Patient Safety Culture and the Second Victim Phenomenon: Connecting Culture to Staff Distress in Nurses
Patient Safety Culture and the Second Victim Phenomenon: Connecting Culture to Staff Distress in Nurses
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DOI：
10.1016/s1553-7250(16)42053-2
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发表时间：
2016-08-01
影响因子：
2.3
通讯作者：
Hoffman, James M.
中科院分区：
文献类型：
--
作者：
Quillivan, Rebecca R.;Burlison, Jonathan D.;Hoffman, James M.
背景：第二受害者的经验可以影响健康护理提供者的福祉和损害病人的安全。许多与患者安全事件参与后改善应对相关的因素也是强大的患者安全文化的组成部分，因此支持性患者安全文化可以减少第二次受害者相关创伤。一项横断面调查研究被用来评估病人安全文化对二次受害者相关痛苦的影响。医疗保健研究和质量机构（AHRQ）关于患者安全文化的医院调查-（HSOPSC）和第二受害者体验和支持工具（SVEST），该工具旨在评估参与患者安全事件后的组织支持以及个人和专业困扰，结果：在358名儿科专科医院的护士中，169名（47.2%）完成了两项调查。分层线性回归表明，患者安全文化调查维度对错误的非惩罚性反应与第二个受害者调查维度-心理，身体和职业困扰的减少显著相关（p < 0.001）。组织支持作为中介变量，完全解释了非惩罚性错误反应与身体困扰、非惩罚性错误反应与职业困扰的关系，部分解释了非惩罚性错误反应与心理困扰的关系。结果表明，惩罚性安全文化可能有助于自我报告的第二受害者相关的心理，身体和职业困扰的看法，这可能反映了缺乏组织支持。减少对错误的惩罚性反应和鼓励支持同事，-主管，和机构的互动可能是有用的策略，以管理第二受害者的经验的严重性。
Background: Second victim experiences can affect the well-being of health care providers and compromise patient safety. Many factors associated with improved coping after patient safety event involvement are also components of a strong patient safety culture, so that supportive patient - safety cultures may reduce second victim-related trauma. A cross-sectional survey study was conducted to assess the influence of patient safety culture on second victim-related distress.Methods: The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture - (HSOPSC) and the Second Victim Experience and Support Tool (SVEST), which was developed to assess organizational support and personal and professional distress after involvement in a patient safety event, were administered to nurses involved in direct patient care.Results: Of 358 nurses at a specialized pediatric hospital, 169 (47.2%) completed both surveys. Hierarchical linear regression demonstrated that the patient safety culture survey dimension nonpunitive response to error was significantly associated with reductions in the second victim survey dimensions - psychological, physical, and professional distress (p < 0.001). As a mediator, organizational support fully explained the nonpunitive response to error-physical distress and nonpunitive response to error-professional distress relationships and partially explained the nonpunitive response to error-psychological distress relationship.Conclusions: The results suggest that punitive safety cultures may contribute to self-reported perceptions of second victim-related psychological, physical, and professional distress, which could reflect a lack of organizational support. Reducing punitive response to error and encouraging supportive coworker, - supervisor, and institutional interactions may be useful strategies to manage the severity of second victim experiences.