介護施設における患者安全文化と有害事象報告の障害

Patient safety culture and obstacles to adverse event reporting in nursing homes.

• Haiyan He
• Pingping Yu
• Li Li
• Xueling Xiao
• Yanfang Long
• Liqian Wang
• Jiaqi Zeng
• Yinglan Li

抄録

エーアイエムズ:

中国の介護施設における患者安全文化と有害事象報告の障害との関係を調査する。

AIMS: To investigate patient safety culture and its relationship with obstacles to adverse event reporting in Chinese nursing homes.

背景:

報告障害は有害事象の高発生率および未報告率と関連している。患者安全文化も有害事象と関連している。しかし，介護施設における報告障害と患者安全文化との関係は不明である。

BACKGROUND: Reporting obstacles are related to high incidences and unreported rates of adverse events. Patient safety culture is also associated with adverse events. However, the relationship between reporting obstacles and patient safety culture in nursing homes is unclear.

方法:

6 ヵ所の介護施設の職員 549 名を対象に，「患者安全文化に関する介護施設調査」と「有害事象報告障害尺度」の尺度を用いて，ランダムサンプリング法による横断的調査を実施した．ピアソン相関係数、独立t検定、ANOVA検定、多変量回帰分析を用いた。

METHODS: A cross-sectional survey was conducted with a random sampling method among 549 staff members in six nursing homes using instruments of the Nursing Home Survey on Patient Safety Culture and the Adverse Event Reporting Obstacle Scale. The Pearson correlation coefficient, independent t-tests, ANOVA tests, and multivariate regression analysis were used.

結果:

介護施設における患者安全文化は、施設所有（p<0.001）、施設規模（p<0.001）、報告管理（p<0.001）、統合ケア施設であるかどうか（p=0.006）、患者の安全に対する懸念の頻度（p=0.001）、部門における有害事象の発生（p=0.001）、懲罰的な雰囲気（p=0.044）と関連していた。有害事象報告の障害は、患者の安全文化と負の相関があった（p<0.05）。

RESULTS: Patient safety culture in nursing homes was associated with facility ownership (p<0.001), facility scale (p<0.001), reporting management (p<0.001), whether it was an integrated care institution (p=0.006), frequency of concern about patient safety (p=0.001), occurrence of adverse events in departments (p=0.001), and a punitive atmosphere (p=0.044). Adverse event reporting obstacles were negatively correlated with patient safety culture (p<0.05).

結論:

患者安全文化の改善は、介護施設における報告障害の減少と関連していた。

CONCLUSION: An improvement in patient safety culture was associated with a reduction in reporting obstacles in nursing homes.

看護管理への影響:

バリアフリーな有害事象報告システムを構築して、報告の障害を軽減し、非懲罰的な患者安全文化を介護施設で創出すべきである。

IMPLICATIONS FOR NURSING MANAGEMENT: A barrier-free adverse event reporting system should be built to reduce reporting obstacles and create a non-punitive patient safety culture in nursing homes.

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