杭州市三级医院医护人员患者安全文化认知及影响因素分析

摘要

Objective: To investigate the cognitive status and influencing factors of patient safety culture in Hangzhou tertiary hospitals.Methods: The Hospital Survey on Patient Safety Culture was used to investigate 996 doctors and nurses.The score of each dimension and the positive response rate were calculated.The influencing factors of patient safety culture's total score and the area to be improved were analyzed by single factor analysis of variance, t test and multiple linear regression analysis.Results:The higher positive response rate dimensions and the advantage areas were organizational learning and continuous improvement (80.96%) and department team(83.68%).The lower positive response rate dimensions and areas to be improved were non-puni-tive response to the error ( 28.85%) , staff configuration ( 31.15%) , adverse event reporting frequency ( 33.00%) and communica-tion openness (45.78%).Univariate and multivariate linear regression analysis showed that the factors influencing the patients' safety culture were post, department, working time of the department, daily working hours, average number of night shifts per week, the number of safety culture education (all P<0.05).Conclusion:Hangzhou tertiary hospitals' patient safety culture was in the overall general level.The advantage and disadvantage areas were coexisting.The patient safety culture level was affected by such factors as department, workload, education and training%目的:调查杭州市三级医院医护人员对患者安全文化的认知现状和影响因素.方法:采用《医院患者安全文化问卷》对996名医护人员进行调查,计算各维度得分和积极反应率,采用单因素方差分析、T检验和多重线性回归分析分析患者安全文化总得分和待改进区域的影响因素.结果:医护人员患者安全文化积极反应率较高的维度即优势区域是组织学习与持续改进(80.96%)、科室团队合作(83.68%);积极反应率较低的维度即待改进区域是对错误的非惩罚性反应(28.85%)、人员配置(31.15%)、不良事件报告频率(33.00%)、沟通开放程度(45.78%).综合单因素分析和多重线性回归分析显示,患者安全文化的影响因素有岗位、科室、本科室工作年限、日均工作时间、平均每周夜班数、每年安全文化教育次数(均P<0.05).结论:杭州市三级医院医护人员患者安全文化总体上处于一般水平,优势区域和待改进区域共存;患者安全文化水平受科室、工作量、教育培训等因素的影响.