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目的 了解某医院医务人员的医院安全文化认知情况,并与国内外的研究成果相比较,为制定医院安全文化提升策略提供可靠依据。方法 采用问卷调查法,借助中文版的HSOPSC问卷对目标医院医务人员的安全文化认知进行调查,测评维度和条目的积极反应率。结果 医务人员对于安全文化的积极反应率排名在前三位的维度为:科室内部团结(84.25%),组织的持续改进与学习(82.74%),对差错的反馈与沟通(76.37%)。积极反应率最低的维度为人员配置(35.26%)。结论 目标医院的安全文化总体比较积极,但在人员配置和沟通的开放性方面仍需进一步完善。 相似文献
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目的
以贝塔朗菲系统论为依据,构建新的医院护理不良事件管理模式,杜绝或减少各类不良事件的发生,保证患者安全。方法 通过一线护士将临床工作中的安全隐患上报护理部,护理部与相关处室沟通,医院各处室管理层及时解决存在的问题。结果 通过扩大隐患事件上报范围,护理隐患事件上报率较未扩大前增加275.7%;同类护理隐患事件未再发生或明显减少。结论 “护理部首接,多职能科(处)合作”的不良事件管理模式,促进了医院服务效率与质量的提高,保障了患者的就医安全。 相似文献
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目的 采取有效的防范措施,最大限度地减少医院内跌倒和因跌倒导致的伤害事件的发生。方法 对跌倒事件采用柏拉图分析法进行分析,区分“少数重点因素”和“大量微细因素”。结果 病人的身心疾病、病人独自行动以及病人不愿求助和不安全的环境是防范病人跌倒时尤其要关注的因素。结论 根据柏拉图分析法,修订病人跌倒/坠床危险因子评估表,落实个体化的跌倒防范措施,营造安全的设施及环境,加强病人及家属的教育,有助于防范医院内病人跌倒的发生。 相似文献
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目的 探讨医院电梯安全管理要注意的问题。方法 回顾性分析医院电梯管理现状,并给出具体的改善措施。 结果 医院电梯安全管理中工作人员起着非常重要的作用,其技术水平直接影响到管理效果。 结论 医院电梯安全管理质量直接影响到患者就诊,需要得到院方重视。 相似文献
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????? 目的 了解医务人员对患者安全文化认知及建设的现状,为患者安全管理及研究提供依据。方法 2012年1月随机抽取某三级甲等中医医院257名医务人员,应用患者安全文化现状评价调查问卷,用以了解临床医务人员的患者安全文化态度及其机构相关的患者安全文化。结果 不同专业医务工作者在团队精神、安全措施、医院管理及交接班程序之间存在差异,提示它具有重要的研究意义。其中药剂人员(4.5±0.6)以及护士(4.5±0.6)的总分认知度最高,医技人员总分认知度最低(4.4±0.5)。不同职务的医务人员认同的病人安全文化:副/高级(4.8±0.4)>中级(4.6±0.6)>初级(4.4±0.5)。安全文化待改进领域:“人员配置”、“工作量”、“如果发生医疗安全(不良)事件,医院更加重视帮助与教育” 反应率﹤50%,是医务人员共同认为的有待改进的地方前几位。结论 某三甲医院有积极的患者安全文化,但仍需完善现有的不良事件报告系统及加强高风险科室的安全管理与培训。 相似文献
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目的 通过调查医院安全绩效的现状,了解和探究医院安全绩效的影响因素,并提出医院安全绩效的提升策略。方法 采用随机抽样的方法选取10家三级甲等医院的医务人员作为研究对象,通过简单回归分析和多元回归分析等方法对医院安全绩效影响因素进行分析。结果(1)安全训练和事故分析两个维度的积极反应率均低于75%;(2)医院安全文化与病人安全行为均对安全绩效具有影响作用。结论 医院安全绩效管理水平提升需加强医务人员的素质培养,同时营造良好的安全文化氛围,规范医务人员的安全行为。 相似文献
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目的
了解国内外医疗机构患者安全文化测评工具的特征、优劣点及研究趋势,为后续研究及医院管理提供借鉴与参考。方法 在PubMed和CNKI上,对2000-2016年间国内外公开发表的患者安全测评工具进行系统文献综述。结果 最终检索并纳入68篇文献,涉及20个患者安全文化测评工具;在调查方法上,除MaPSAF采用访谈法之外,另外19个测评工具均采用问卷法;在调查对象上,除Parental-reported hospital safety climate是服务对象之外,另外19个测评工具均是医务人员;PSCHO、MaPSAF、SAQ、HSOPSC和SCOPE 这5个测评工具针对不同机构或国家地区提供了修订版本,其中HSOPSC的修订版本最多达23个。结论 国内外医疗机构患者安全文化测评工具研究日趋成熟,针对不同机构或文化背景的测评工具研究已成为研究热点及趋势之一;建议将患者安全文化测评纳入医疗机构的评审指标或规范化管理流程之中,以更好地促进患者安全和医疗服务质量。 相似文献
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目的 探讨病人安全文化与医疗服务结局的关联性。方法 采用自行设计的病案评阅表对我国东、中、西3省(直辖市)18所公立医院的社区获得性肺炎、急性心肌梗塞、急性左心功能衰竭、计划性剖宫产和胆囊结石合并急性胆囊炎5个病种进行调查;通过机构问卷调查,收集医院层面的医疗服务状况数据;采用中国版医疗机构病人安全文化调查量表进行病人安全文化调查。结果 在医院层面上,未发现病人安全文化与医疗服务状况各指标的关联性;在病种层面上,多因素分析也未显示病人安全文化与治愈好转状况、住院天数和住院总费用的关联性。结论 病人安全文化对医疗服务结局的影响不显著,可能是通过间接途径作用于医疗服务结局。 相似文献
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Objective
The aim of the study was to assess non-technical aspects of patient safety practices using non-participant observation in different clinical areas.Design
Qualitative study using non-participant observation and thematic analysis.Setting
Two eye care units in Uganda.Participants
Staff members in each hospital.Main outcome measures
A set of observations of patient safety practices by staff members in clinical areas that were then coded using thematic analysis.Results
Twenty codes were developed that explained patient safety practices in the hospitals based on the observations. These were grouped into four themes: the team, the environment, patient-centred care and the process. The complexity of patient safety in each hospital was described using narrative reports to support the thematic analysis. Overall both hospitals demonstrated good patient safety practices however areas for improvement were staff-patient communication, the presence and use of protocols and a focus on consistent practice.Conclusions
This is the first holistic assessment of patient safety practices in a low-income setting. The methods allowed the complexity of patient safety to be understood and explained with areas of concern highlighted. The next step will be to develop a useful and easy to use tool to measure patient safety practices in low-income settings. 相似文献13.
Ann-Marie Howell Elaine M. Burns George Bouras Liam J. Donaldson Thanos Athanasiou Ara Darzi 《PloS one》2015,10(12)
Background
The National Reporting and Learning System (NRLS) collects reports about patient safety incidents in England. Government regulators use NRLS data to assess the safety of hospitals. This study aims to examine whether annual hospital incident reporting rates can be used as a surrogate indicator of individual hospital safety. Secondly assesses which hospital characteristics are correlated with high incident reporting rates and whether a high reporting hospital is safer than those lower reporting hospitals. Finally, it assesses which health-care professionals report more incidents of patient harm, which report more near miss incidents and what hospital factors encourage reporting. These findings may suggest methods for increasing the utility of reporting systems.Methods
This study used a mix methods approach for assessing NRLS data. The data were investigated using Pareto analysis and regression models to establish which patients are most vulnerable to reported harm. Hospital factors were correlated with institutional reporting rates over one year to examine what factors influenced reporting. Staff survey findings regarding hospital safety culture were correlated with reported rates of incidents causing harm; no harm and death to understand what barriers influence error disclosure.Findings
5,879,954 incident reports were collected from acute hospitals over the decade. 70.3% of incidents produced no harm to the patient and 0.9% were judged by the reporter to have caused severe harm or death. Obstetrics and Gynaecology reported the most no harm events [OR 1.61(95%CI: 1.12 to 2.27), p<0.01] and pharmacy was the hospital location where most near-misses were captured [OR 3.03(95%CI: 2.04 to 4.55), p<0.01]. Clinicians were significantly more likely to report death than other staff [OR 3.04(95%CI: 2.43 to 3.80) p<0.01]. A higher ratio of clinicians to beds correlated with reduced rate of harm reported [RR = -1.78(95%Cl: -3.33 to -0.23), p = 0.03]. Litigation claims per bed were significantly negatively associated with incident reports. Patient satisfaction and mortality outcomes were not significantly associated with reporting rates. Staff survey responses revealed that keeping reports confidential, keeping staff informed about incidents and giving feedback on safety initiatives increased reporting rates [r = 0.26 (p<0.01), r = 0.17 (p = 0.04), r = 0.23 (p = 0.01), r = 0.20 (p = 0.02)].Conclusion
The NRLS is the largest patient safety reporting system in the world. This study did not demonstrate many hospital characteristics to significantly influence overall reporting rate. There were no association between size of hospital, number of staff, mortality outcomes or patient satisfaction outcomes and incident reporting rate. The study did show that hospitals where staff reported more incidents had reduced litigation claims and when clinician staffing is increased fewer incidents reporting patient harm are reported, whilst near misses remain the same. Certain specialties report more near misses than others, and doctors report more harm incidents than near misses. Staff survey results showed that open environments and reduced fear of punitive response increases incident reporting. We suggest that reporting rates should not be used to assess hospital safety. Different healthcare professionals focus on different types of safety incidents and focusing on these areas whilst creating a responsive, confidential learning environment will increase staff engagement with error disclosure. 相似文献14.
Lixin Ou Jack Chen Hassan Assareh Stephanie J. Hollis Ken Hillman Arthas Flabouris 《PloS one》2014,9(5)
Background
Despite the increased acceptance of failure-to-rescue (FTR) as an important patient safety indicator (defined as the percentage of deaths among surgical patients with treatable complications), there has not been any large epidemiological study reporting FTR in an Australian setting nor any evaluation on its suitability as a performance indicator.Methods
We conducted a population-based study on elective surgical patients from 82 public acute hospitals in New South Wales, Australia between 2002 and 2009, exploring the trends and variations in rates of hospital complications, FTR and 30-day mortality. We used Poisson regression models to derive relative risk ratios (RRs) after adjusting for a range of patient and hospital characteristics.Results
The average rates of complications, FTR and 30-day mortality were 13.8 per 1000 admissions, 14.1% and 6.1 per 1000 admission, respectively. The rates of complications and 30-day mortality were stable throughout the study period however there was a significant decrease in FTR rate after 2006, coinciding with the establishment of national and state-level peak patient safety agencies. There were marked variations in the three rates within the top 20% of hospitals (best) and bottom 20% of hospitals (worst) for each of the four peer-hospital groups. The group comprising the largest volume hospitals (principal referral/teaching hospitals) had a significantly higher rate of FTR in comparison to the other three groups of smaller-sized peer hospital groups (RR = 0.78, 0.57, and 0.61, respectively). Adjusted rates of complications, FTR and 30-day mortality varied widely for individual surgical procedures between the best and worst quintile hospitals within the principal referral hospital group.Conclusions
The decrease in FTR rate over the study period appears to be associated with a wide range of patient safety programs. The marked variations in the three rates between- and within- peer hospital groups highlight the potential for further quality improvement intervention opportunities. 相似文献15.
医疗机构评审联合委员会国际部(Joint Commission International,JCI)标准是全世界公认的医疗质量和服务评价标准,代表了医院的服务和管理水平。最新修订的第5版JCI标准对我国医院建立规范化、流程化、科学化和国际化的管理体系,实现医院持续质量改进,保证患者安全,提高患者满意度具有重要借鉴意义。 相似文献
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Gavin Daker-White Rebecca Hays Jennifer McSharry Sally Giles Sudeh Cheraghi-Sohi Penny Rhodes Caroline Sanders 《PloS one》2015,10(8)
Objective
Studies of patient safety in health care have traditionally focused on hospital medicine. However, recent years have seen more research located in primary care settings which have different features compared to secondary care. This study set out to synthesize published qualitative research concerning patient safety in primary care in order to build a conceptual model.Method
Meta-ethnography, an interpretive synthesis method whereby third order interpretations are produced that best describe the groups of findings contained in the reports of primary studies.Results
Forty-eight studies were included as 5 discrete subsets where the findings were translated into one another: patients’ perspectives of safety, staff perspectives of safety, medication safety, systems or organisational issues and the primary/secondary care interface. The studies were focused predominantly on issues seen to either improve or compromise patient safety. These issues related to the characteristics or behaviour of patients, staff or clinical systems and interactions between staff, patients and staff, or people and systems. Electronic health records, protocols and guidelines could be seen to both degrade and improve patient safety in different circumstances. A conceptual reading of the studies pointed to patient safety as a subjective feeling or judgement grounded in moral views and with potentially hidden psychological consequences affecting care processes and relationships. The main threats to safety appeared to derive from ‘grand’ systems issues, for example involving service accessibility, resources or working hours which may not be amenable to effective intervention by individual practices or health workers, especially in the context of a public health system.Conclusion
Overall, the findings underline the human elements in patient safety primary health care. The key to patient safety lies in effective face-to-face communication between patients and health care staff or between the different staff involved in the care of an individual patient. Electronic systems can compromise safety when they override the opportunities for face-to-face communication. The circumstances under which guidelines or protocols are seen to either compromise or improve patient safety needs further investigation. 相似文献17.
Enrique Castro-Sánchez Esmita Charani Lydia N. Drumright Nick Sevdalis Nisha Shah Alison H. Holmes 《PloS one》2014,9(1)