(magistrsko delo)
Zdenka Kramar (Author), Andrej Robida (Mentor), Majda Pajnkihar (Co-mentor)

Abstract

Izhodišče: Varnost pacientov mora biti prioriteta vsakega zaposlenega v zdravstvu, ki se srečuje z oskrbo pacientov ne glede na poklicno skupino in nivo delovanja. Namen: Želeli smo primerjati stopnjo zaznavanja kulture varnosti pacientov pri zaposlenih v Splošni bolnišnici Jesenice med letoma 2010 in 2013. Raziskovalna metodologija: Merski instrument je bil anketni vprašalnik Agencije za raziskave in kakovost zdravstvene obravnave. Vključenih je bilo 380 zaposlenih, vrnjenih 91 % anketnih vprašalnikov. Statistična analiza je bila narejena s programom IBM SPSS 20.0 (IBM Corp., Armonk, NY). Z opisno statistiko smo prikazali odstotke pozitivnih, nevtralnih in negativnih odgovorov. Hipoteze smo preučevali s testom hi-kvadrat. Vrednost p < 0,05 je določala mejo statistične pomembnosti. Velikost učinka smo določili s Cramerjevim V koeficientom. Rezultati: Statistično pomembne razlike smo ugotovili tako pri skupni oceni pozitivnih odgovorov kulture varnosti pacientov med letoma 2013 (63,7 %) in 2010 (53,9 %), (χ2 = 4,991; p = 0,082, C – V 0,108) kot tudi pri podpori vrhnjega vodstva, pri učeči se organizaciji, pri podpori vodstva oddelka, pri povratni informaciji o napakah, pri timskem delu med bolnišničnimi oddelki, nekaznovalnem odzivu na napake ter ustreznosti števila in kompetentnosti zaposlenih. Statistično pomembne izboljšave smo ugotovili pri diplomiranih medicinskih sestrah, tehnikih zdravstvene nege in pri skupini drugih zaposlenih pri nekaznovalnem odzivu na napake in podpori vrhnjega vodstva. Pri tehnikih zdravstvene nege smo ugotovili statistično pomembno boljše rezultate pri timskem delu med bolnišničnimi enotami. Pri zdravnikih nismo ugotovili statistično pomembnih razlik. Statistično pomembne izboljšave smo ugotovili pri trditvi o podpori vrhnjega vodstva na internem, kirurškem oddelku, anesteziji, urgenci in na drugih manjših oddelkih. Statistično pomembno boljše rezultate smo ugotovili še pri naslednjih trditvah na posameznih oddelkih: kirurški oddelek – timsko delo med enotami, nekaznovalni odziv na napake, učeča se organizacija; urgenca – nekaznovalni odziv na napake; manjši oddelki – učeča se organizacija; anesteziološki oddelek – timsko delo med enotami. Na ginekološko-porodniškem in pediatričnem oddelku, na oddelku za radiologijo in v laboratoriju nismo našli statistično pomembnih izboljšav, saj so bile izhodiščne vrednosti v letu 2010 relativno visoke in je bilo zato izboljšave težje doseči. Sklep: Ugotovili smo, da se je skupno zaznavanje kulture varnosti med letoma 2010 in 2013 v bolnišnici statistično pomembno izboljšalo, zaznane so izboljšave pri določenih sklopih, pa tudi pri poklicnih skupinah in oddelkih.

Keywords

kultura varnosti;napake v zdravstvu;varnost pacientov;bolnišnica;anketa;

Data

Language: Slovenian
Year of publishing:
Typology: 2.09 - Master's Thesis
Organization: UM FZV - Faculty of Health Sciences
Publisher: [Z. Kramar]
UDC: 614.2(043.2)
COBISS: 2056868 Link will open in a new window
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Other data

Secondary language: English
Secondary title: CHANGES IN PERCEPTION OF PATIENT SAFETY CULTURE IN GENERAL HOSPITAL JESENICE
Secondary abstract: Background: Patient safety must be a priority of every employee in the health sector, regardless of occupational group and level of activity. Objective: To compare the level of perception of patient safety culture among employees in General Hospital Jesenice between years 2010 and 2013. Research Methodology: The questionnaire of Agency for Healthcare Research and Quality was used. The survey included 380 employees and the response rate was 91%. Statistical analysis was performed with SPSS 20.0 software IBM (IBM Corp., Armonk, NY). The percentage of positive, neutral and negative responses were calculated. The chi-square test was employed to examine the hypotheses. P-value <0.05 was considered as statistically significant. The effect size was determined by Cramer's V coefficient. Results: Statistically significant differences were observed in the overall assessment of the positive responses of patient safety culture between 2013 (63.7%) and 2010 (53.9%) (χ2 = 4.991, p = 0.082, C - V 0.108), as well as in support of the top leadership, organizational learning, support of the management of departmental managers, the feedback and communication about errors, teamwork across hospital departments, non-punitive response to error, and the adequacy of the number and competence of the staff. Statistically significant improvements were observed in the professional group of registered nurses and nursing technicians in the domains of a non-punitive response to error and in the support of the top leadership. The same was found also in the group that was labelled other employees. The nursing technicians also showed improvement in teamwork across hospital departments. There were no statistically significant changes in professional group of physicians.Statistically significant improvements were found in the departments of internal medicine, surgery, anaesthesia, emergency room and other smaller units in the support of the top leadership. Significantly better results were observed as well in the following domains and departments: the surgical department - teamwork across hospital departments, non-punitive response to error, organizational learning; the emergency department – non-punitive response to error; smaller units – organizational learning and the department of anaesthesia – teamwork across hospital departments.In the department of gynaecology/obstetric, paediatric department, the department of radiology and the laboratory statistically significant improvements were not found, since their basic values in 2010 were relatively high and it was, therefore, more difficult to achieve the improvements. Conclusion: The findings of this research showed significant improvement in the overall perception of safety culture in the hospital between 2010 and 2013, as well as improvements in certain domains in some professional groups and departments.
Secondary keywords: culture of safety;errors in health care;patient safety;hospital survey;614.2;
URN: URN:SI:UM:
Type (COBISS): Master's thesis/paper
Thesis comment: Univ. v Mariboru, Fak. za zdravstvene vede
Pages: IX, 103 str., 39 str. pril.
ID: 8730897