重庆市公立综合医院医疗质量安全项目及护理参与执行状况调查

目的 从护理管理视角了解重庆市公立综合医院执行《2021年国家医疗质量安全改进目标》（10项）状况,为持续改进医疗护理质量提供参考依据。方法 采用自制问卷选取重庆市77所二级及以上公立综合医院护理部进行调查。结果 73所（94.81%）医院护理部参与了年度目标执行; 61所（83.56%）医院护理部主导了降低血管内导管相关血流感染发生率;核心策略中开展业务培训执行率最高（94.52%）,建立并实施多部门合作方案最低（28.77%）。认为信息系统不能完整提供相关数据、护理部无专人负责等是主要影响因素;二级医院护理部无专人负责、不能及时获得目标实施信息、缺乏相关技术专家指导、无信息系统提供数据支撑等4项安全管理隐患发生率显著高于三级医院（均P＜0.05）。结论 重庆市二级及以上公立综合医院护理部年度目标改善执行参与率、核心策略执行力等均需要进一步提升,二级医院更应加强相应制度与信息化建设,强化医护人员培训,以全面提升医疗护理质量安全与服务品质。

Status of medical quality and safety projects and nursing participation in public general hospitals in Chongqing

Objective To comprehend the execution status of the 2021 National Healthcare Quality and Safety Improvement Goals (10 goals) in public general hospitals in Chongqing from nursing management perspective, and to provide reference for continuous quality improvement. Methods A self-designed questionnaire was used to investigate the nursing departments of 77 secondary and higher-level public general hospitals in Chongqing. Results Of the participants, 73 (94.81%) participated in this initiative and 61 (83.56%) took the lead in reducing the incidence of catheter-related bloodstream infections. Among core strategies, the highest implementation rate was observed in conducting professional training (94.52%), while establishment and implementation of interdisciplinary cooperation exhibited the lowest rate (28.77%). Factors such as incomplete data provision by information systems and absence of dedicated personnel in charge of this task in nursing departments were identified as primary influencing factors. The incidences of potential safety hazards, including lack of dedicated personnel in charge of this task in nursing departments,lack of timely access to information of goal implementation,lack of instruction from technical experts, and lack of data support from information system, were significantly higher in secondary hospitals compared with tertiary hospitals (all P<0.05). Conclusion The participation rate in the annual goal initiative and the implementation of core strategies need to be further improved in secondary and higher level public general hospitals in Chongqing. Secondary hospitals, in particular, should strengthen the development of relevant regulations and information technology infrastructure, intensify training of healthcare staff, and there by comprehensively enhance medical safety and care quality.