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探索护理专业学生对临床环境中患者安全文化的看法:一项混合方法研究。

Exploring Nursing Students' Perspectives on Patient Safety Culture in Clinical Settings: A Mixed-Method Study.

作者信息

Bartoníčková Daniela, Kohanová Dominika, Cakirpaloglu Simona Dobešová, Steven Alison, Žiaková Katarína

机构信息

Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic.

Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovak Republic.

出版信息

J Clin Nurs. 2025 May 6. doi: 10.1111/jocn.17812.

Abstract

BACKGROUND

Patient safety in undergraduate nursing studies is an indispensable component of the curriculum. The process of experiential learning from practice is of high value not only in terms of personal development but also enables students to identify and address critical areas of patient safety that require improvement.

AIM

To explore Czech undergraduate nursing students' perceptions of patient safety culture during clinical practice through a mixed-method sequential study.

METHODS

Data were collected between 2021 and 2024 using a mixed-method approach. The quantitative phase utilised the hospital survey on patient safety culture for nursing students. Four hundred and eighty-two undergraduate nursing students from 16 faculties across the Czech Republic participated. The subsequent qualitative phase employed semi-structured interviews with 12 undergraduate nursing students from one faculty in the Czech Republic. Descriptive and inferential statistical methods were used to analyse quantitative results, complemented by a reflective thematic analysis of qualitative data.

RESULTS

The most negatively rated survey dimensions were 'Frequency of events reported' (37.0%) and 'Nonpunitive responses to errors' (42.4%). Predictors for reporting adverse events in clinical practice were 'Indicators of good practice' (p ≤ 0.05). Based on the quantitative phase, the interpretive journey of nursing students' experiences from Exposure to adverse events, through Feeling disconnected and Cognitive dissonance, to the necessity of Speaking up for patient safety culture was captured in the qualitative phase.

CONCLUSIONS

Nursing students struggle to engage in a patient safety culture, particularly in reporting adverse events during clinical practice. Strengthening education on reporting and standards is essential for students, along with professional development for clinical staff to align practices and cultures.

摘要

背景

本科护理专业学习中的患者安全是课程中不可或缺的组成部分。从实践中进行体验式学习的过程不仅对个人发展具有很高的价值,还能使学生识别并解决患者安全中需要改进的关键领域。

目的

通过一项混合方法的序贯研究,探索捷克本科护理专业学生在临床实习期间对患者安全文化的认知。

方法

在2021年至2024年期间采用混合方法收集数据。定量阶段使用了针对护理专业学生的患者安全文化医院调查问卷。来自捷克共和国16所院校的482名本科护理专业学生参与了调查。随后的定性阶段对来自捷克共和国一所院校的12名本科护理专业学生进行了半结构化访谈。使用描述性和推断性统计方法分析定量结果,并对定性数据进行反思性主题分析作为补充。

结果

调查中评分最低的维度是“事件报告频率”(37.0%)和“对错误的无惩罚性回应”(42.4%)。临床实习中不良事件报告的预测因素是“良好实践指标”(p≤0.05)。基于定量阶段的结果,在定性阶段捕捉到了护理专业学生从接触不良事件、感到脱节和认知失调,到为患者安全文化发声的必要性这一体验的解读过程。

结论

护理专业学生在参与患者安全文化方面存在困难,尤其是在临床实习期间报告不良事件方面。加强关于报告和标准的教育对学生至关重要,同时临床工作人员的专业发展也很重要,以使其实践和文化保持一致。

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