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一项使用横断面调查数据对用药记录质量进行的多组路径分析:领导力、工作满意度、患者相关倦怠和患者安全文化的影响

A multi-group path analysis of medication documentation quality using cross-sectional survey data: Impact of leadership, job satisfaction, patient-related burnout, and patient safety culture.

作者信息

Gambashidze Nikoloz, Wagner Anke, Manser Tanja, Rieger Monika A, Martus Peter, Hammer Antje

机构信息

Institute for Patient Safety, University Hospital of Bonn, Bonn, Germany.

Institute of Occupational and Social Medicine and Health Services Research, University Hospital of Tübingen, Tübingen, Germany.

出版信息

PLoS One. 2025 Sep 12;20(9):e0330499. doi: 10.1371/journal.pone.0330499. eCollection 2025.

DOI:10.1371/journal.pone.0330499
PMID:40938869
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12431215/
Abstract

Medication-related adverse events are a major problem for patient safety and quality of care. This study explored the effects of leadership, job satisfaction, patient-related burnout and patient safety culture, measured through surveys of frontline workers, on documentation quality. Perceptions of physicians and nurses were surveyed using established instruments including the Transformational Leadership Inventory, the Copenhagen Psychosocial Questionnaire, the Copenhagen Burnout Inventory, and the Hospital Survey on Patient Safety Culture. Documentation quality was evaluated using retrospective review of patient records with the MediDoq instrument. Data from 24 departments, covering 282 physicians, 417 nurses, and 802 patient records, were analysed through a multi-group (physicians and nurses) path analysis to evaluate the theoretical model. The theoretical model revealed satisfactory fit, explaining about 76-80% of the variance in Documentation Quality for physicians and nurses. Perceived Patient Safety had a significant effect on Documentation Quality only for nurses. The analyses revealed differences between professional groups. Based on these results, (i) medication documentation quality may be affected by various organizational factors; (ii) perceived Patient Safety reported by the nurses may mediate some of these effects; (iii) the effects of various organizational factors on documentation quality may vary significantly across professional groups.

摘要

与用药相关的不良事件是患者安全和医疗质量的一个主要问题。本研究通过对一线工作人员进行调查,探讨了领导力、工作满意度、患者相关倦怠和患者安全文化对文件记录质量的影响。使用包括变革型领导量表、哥本哈根心理社会问卷、哥本哈根倦怠量表和患者安全文化医院调查等既定工具对医生和护士的认知进行了调查。使用MediDoq工具通过回顾性审查患者记录来评估文件记录质量。通过多组(医生和护士)路径分析对来自24个科室、涵盖282名医生、417名护士和802份患者记录的数据进行分析,以评估理论模型。理论模型显示拟合良好,解释了医生和护士文件记录质量差异的约76 - 80%。仅对护士而言,感知到的患者安全对文件记录质量有显著影响。分析揭示了不同专业群体之间的差异。基于这些结果,(i)用药文件记录质量可能受到各种组织因素的影响;(ii)护士报告的感知到的患者安全可能介导其中一些影响;(iii)各种组织因素对文件记录质量的影响在不同专业群体之间可能有显著差异。

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本文引用的文献

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The Impact of Real-Time Documentation of In-Hospital Medication Changes on Preventing Undocumented Discrepancies at Discharge and Improving Physician-Pharmacist Communication: A Retrospective Cohort Study and Survey.住院期间用药变更实时记录对预防出院时未记录差异及改善医师 - 药师沟通的影响:一项回顾性队列研究与调查
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Safety perception in the operating environment: The nurses' perspective versus that of the surgeons.手术环境中的安全认知:护士与外科医生的观点对比
Heliyon. 2023 Jan 4;9(1):e12676. doi: 10.1016/j.heliyon.2022.e12676. eCollection 2023 Jan.
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The association between nurse managers' transformational leadership and quality of patient care: A systematic review.
护士长的变革型领导与患者护理质量之间的关联:一项系统综述。
Int Nurs Rev. 2023 Jun;70(2):175-184. doi: 10.1111/inr.12819. Epub 2022 Dec 30.
4
Exploring Nurses' Perceptions of Medication Error Risk Factors: Findings From a Sequential Qualitative Study.探索护士对用药错误风险因素的认知:一项序贯定性研究的结果
Glob Qual Nurs Res. 2022 Jun 28;9:23333936221094857. doi: 10.1177/23333936221094857. eCollection 2022 Jan-Dec.
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Associations of person-related, environment-related and communication-related factors on medication errors in public and private hospitals: a retrospective clinical audit.人与环境及沟通相关因素与公立和私立医院用药错误的关联:一项回顾性临床审计。
BMC Health Serv Res. 2021 Sep 28;21(1):1025. doi: 10.1186/s12913-021-07033-8.
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Interventions to reduce medication errors in adult medical and surgical settings: a systematic review.减少成人医疗和外科环境中用药错误的干预措施:一项系统综述。
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