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不良事件上报障碍与患者安全文化的相关性研究
发布人：yaot 发布时间：2022/10/25 17:11:58 浏览次数：1014次
——邱阳阳 刘宗燕 闫冬勤 秦春香 陈兵林
【摘要】目的 探讨不良事件上报障碍与患者安全文化之间的相关性，为提高不良事件上报率提供建议。方法 以某三甲医院304名临床医师和医技人员为研究对象，采用《不良事件上报障碍量表》《患者安全文化测评量表》进行调查，使用SPSS 25.0软件和AMOS 22.0软件进行数据统计分析，利用Mplus 8.6软件进行路径分析。结果 不良事件上报障碍量表总分与患者安全文化测评量表总分呈负相关（r=-0.612,P＜0.01）,两量表各维度之间也均呈负相关（r=-0.570～-0.356,P＜0.01）。患者安全文化测评量表各维度除对不良事件上报障碍产生直接负效应（β=-0.702～-0.387,P＜0.05）外，也可作为中介变量间接对其产生负效应（β=-1.937～-0.091,P＜0.05）。结论 医院应强化高职称、长工龄职工的安全教育培训，构建非惩罚性的不良事件上报机制，加强领导重视和内部沟通，营造安全文化氛围，提高不良事件上报率。
【关键词】不良事件；上报障碍；安全文化；相关性；路径分析；患者安全
中图分类号：R192；R197.323 文献标识码：A
The Correlation Between Adverse Event Reporting Barriers and Patient Safety Culture/QIU Yangyang,LIU Zongyan,YAN Dongqin,et al.//Chinese Health Quality Management，2022,29(9):34-38
Abstract Objective To explore the correlation between adverse event reporting barriers and patient safety culture, and provide suggestions for improving adverse event reporting rate.Methods A total of 304 medical staff in a tertiary hospital were recruited to complete adverse event reporting barriers scale and patient safety culture evaluation scale. The SPSS 25.0 software and AMOS 22.0 software were used for statistical analysis of data, and Mplus 8.6 software was used for path analysis.Results There was a negative correlation between the total score of the adverse event reporting barriers scale and the total score of the patient safety culture evaluation scale (r =-0.612, P < 0.01), and there was also a negative correlation between the dimensions of the two scales (r=-0.570～-0.356, P < 0.01). Each dimension of patient safety culture not only had a direct negative effect on the reporting barrier of hospital adverse events (β=-0.702～-0.387, P < 0.05), but also had an indirect negative effect as an intermediary variable (β=-1.937～-0.091, P < 0.05).Conclusion Hospitals should strengthen safety education and training for staff with high professional titles and long service life, construct a non-punitive adverse event reporting mechanism, strengthen leadership attention and internal communication, create a good safety culture atmosphere, and improve the reporting rate of adverse events.
Key words Adverse Events; Reporting Barriers; Safety Culture; Correlation; Path Analysis; Patient Safety
First-author's address South Hospital District of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 451162, China
患者安全文化建设是医疗质量管理的重要基础。目前，患者安全文化越来越受到国内外医疗机构的重视［1-2］。良好的患者安全文化不仅能够提高医疗服务的安全性，而且对构建和谐医患关系也有一定促进作用。不良事件的收集、分析以及改进对医疗活动起到警示和预防作用［3-4］。既往文献［5］显示，加强患者安全文化建设有助于提高不良事件上报率。目前，关于不良事件上报和患者安全文化的相关研究［6-7］多聚焦护士，在临床医师及医技人员中的应用较少。因此，本研究针对某三甲医院临床医师和医技人员开展问卷调查，分析不良事件上报障碍和患者安全文化之间的相关性，以期提高不良事件上报率，识别潜在医疗隐患，从而确保患者安全。