Analysis of affecting factors on patient safety culture in public and private hospitals in Iran
Analysis of affecting factors on patient safety culture in public and private hospitals in Iran
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DOI：
10.1186/s12913-019-4863-x
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发表时间：
2019-12-30
影响因子：
2.8
通讯作者：
Sheidaei, Ali
中科院分区：
文献类型：
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作者：
Khoshakhlagh, Amir Hossein;Khatooni, Elham;Sheidaei, Ali
背景资料：患者安全文化是卫生服务质量的主要组成部分之一，也是卫生研究的主要优先事项之一。因此，本研究的目的是确定和比较的意见，医护人员对病人的安全文化和有效因素对病人的安全文化的影响，在公立和私立医院在德黑兰，Iran.Methods：本横断面研究进行了1203名医护人员受雇于三个公立和私立医院在德黑兰，伊朗的样本。本研究采用分层随机抽样方法。使用Maslach倦怠量表和患者安全文化问卷（HSOPSC）收集数据。结果：共纳入女性867例（72.57%），男性747例（27.43%），平均年龄33.88 ± 7.66岁。公立和私立医院对安全文化问卷的平均正面回答百分比分别为65.5%和58.3%。公立医院病人安全文化的优势体现在三个维度上，即对错误的非惩罚性反应（80%）、组织学习-持续改进（79.77%），以及对患者安全性的总体看法（75.16%）、私立医院的医疗差错应对方式为非惩罚性应对（71.41%）、组织学习与持续改进（69.24%）和单位内团队合作（62.35%）。医院类型和轮班时间影响倦怠和患者安全问卷评分（P值< 0.05）。通径分析结果表明，所提出的模型的拟合（RMSEA = 0.024）。结果表明，工作班次（β =-0.791），职业倦怠（β =-0.554）和医院类型（β =-0.147）上遵守病人安全culture.Conclusion的负面影响：提供反馈的错误和频繁的事件报告的要求，和病人的信息交流似乎有必要促进病人的安全文化。此外，考虑到轮班工作和倦怠对患者安全文化的负面影响，通过适当地规划和管理这些因素，可以设计正确的行动来改善安全文化。
Background: Patient safety culture is one of the main components of the quality of health services and is one of the main priorities of health studies. Accordingly, this study aimed to determine and compare the views of healthcare staff on the patient safety culture and the impact of effective factors on patient safety culture in public and private hospitals in Tehran, Iran.Methods: This cross-sectional study was carried out on a sample of 1203 health care workers employed in three public and three private hospitals in Tehran, Iran. Stratified random sampling was used in this study. Data were collected using the Maslach burnout inventory and patient safety culture questionnaire (HSOPSC). IBM SPSS v22 and Amos v23 were used to perform path analysis.Results: Eight hundred sixty-seven (72.57%) females and 747 (27.43%) males with a mean age of 33.88 +/- 7.66 were included. The average percentage of positive responses to the safety culture questionnaire in public and private hospitals was 65.5 and 58.3%, respectively. The strengths of patient safety culture in public hospitals were in three dimensions including non-punitive response to errors (80%), organizational learning-continuous improvement (79.77%), and overall perceptions of patient safety (75.16%), and in private hospitals, were three dimensions including non-punitive responses to errors (71.41%), organizational learning & continuous improvement (69.24%), and teamwork within units (62.35%). The type of hospital and work-shift hours influenced the burnout and patient safety questionnaire scores (P-value < 0.05). The path analysis results indicate the fitness of the proposed model (RMSEA = 0.024). The results showed a negative impact of a work shift (beta = - 0.791), occupational burnout (beta = - 0.554) and hospital type (beta = - 0.147) on the observance of patient safety culture.Conclusion: Providing feedback on errors and requirements for the frequent incident reporting, and patient information exchange seem necessary to promote the patient safety culture. Also, considering the negative impact of the shift work and burnout on patient safety culture, by planning and managing these factors appropriately, correct actions could be designed to improve the safety culture.