بررسی ارتباط جو ایمنی پرستاران بر روی فرهنگ ایمنی بیمار در بیمارستان یزد

جو ایمنی به عنوان شاخص پیشگیرانه برای ارزیابی عملکرد ایمنی بوده و از آنجایی جو ایمنی حاکم بر نگرش پرستاران ممکن است بر ایمنی بیماران تاثیر گذار باشد، مطالعه حاضر با هدف تعیین ارتباط جو ایمنی پرستاران با فرهنگ ایمنی بیمار در بیمارستان انجام شد. روش تحقیق از نوع توصیفی - تحلیلی و به لحاظ هدف کاربردی می‌باشد. جامعه مورد پژوهش پرستاران بخش‌های مختلف بیمارستان شهید صدوقی یزد بودند که به روش سرشماری مورد مطالعه قرار گرفتند. برای بررسی جو ایمنی پرستاران از پرسشنامه جو ایمنی شغلی نوردیک (nosacq ) و برای بررسی فرهنگ ایمنی بیمار از پرسشنامه پیمایش بیمارستانی فرهنگ ایمنی بیمار (hsopsc) استفاده شد. به منظور تجزیه و تحلیل داده‌ها از نرم افزار spss.20 و آزمون‌های ضریب همبستگی پیرسون و آزمون test t استفاده شد. میانگین و انحراف معیار سن و سابقه کار پرستاران به ترتیب7/67±32/93 سال و 6/56±7/80 سال بود. نمره کلی شاخص جو ایمنی که پرستاران گزارش کرده‌اند 2/36 با انحراف معیار 0/14 بود. بین ابعاد مختلف جو ایمنی، بعد اولویت ایمنی کارکنان و ریسک ناپذیری با نمره 2/54 بیشترین و بعد تعهد ایمنی کارکنان با نمره 2/10 کمترین نمره را داشته‌اند. نمره کلی فرهنگ ایمنی بیمار2/57 با انحراف معیار 0/21 و میزان فرهنگ ایمنی بیمار در بین پرستاران 51/4 درصد بود. بعد برخورد غیرتنبیهی با خطاها و اشتباهات با نمره 2/84 بیشترین و بعد جابجایی اطلاعات مهم بیمار بین بخش‌ها و شیفت‌های کاری با نمره 2/29 کمترین نمره را در بین ابعاد مختلف فرهنگ ایمنی بیمار داشته اند. رابطه معنی‌داری بین فرهنگ ایمنی بیمار و جو ایمنی پرستاران در سطح 0/05 وجود داشته است. مطالعه حاضر نشان داد جو ایمنی و فرهنگ ایمنی بیمار در بین پرستاران بیمارستان شهید صدوقی نمره متوسطی داشته است. بنایراین پرستاران بیمارستان شهید صدوقی یزد نیازمند دریافت آموزش‌های صحیح و کامل در خصوص نگرش ایمنی و فرهنگ ایمنی بیمار می‌باشند.

investigating the relationship between nurses' safety atmosphere and patient safety culture in hospital

introduction patient safety has become a very important issue in the promotion and improvement of health services in countries. paying attention to patient safety is an important issue in providing hospital services and any shortcoming in it can have unfortunate consequences. the world health organization considers the culture of patient safety as a basic concept in the provision of clinical services and considers it as the most central key to providing quality and standard clinical and health services.observance of safety principles in hospitals as one of the most important institutions providing health services is very important. one of the most important factors determining patient safety in hospitals is safety culture.the safety atmosphere is a multidimensional factor and is considered as an important precondition for safety in the workplace. measuring the safety atmosphere can provide a complete picture of the safety situation and safety culture of the organization at a given time. by examining the safety atmosphere in different organizations, zohr has determined the dimensions of the safety atmosphere, which are: management attitude towards safety, the effects of implementing safety instructions on promotion, work pressure, social status of individuals, observance of safety principles by the safety officer, the status of the safety committee, the importance of safety training and the risks in the workplace. the nature of safety atmosphere has similarities with safety culture, except that safety atmosphere is a psychological phenomenon and shows the attitude of employees about the safety situation in a cross sectional manner and is dependent on environmental and situational factors and is temporary and local while is also. while culture is resistant to change and embraces common values among all members of an organization at all levels.nurses are one of the groups working in the hospital who perform important activities in the hospital. stressful occupational nursing is a stressful profession with a high rate of accidents and occupational diseases. according to the bureau of labor statistics, nursing has the thirteenth highest accident rate in the united states. so that 8.7 occupational accidents occur per 100 full time nurses annually and is classified as the seventh job in terms of loss of working days due to accidents. nursing professional behavior is the observance of special standards in providing nursing care to patients in order to improve nursing performance. the nurse must apply the standards of professional conduct and professional principles inherent in the provision of care. providing safe care based on professional principles can increase hospital productivity and possibly promote patient safety culture. given that the safety atmosphere can be used as a preventive indicator to assess safety performance and the results obtained to improve the safety of the organization and since the safety atmosphere governing the attitude of nurses may affect the safety of patients, the study the aim was to determine the relationship between nurses' safety atmosphere and patient's safety culture in the hospital.methodology due to the nature of the subject, the research method is descriptive analytical and applied in terms of purpose. the study population in this study was nurses from different wards of hospitals in isfahan, which was studied by census sampling. in this study, the nordic occupational safety inventory (nosacq) questionnaire was used to assess the nurses' safety climate and the patient safety culture hospital (hsopsc) questionnaire was used to assess the perceptions of patient safety care providers. in addition to these two main questionnaires, using the demographic questionnaire containing questions to assess some variables such as age, gender, field and degree, occupation, type of employment, work experience in the hospital, work experience in the last unit, hours weekly work, specialized work experience and type of work contact with patients, nurses' demographic characteristics were collected.the nordic occupational safety questionnaire (nosacq) was used to determine the status of safety atmosphere. this questionnaire was prepared by danish experts and then used in the nordic countries and has recently been used in several different european countries. the validity and reliability of the main questionnaire, which was in english, has been determined in the nordic countries. the validity and reliability of this persian version of this questionnaire has been determined in the study of yousefi et al. [20]. this questionnaire contains 50 questions (items) by which people's attitudes and perceptions about the safety situation in the workplace will be determined and recorded. these questions cover 7 dimensions of safety climate, which include safety management ability and priority, safety management authority, safety management justice, workers' commitment to safety issues, risk acceptance and safety priority by workers, communication between colleagues and learning about safety issues and workers' confidence in the effectiveness of safety systems. respondents to the questionnaire will announce their agreement with the questions raised in the 5 likert series. the number 1 indicates a strongly disagree opinion and the number 5 indicates a strongly agree opinion. some of the questions were designed in such a way that a completely opposite answer indicated a positive view of the safety situation.to evaluate nurses' perceptions of patient safety culture from safety culture hospital survey questionnairepatient (hsopsc), developed by the american agency for research and quality in health (ahrq) in 2004. this questionnaire consists of two parts, the first part contains demographic information and the second part asks questions about the 12 dimensions of patient safety culture in different dimensions, which are: general understanding of staff to patient safety, expectations and performance of the supervisor. department in order to improve patient safety, organizational training or continuous improvement, teamwork within units, open and transparent communication, feedback and communication related to safety errors, non punitive responses to errors, options related to staff workload, manager support hospital's patient safety, cartilage between different hospital units, how the patient is transferred bet.