, Tian Lingyun, Long Yanfang, Li Li, Yang Ning, Tang Siyuan
Teaching and Research Section of Clinical Nursing, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
Xiangya School of Nursing, Central South University, Changsha, Hunan, China.
BMC Nurs. 2023 Sep 25;22(1):329. doi: 10.1186/s12912-023-01494-4.
Patient safety is a global challenge influenced by perceived patient safety culture. However, limited knowledge exists regarding the patient safety culture perceived by hospital clinical managers and its associated factors. This study aims to investigate the perceptions of patient safety culture and associated factors among clinical managers of tertiary hospitals in China.
A cross-sectional survey was conducted from June 19 to July 16, 2021, involving 539 clinical managers from four tertiary hospitals in Changsha City of Hunan Province. The Hospital Survey on Patient Safety Culture (HSOPSC) was utilized to assess perceived patient safety culture. Bivariate, multivariable linear regression, and logistic regression analyses were performed.
The mean score for the total HSOPSC was 72.5 ± 7.6, with dimensional scores ranging from 62.1 (14.9) to 86.6 (11.7). Three dimensions exhibited positive response rates (PRRs) < 50%, indicating areas that need to be improved: "nonpunitive response to errors" (40.5%), "staffing" (41.9%), and "frequency of events reported" (47.4%). Specialized hospitals (β = 1.744, P = 0.037), female gender (β = 2.496, P = 0.003), higher professional title (β = 1.413, P = 0.049), a higher education level (β = 1.316, P = 0.001), and shorter time delays per shift (β=-1.13, P < 0.001) were correlated with higher perceived patient safety culture. Education level, work department, "teamwork within a unit", "management support for patient safety", "communication openness", and "staffing" dimensions were associated with patient safety grades (all P < 0.05). Years worked in hospitals, occupation, education level, work department, hospital nature, professional title, "communication openness", and "handoffs & transitions" were associated with the number of adverse events reported (all P < 0.05).
Our study revealed a generally low level of patient safety culture perceived by clinical managers and identified priority areas requiring urgent improvement. The associated factors of patient safety culture provide important guidance for the development of targeted interventions in the future. Promoting patient safety by optimizing the patient safety culture perceived by clinical managers should be prioritized.
患者安全是一项受感知到的患者安全文化影响的全球性挑战。然而，关于医院临床管理人员所感知到的患者安全文化及其相关因素的了解有限。本研究旨在调查中国三级医院临床管理人员对患者安全文化的认知及其相关因素。
于2021年6月19日至7月16日进行了一项横断面调查，涉及湖南省长沙市四家三级医院的539名临床管理人员。采用医院患者安全文化调查（HSOPSC）来评估感知到的患者安全文化。进行了双变量、多变量线性回归和逻辑回归分析。
HSOPSC总分的平均分为72.5±7.6，各维度得分范围为62.1（14.9）至86.6（11.7）。三个维度的积极回应率（PRR）<50%，表明需要改进的方面：“对差错的无惩罚性回应”（40.5%）、“人员配备”（41.9%）和“事件报告频率”（47.4%）。专科医院（β = 1.744，P = 0.037）、女性（β = 2.496，P = 0.003）、较高的职称（β = 1.413，P = 0.049）、较高的教育水平（β = 1.316，P = 0.001）以及每班较短的时间延迟（β = -1.13，P < 0.001）与较高的感知患者安全文化相关。教育水平、工作科室、“科室内部团队合作”、“对患者安全的管理支持”、“沟通开放性”和“人员配备”维度与患者安全等级相关（均P < 0.05）。在医院工作的年限、职业、教育水平、工作科室、医院性质、职称、“沟通开放性”和“交接班与转接”与报告的不良事件数量相关（均P < 0.05）。
我们的研究揭示了临床管理人员所感知到的患者安全文化总体水平较低，并确定了需要紧急改进的优先领域。患者安全文化的相关因素为未来制定针对性干预措施提供了重要指导。应优先通过优化临床管理人员所感知到的患者安全文化来促进患者安全。
