尼加拉瓜公立醫院病人安全之評估

Evaluation of Patient Safety Climate at a Public Hospital in Nicaragua

菱美方(Sara Estrada Rivera)

指導教授 ： 許怡欣

臺北醫學大學/管理學院/醫務管理學研究所/碩士(2016年)

摘要

無資料

關鍵字

患者安全 ； 患者安全氣候 ； 醫務工作者的看法

並列摘要

Employee fatalities and injuries among high hazard industries such as nuclear energy and aviation originated attention to assessing safety, driving consciously attention to further aspects as management and human factors than simply errors, and focusing on the assessment of safety systems.
Healthcare organizations as complex systems prone to accidents, are considered high hazard industries that also focus attention on patient safety. Furthermore the importance of ongoing improvements among professions as mechanisms that contribute to create a culture of safety and reduction of errors instead of blaming individuals as a more effective process to learn from mistakes.
Patient safety climate has been related reciprocally to culture, and it is recognized as a form of organizational climate. Although patient safety culture and patient safety climate have been used as similar constructs, there is still confusion among literature, because discrimination among climate and culture is not clear. However, aspects of organizational climate are easier to measure because they are tangible and quantitative methods are best suited to measure safety climate. In this fashion, we can understand safety climate as surface features from attitudes and perceptions of safety culture, that can be measured from the safety culture elements of health organizations in a given moment.
This study aim to know how is the perception of healthcare workers regarding patient safety climate at a public hospital in Nicaragua, from its patient safety culture elements, by the application of the Spanish version of the Hospital survey on patient safety. Furthermore, we made a descriptive analysis regarding patient safety climate at the Humberto Alvarado Vasquez hospital, including socio-professional factors. Also, we made an analysis of strengths and opportunities for improvement in the hospital, following the criteria suggested by The Agency for Healthcare Research and Quality (AHRQ).

For the statistical evaluation, we made a correlation test among dimensions of patient safety culture and the outcomes measures of patient safety climate, as well as a regression analysis among the dimensions of patient safety culture as predictor variable, and outcomes of patient safety climate as predictive variable.

A total of 298 questionnaires were distributed, of which 232 were responded validly (response rate of 77.85%). Globally, positive responses rate for the 12 dimension, ranged from 39.45% to 79.74%, the average rate was 62.71%. The highest positive responses rates per dimension were “Supervisor/Manager expectations & actions promoting safety” (79.74%), “Organizational learning and continuous improvement” (78.53%), and “Teamwork across hospital units” (76.40%). Following Spearman’s correlation test. The strongest correlations showed, were among “Frequency of events reported” with “Hospital handoffs and transitions” (Rho= .541), and “Frequency of events reported” with “Nonpunitive response to error” (Rho= -.485). The weakest correlations showed were among, “Overall perception of safety grade” with “Hospital management support for patient safety” (Rho=.177), and “Overall perception of safety grade” with “Staffing” (Rho=.143).
Regarding the regression analysis, the predictive value of “Teamwork across hospital units” for the variable “patient safety climate grade” is high (adjust R2 =0.67), corresponding to the correlation results. Which indicates that the better the teamwork across the units, the better the patient safety climate.

The goodness of fit test, shows that our results by job type are representative of the hospital population.
The study shows that, in general the healthcare workers at the hospital in Nicaragua, feel positive towards patient safety climate. Both, strengths and opportunities for improvement have been identified.

並列關鍵字

Patient safety ； Patient safety climate ； Healthcare workers perception

參考文獻

REFRENCES

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