护士在临床护理信息系统任务中自我报告的险些失误的影响因素：一项多中心横断面研究

Influencing factors of self-reported near-miss in clinical nursing information system tasks among nurses: a multicenter cross-sectional study.

作者信息

Du Xingyao, Shi Haoning, Peng Ying, Jiang Siqi, Song Jingyan, Wang Chunni, Li Lin, Xiao Mingzhao, Zhao Qinghua, Huang Huanhuan

机构信息

Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Center of Nursing Research, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

BMC Nurs. 2025 Jul 22;24(1):960. doi: 10.1186/s12912-025-03622-8.

DOI:10.1186/s12912-025-03622-8

PMID:40696341

Abstract

BACKGROUND

Clinical nursing information systems have certain safety vulnerabilities in the complex interactions of the healthcare environment. Near-misses refer to patient safety incidents that have the potential to cause harm but do not result in adverse outcomes, serving as frontline sentinels for identifying risks. The aim of this study was to assess the current status of near misses in clinical nursing information system tasks and the factors that influence them, to provide insights for improving patient safety and enhancing care management.

METHODS

The study was based on the Human-Machine-Environment (HME) systems engineering framework and utilized three validated tools: the Nurse Informatics Competency Assessment Scale (NICAS), the Clinical Nursing Information System Effectiveness Evaluation Scale (CNISEES), and the Workplace Interruption Measurement Scale (WIMS). Using a multicenter cross-sectional design, we recruited 1,311 clinical nurses from 12 tertiary hospitals in Chongqing, China. Descriptive statistics, chi-square tests, one-way analysis of variance, Pearson correlation analysis, and binary logistic regression were employed to identify the influencing factors of near-miss events in nursing information system tasks.

RESULTS

The study found that 52.78% (692/1,311) of clinical nurses had experienced near-miss events of nursing information system tasks in the past three months. Among them, information transmission is the most vulnerable process (931 occurrences). The total score of nursing practice information competency was (57.78 ± 16.72), the total score of the clinical nursing information system effectiveness was (86.65 ± 18.99), and the total score of the workplace interruption was (21.45 ± 8.56). Logistic regression analysis revealed that nurses' professional titles, information management competency, work intensity, clinical teaching, system net benefits, and workplace interruptions were influencing factors for the occurrence of near-miss events in nursing information systems.

CONCLUSION

Near-misses in nursing information system tasks within healthcare information systems are prevalent and influenced by the personal circumstances of nurses, the effectiveness of the information system, and workplace interruptions. These findings underscore the importance of studying near-miss events in nursing information system tasks as sentinels for patient safety. Targeted interventions, including enhanced training in informatics, optimization of clinical information systems, and strategies to reduce workplace disruptions, are essential to prevent potential adverse events and improve patient safety.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

临床护理信息系统在医疗环境的复杂交互中存在一定的安全漏洞。险些失误是指有可能造成伤害但未导致不良后果的患者安全事件，可作为识别风险的前沿哨兵。本研究旨在评估临床护理信息系统任务中险些失误的现状及其影响因素，为提高患者安全和加强护理管理提供见解。

方法

本研究基于人-机-环境（HME）系统工程框架，使用了三种经过验证的工具：护士信息学能力评估量表（NICAS）、临床护理信息系统有效性评估量表（CNISEES）和工作场所干扰测量量表（WIMS）。采用多中心横断面设计，从中国重庆的12家三级医院招募了1311名临床护士。运用描述性统计、卡方检验、单因素方差分析、Pearson相关分析和二元逻辑回归来确定护理信息系统任务中险些失误事件的影响因素。

结果

研究发现，52.78%（692/1311）的临床护士在过去三个月中经历过护理信息系统任务的险些失误事件。其中，信息传递是最易出现问题的环节（发生931次）。护理实践信息能力总分为（57.78±16.72），临床护理信息系统有效性总分为（86.65±18.99），工作场所干扰总分为（21.45±8.56）。逻辑回归分析显示，护士的职称、信息管理能力、工作强度、临床教学、系统净效益和工作场所干扰是护理信息系统中险些失误事件发生的影响因素。

结论

医疗信息系统中护理信息系统任务的险些失误很普遍，且受护士个人情况、信息系统有效性和工作场所干扰的影响。这些发现强调了将护理信息系统任务中的险些失误事件作为患者安全哨兵进行研究的重要性。针对性的干预措施，包括加强信息学培训、优化临床信息系统以及减少工作场所干扰的策略，对于预防潜在不良事件和提高患者安全至关重要。