神经外科ICU护士对患者安全文化认知与实践的质性研究

目的深入了解神经外科ICU护士对患者安全文化的认知与实践,为促进患者安全文化的构建提供参考。方法应用现象学研究方法,对12名神经外科ICU护士进行半结构式深度访谈,对访谈资料进行转录、编码、类属分析、描述和组织。结果神经外科ICU护士对患者安全文化的认知可归纳为高度的认同与肯定和支持患者参与患者安全2个主题;对影响患者安全文化构建实践中的障碍因素可提炼为护理人力资源配置不当、全员共同参与患者安全的氛围缺乏、患者安全的教育培训体系缺乏、不良事件非惩罚性上报机制的不完善和对护士的心理支持关注不足5个主题。结论护士在医院患者安全文化构建中发挥着引导和示范作用,了解护士对患者安全文化的认知及影响其实践行为的因素,可为制订科学、系统的患者安全文化管理体系提供参考。

A qualitative research on cognition and practice of NICU nurses on patient safety culture

Objective To further understand the cognition and practice of NICU（Neurosurgical Intensive Care Unit）nurses on patients’ safety culture,so as to provide references for promoting the construction of patients’ safety culture.Methods 12 nurses in NICU were interviewed in an in-depth semi-structured way by phenomenological research methods. The interview materials were transcribed,coded,analyzed,described and organized.Results The cognition of NICU nurses on patients’ safety culture can be summarized into 2 themes including high recognition and affirmation,and support of patients’ participation in patients’ safety. The obstacles affecting the construction of patients’ safety culture can be extracted into 5 themes,namely improper allocation of nursing human resources,lack of climate for all staff to participate in patients’ safety,lack of education and training system for patients’ safety,imperfect reporting mechanism of non-punitive adverse events and inadequate attention to psychological support of nurses.Conclusion Nurses play leading and exemplary roles in the construction of patients’ safety culture in hospitals. To explore the cognition of nurses on patients’ safety culture and the factors affecting their practical behaviors can provide a reference for the establishment of a scientific and systematic management system of patients’ safety culture.