教育干预对妇产科医护人员患者安全文化的影响。
Impact of an educational intervention on patient safety culture among gynecology-obstetrics' healthcare professionals.
机构信息
Université de Sousse, Faculté de Médecine de Sousse, Sousse, LR12ES03, 4000, Tunisie.
Service de Gynécologie Obstétrique CHU Farhat Hached, Sousse, 4000, Tunisie.
出版信息
BMC Health Serv Res. 2024 Jun 5;24(1):704. doi: 10.1186/s12913-024-11152-3.
BACKGROUND
In recent years, patient safety has begun to receive particular attention and has become a priority all over the world. Patient Safety Culture (PSC) is widely recognized as a key tenet that must be improved in order to enhance patient safety and prevent adverse events. However, in gynecology and obstetrics, despite the criticality of the environment, few studies have focused on improving PSC in these units. This study aimed at assessing the effectiveness of an educational program to improve PSC among health professionals working in the obstetric unit of a Tunisian university hospital.
METHODS
We conducted a quasi-experimental study in the obstetric unit of a university hospital in Sousse (Tunisia). All the obstetric unit's professionals were invited to take part in the study (n = 95). The intervention consisted of an educational intervention with workshops and self-learning documents on patient safety and quality of care. The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture. Normality of the data was checked using Kolmogorov-Smirnov test. The comparison of dimensions' scores before and after the intervention was carried out by the chi2 test. The significance level was set at 0.05.
RESULTS
In total, 73 participants gave survey feedback in pre-test and 68 in post-test (response rates of 76.8% and 71.6, respectively). Eight dimensions improved significantly between pre- and post-tests. These dimensions were D2 "Frequency of adverse events reported" (from 30.1 to 65.6%, p < 0.001), D3 "Supervisor/Manager expectations and actions promoting patient safety" (from 38.0 to 76.8%, p < 0.001), D4 "Continuous improvement and organizational learning" (from 37.5 to 41.0%, p < 0.01), D5 "Teamwork within units" (from 58.2 to 79.7%, p < 0.01), D6 "Communication openness" (from 40.6 to 70.6%, p < 0.001), and D7 "Non-punitive response to error" (from 21.1 to 42.7%, p < 0.01), D9 "Management support for patient safety" (from 26.4 to 72.8%, p < 0.001), and D10 "Teamwork across units" (from 31.4 to 76.2%, p < 0.001).
CONCLUSIONS
Educational intervention, including workshops and self-learning as pedagogical tools can improve PSC. The sustainability of the improvements made depends on the collaboration of all personnel to create and promote a culture of safety. Staff commitment at all levels remains the cornerstone of any continuous improvement in the area of patient safety.
背景
近年来，患者安全已开始受到特别关注，并已成为全球的优先事项。患者安全文化（PSC）被广泛认为是必须改进的关键原则，以提高患者安全并预防不良事件。然而，在妇产科，尽管环境至关重要，但很少有研究关注改善这些单位的 PSC。本研究旨在评估一项教育计划在提高突尼斯一所大学医院妇产科专业人员的 PSC 方面的有效性。
方法
我们在苏塞的一所大学医院的妇产科进行了一项准实验研究（突尼斯）。邀请所有妇产科专业人员参加研究（n=95）。干预措施包括关于患者安全和护理质量的教育干预，包括讲习班和自学文件。研究工具是经过验证的法国版《医院患者安全文化调查》。使用 Kolmogorov-Smirnov 检验检查数据的正态性。干预前后维度得分的比较通过卡方检验进行。显著性水平设为 0.05。
结果
共有 73 名参与者在预测试中提供了调查反馈，68 名在 post-test 中提供了反馈（响应率分别为 76.8%和 71.6%）。有 8 个维度在预测试和 post-test 之间有显著改善。这些维度是 D2“报告的不良事件频率”（从 30.1%到 65.6%，p<0.001）、D3“主管/经理对患者安全的期望和行动”（从 38.0%到 76.8%，p<0.001）、D4“持续改进和组织学习”（从 37.5%到 41.0%，p<0.01）、D5“单位内团队合作”（从 58.2%到 79.7%，p<0.01）、D6“沟通开放性”（从 40.6%到 70.6%，p<0.001）、D7“对错误的非惩罚性反应”（从 21.1%到 42.7%，p<0.01）、D9“管理层对患者安全的支持”（从 26.4%到 72.8%，p<0.001）和 D10“单位间团队合作”（从 31.4%到 76.2%，p<0.001）。
结论
包括讲习班和自学在内的教育干预措施可以提高 PSC。改进的可持续性取决于所有人员的合作，以创建和促进安全文化。各级工作人员的承诺仍然是患者安全领域任何持续改进的基石。
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