重庆市养老机构员工对患者安全文化的评价

目的了解重庆市养老机构患者安全文化现状,为养老机构患者安全文化建设提供参考。方法运用养老机构患者安全文化调查表(NHSPSC)对重庆市5所养老机构的237名工作人员进行调查。结果76.37%被调查者对所在养老机构患者安全文化的评级为"优秀"或"好"。养老机构患者安全文化总评分为3.84±1.18,正向同意率为61.69%;非惩罚性反应维度正向同意率最低(42.57%),团队维度最高(82.23%)。其中,团队观念与协作、安全意识、安全隐患处理、入住者安全管理等9个条目正向同意率75%,为优势条目;而工作流程、人员配置、不良事件上报、入住者信息沟通、员工培训等11个条目正向同意率50%,为待改进条目。结论重庆市养老机构有积极的患者安全文化,但因处于初期发展阶段,还存在人力资源不足,护理人员队伍整体素质偏低,缺乏标准规范的工作流程等问题,需要进一步改进员工培训,加强团队建设,完善机构内部信息交接制度,积极营造非惩罚性氛围,不断提高管理者和员工安全意识,共同推进养老机构患者安全文化建设。

Nursing home staffers' perspective of patient safety culture in Chongqing

Objective To investigate nursing home staffers' perspective of patient safety culture,and to provide references for the construction of nursing home patient safety culture in China.Methods The questionnaire of Nursing Home Survey on Patient Safety Culture(NHSPSC) was used to investigate the perspectives of staffers working in five nursing homes in Chongqing,China.Results Totally,76.37％ of the staffers described patient safety culture in the nursing home where they worked as "excellent" or "very good".They scored 3.84±1.18 in NHSPSC,with a positive response rate of 61.69％;the dimension of nonpunitive response to mistakes had the lowest positive response rate of 42.57％,while dimension of teamwork had the highest,at 82.23％.Nine items of "staff feel like they are part of a team","in this nursing home,we discuss ways to keep residents safe from harm","when staff report something that could harm a resident,someone takes care of it","management asks staff how the nursing home can improve resident safety",etc.had a positive response rate over 75 ％,implicating an excellent job concerning these items;while 11 items of "staff follow standard procedures to care for residents","we have enough staff to handle the workload","staff feel safe reporting their mistakes","staff are given all the information they need to care for residents","staff get the training they need in this nursing home",etc.had the answer of "agree" and'strongly agree'selected by less than 50％ of the staffers,indicating an improvement scheme is needed for these items.Conclusion Although staffers working in nursing homes in Chongqing have an overall positive per spective of patient safety culture,several aspects,such as understaffing,poor professional quality of nursing workers,lack of standard procedures,ect.,need to be improved.Measures as staff training,team building,efficient intra-organizational information handovers,and nonpunitive reporting culture,not only improve the safety consciousness of managers and staffers,but also advance patient safety culture across the institutions.