The Association of the Nurse Work Environment and Patient Safety in Pediatric Acute Care.
The Association of the Nurse Work Environment and Patient Safety in Pediatric Acute Care.
复制标题
儿科急症护理中护士工作环境和患者安全协会。
DOI：
10.1097/pts.0000000000000559
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发表时间：
2021
影响因子：
2.2
通讯作者：
Aiken,LindaH
中科院分区：
文献类型：
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作者：
Lake,EileenT;Roberts,KathrynE;Agosto,PaulaD;Ely,Elizabeth;Bettencourt,AmandaP;Schierholz,ElizabethS;Frankenberger,WarrenD;Catania,Gianluca;Aiken,LindaH
目的18年前，医学研究所估计，医院内的医疗差错是导致死亡的主要原因。从那时起，减少患者伤害和改善患者安全文化一直是国家医疗保健的优先事项。该研究的目标是描述儿科急性护理环境中患者安全的现状，并评估组织的可修改特征是否与更好的安全文化相关。方法一项观察性横断面研究使用了2015-2016年美国四个州177家医院的调查数据，包括综合医院和独立儿童医院的儿科护理。提供直接病人护理的儿科注册护士评估医院安全和临床工作环境。安全性是由医疗研究和质量文化患者安全调查的项目来衡量的。采用国家质量论坛认可的执业环境量表对医院临床工作环境进行测量。结果1875名儿科护士对医院进行了安全评价。60%的儿科护士在患者安全方面给他们的医院打的分数不是很好；不同医院之间的差异很大。在普通医院，46%的护士报告说自己犯了错误，28%的护士不觉得自己有权质疑不安全的做法。临床工作环境较好的医院获得了较好的患者安全等级。结论美国医院儿科设置的患者安全文化有所不同。在更好的临床工作环境中，护士报告更积极的安全文化和更高的安全等级。
ObjectivesEighteen years ago, the Institute of Medicine estimated that medical errors in hospital were a major cause of mortality. Since that time, reducing patient harm and improving the culture of patient safety have been national health care priorities. The study objectives were to describe the current state of patient safety in pediatric acute care settings and to assess whether modifiable features of organizations are associated with better safety culture.MethodsAn observational cross-sectional study used 2015–2016 survey data on 177 hospitals in four US states, including pediatric care in general hospitals and freestanding children’s hospitals. Pediatric registered nurses providing direct patient care assessed hospital safety and the clinical work environment. Safety was measured by items from the Agency for Healthcare Research and Quality’s Culture of Patient Safety survey. Hospital clinical work environment was measured by the National Quality Forum-endorsed Practice Environment Scale.ResultsA total of 1875 pediatric nurses provided an assessment of safety in their hospitals. Sixty percent of pediatric nurses gave their hospitals less than an excellent grade on patient safety; significant variation across hospitals was observed. In the average hospital, 46% of nurses report that mistakes are held against them and 28% do not feel safe questioning authority regarding unsafe practices. Hospitals with better clinical work environments received better patient safety grades.ConclusionsThe culture of patient safety varies across US hospital pediatric settings. In better clinical work environments, nurses report more positive safety culture and higher safety grades.