نوع مقاله : مقاله پژوهشی
1 کارشناسی ارشد، مهندسی صنایع گرایش مهندسی ایمنی، بهداشت و محیط زیست (HSE)
2 مهندسی بهداشت حرفهای وارگونومی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی شهید صدوقی یزد
عنوان مقاله [English]
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.
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. . 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 questionnaire
Patient (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 between wards and finally the frequency of reported accidents (42 questions in total). This questionnaire was scored using the Likert scale and the answers to the questions were scored with the options I completely agree (with a score of 5) to completely disagree (with a score of 1). In relation to questions that have a negative connotation, the scoring method is reversed so that I strongly agree with the lowest score (1) and strongly disagree with the highest score (5). To determine the status of safety culture in each dimension, the scores of the questions in each dimension will be added and divided by the number of questions in each dimension. And to get the general score of patient safety culture, the score of 42 questionnaire questions will be added together and then divided by the number of questions.
The study by Moghari et al. Confirmed the validity and reliability of the Patient Safety Culture Questionnaire (HSOPSC) for work in Iran. Cronbach's alpha coefficient in this study was 0.86
SPSS.20 software and Pearson correlation coefficient, t-test and regression were used to analyze the data.
The findings of the study showed that the patient's safety climate and safety culture had a moderate score among the nurses of Shahid Sadoughi Hospital. The above results indicate the fact that the nurses of Shahid Sadoughi Hospital in Yazd need to receive correct and complete training on safety attitudes and patient safety culture. Therefore, it is recommended that periodic and in-service training be provided on safety attitudes as well as how to protect and take care of oneself to prevent accidents. The training provided will not only be effective in raising the level of awareness and attitude of employees towards safety attitude but also in improving the performance and care of patients and preventing accidents in themselves and other colleagues, thus increasing staff awareness (safety knowledge management). Improving the motivation system (encouragement and punishment), managing employee safety participation, creating balance in work and time (re-timing) and rooting out the causes of conflicts between safety and operational goals can be suggested to improve the attitude of employees to Safety and finally reducing the grounds for unsafe behaviors should be discussed.