Patient Safety Attitudes between Intensive Care Units and General Ward Staff: A Survey of a Medical Center in Northern Taiwan

加護病房與一般病房病人安全文化現況－以北區某醫學中心為例

黃瑞湘(Swee-Siang Wong) ； 王晨旭(Chen-Hsu Wang) ； 鄭嘉惠(Chia-Hui Cheng) ； 王榮添(Eng-Thiam Ong) ； 黃鈺茹(Yu-Lu Huang) ； 黃啟宏(Chi-Hung Huang)

《輔仁醫學期刊》 15卷3期 (2017/09) Pp. 121-130

https://doi.org/10.3966/181020932017091503001

摘要

Background and Purpose: Patient safety has been a critical healthcare concern in recent years. In this study, we used a structured questionnaire to examine the differences in patient safety attitudes between intensive care unit (ICU) and general ward staff members and explored the future impact of these differences. Methods and Materials: We used the Safety Attitude Questionnaire in this cross-sectional study to assess 6 dimensions of patient safety attitudes of nursing care providers between different units. The scores of the 6 dimensions were compared between different age groups, work experience levels, work units, and managerial functions by using the t test and ANOVA. The multivariable regression model was used to investigate factors that may affect patient safety attitudes. Results: In total, 72 ICU nurses and 164 general ward nurses completed the questionnaire. The scores of the ICU nurses in the 6 dimensions of patient safety attitudes were higher (indicating more positive attitudes) than those of the general ward nurses: stress recognition (74.65 vs. 70.90), teamwork climate (74.17 vs. 71.54), job satisfaction (69.67 vs. 64.63), safety climate (69.18 vs. 68.79), working condition (65.63 vs. 64.58), and management perception (62.36 vs. 60.34). The multivariable regression analysis revealed no significant variations in safety culture between the ICU and general ward nurses, except in the dimension of stress recognition (p = 0.03). Conclusions: Improvements in the dimensions of teamwork climate, job satisfaction, safety climate, working condition, and management perception in ICUs may be warranted.

關鍵字

intensive care ； patient safety attitude ； safety culture ； safety attitude questionnaire

並列摘要

背景：病人安全一直為近年來醫療服務重要且關心的議題，自從美國醫學研究院（Institute of Medicine, IOM）建議改善病人安全可從文化著手後，安全文化的調查即成為改善病人安全的起始點。方法：採用SAQ（Safety Attitudes Questionnaire）安全態度量表比較一般病房與加護病房的護理人員各安全態度構面，包含「團隊合作」、「單位安全的風氣」、「對工作的滿意」、「對壓力的認知」、「對管理的感受」、及「工作狀況」共六項構面的分數，利用χ2 test評估加護病房與一般病房護理人員的人口學特徵。並使用複回歸分析（multiple regression）探討影響不同類別病房護理人員SAQ各項構面得分的因子。結果：加護病房護理人員在各個構面得分皆高於一般病房護理人員，依序為「壓力認知」：74.65 vs. 70.90、「團隊合作」：74.17 vs. 71.54、「對工作的滿意」：69.67 vs. 64.63、「單位安全的風氣」：69.18 vs. 68.79、「工作狀況」：65.63 vs. 64.58、「對管理的感受」：62.36 vs. 60.34；兩個不同的單位同時在「壓力認知」構面上得分最高，在「對管理的感受」構面上得分最少。兩個單位之護理人員對於各個構面得分並沒有顯著差異。但經由複回歸分析發現加護單位之資深或有主管職之護理人員對於「壓力認知」構面得分較高（p＜0.03）。

並列關鍵字

重症 ； 加護病房 ； 病人安全文化 ； 安全態度量表