safety climate

安全气候
  • 文章类型: Journal Article
    背景:患者安全文化和患者体验的度量通常用于评估医疗服务质量,包括医院,但是这两个领域之间的关系仍然不确定。在这项研究中,我们旨在探索和综合已发表的有关医院环境中这些主题之间关系的文献.
    方法:这项研究是使用Arksey和O\'Malley框架的五个阶段进行的,由乔安娜·布里格斯研究所提炼。在CINAHL中进行了搜索,科克伦图书馆,ProQuest,MEDLINE,PsycINFO,SciELO和Scopus数据库。在澳大利亚和全球相关组织的网站上进行了进一步的在线搜索。根据预定标准提取数据。
    结果:4512项研究初步确定;15项研究符合纳入标准。确定了患者安全文化和患者体验领域之间的一些正统计关系。沟通和团队合作是影响患者安全文化与患者体验之间关系的最重要因素。经理和临床医生对安全性持积极看法,并与患者经验保持积极关系,但是,当管理者独自持有这种观点时,情况并非如此。定性方法从患者和家庭的角度提供了对患者安全文化的进一步见解。
    结论:研究结果表明,患者能够认识到医院团队可能遗漏的安全相关问题。然而,研究主要测量员工对患者安全文化的看法,并不总是包括患者对患者安全文化的体验。Further,患者安全文化与患者体验之间的关系通常被确定为统计关系,使用定量方法。评估患者安全文化以及患者体验的进一步研究对于提供更全面的安全性图片至关重要。这将有助于发现可能对患者安全文化和患者体验产生间接影响的问题和其他因素。
    BACKGROUND: Measures of patient safety culture and patient experience are both commonly utilised to evaluate the quality of healthcare services, including hospitals, but the relationship between these two domains remains uncertain. In this study, we aimed to explore and synthesise published literature regarding the relationships between these topics in hospital settings.
    METHODS: This study was performed using the five stages of Arksey and O\'Malley\'s Framework, refined by the Joanna Briggs Institute. Searches were conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, SciELO and Scopus databases. Further online search on the websites of pertinent organisations in Australia and globally was conducted. Data were extracted against predetermined criteria.
    RESULTS: 4512 studies were initially identified; 15 studies met the inclusion criteria. Several positive statistical relationships between patient safety culture and patient experience domains were identified. Communication and teamwork were the most influential factors in the relationship between patient safety culture and patient experience. Managers and clinicians had a positive view of safety and a positive relationship with patient experience, but this was not the case when managers alone held such views. Qualitative methods offered further insights into patient safety culture from patients\' and families\' perspectives.
    CONCLUSIONS: The findings indicate that the patient can recognise safety-related issues that the hospital team may miss. However, studies mostly measured staff perspectives on patient safety culture and did not always include patient experiences of patient safety culture. Further, the relationship between patient safety culture and patient experience is generally identified as a statistical relationship, using quantitative methods. Further research assessing patient safety culture alongside patient experience is essential for providing a more comprehensive picture of safety. This will help to uncover issues and other factors that may have an indirect effect on patient safety culture and patient experience.
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  • 文章类型: Journal Article
    对呼吸保护的有效性缺乏信心可能会导致工人的不确定性,并对工作场所的安全性产生怀疑。迄今为止,没有进行任何研究来研究和了解弹性体半面罩呼吸器(EHMR)的引入-没有呼气阀(EV)或有呼气阀过滤器(EVF),两者都代表了解决工作场所源代码控制的新设计。为了研究这个问题,在COVID-19大流行期间,研究人员与32个医疗服务机构的合作伙伴合作,这些机构从战略国家储备中获得了EHMR。EHMR用户(n=882)在2021年10月至2022年9月之间完成了一项在线调查。分析表明,如果员工接受了健康测试并接受了培训,他们对没有EV/有EVF的EHMR的功效(包括保护用户免受COVID-19伤害的功效)在统计学上更有信心。如果受访者对其组织的安全气候有更积极的看法,他们对EHMR的功效也有统计学上的更自信。随着制造商不断改进呼吸器模型以提高工人的舒适度和使用,结果为定制的配合测试和培训程序提供了见解。结果还表明,即使在突发公共卫生事件中,安全氛围作为支持工人知识的组织因素的作用不容忽视,态度,以及参与呼吸器使用特有的健康和安全行为。
    A lack of confidence in the efficacy of respiratory protection can contribute to uncertainty among workers and cast doubt on workplace safety. To date, no research has been conducted to study and understand the introduction of elastomeric half-mask respirators (EHMRs)-without exhalation valves (EVs) or with exhalation valve filters (EVFs), both representing new designs that address source control-in the workplace. To study this issue, researchers collaborated with partners at 32 health delivery settings that received EHMRs from the Strategic National Stockpile during the COVID-19 pandemic. EHMR users (n = 882) completed an online survey between October 2021 and September 2022. Analyses demonstrated that employees were statistically significantly more confident in the efficacy of EHMRs with no EV/with an EVF (including the efficacy in protecting the user from COVID-19) if they had been fit tested and received training. Respondents were also statistically significantly more confident in the efficacy of their EHMR if they had a more positive perception of their organization\'s safety climate. The results provide insights for tailored fit testing and training procedures as manufacturers continue to improve respirator models to enhance worker comfort and use. Results also show that, even during a public health emergency, the role of safety climate cannot be ignored as an organizational factor to support worker knowledge, attitudes, and participation in health and safety behaviors specific to respirator use.
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  • 文章类型: Journal Article
    有效的未遂管理对于防止工作场所事故非常重要。公司对未遂报告的反应不足会导致工人对公司感到不安全和不满。我们调查了公司对未遂报告的反应与工人离职意向之间的关系。
    我们于2022年3月对日本年龄≥20岁的工人进行了一项横断面研究,使用在线自我管理问卷调查。该分析包括5,071名参与者,他们有差一点的经历,并向他们的公司报告。自变量是公司对未遂报告的回应,分为三类:充分反应组,反应不足组,没有响应组。因变量是离职意向。我们使用嵌套在行业中并针对协变量进行调整的多水平逻辑回归分析,计算了比值比和95%机密区间(CI)。
    在5,071名参与者中,3,058(60.3%)是充分反应组,1,484(29.3%)是反应不充分组,529(10.4%)为无反应组。在多变量调整模型中,与适当的反应组相比,反应不充分组和无反应组的比值比分别为1.80(95%CI:1.56-2.08)和2.63(95%CI:2.15-3.22),分别。
    我们的结果表明,公司对未遂报告的反应与工人的离职意向之间存在关系。重要的是,不仅要收集未遂事件,而且还要对报告做出适当回应并向工人提供反馈。
    UNASSIGNED: Effective near-miss management is important in preventing workplace accidents. A company\'s inadequate response to near-miss reports can lead workers to feel insecure and dissatisfied with the company. We investigated the relationship between companies\' responses to near-miss reports and turnover intentions of workers.
    UNASSIGNED: We conducted a cross-sectional study using online self-administered questionnaire survey to workers aged ≥20 years in Japan in March 2022. The analysis included 5,071 participants who had near-miss experiences and reported them to their companies. The independent variable was companies\' responses to near-miss reports, classified into three categories: adequate response group, inadequate response group, and no response group. The dependent variable was turnover intentions. We calculated the odds ratio and 95% confidential interval (CI) using multilevel logistic regression analyses nested for industries and adjusted for covariates.
    UNASSIGNED: Of the 5,071 participants, 3,058 (60.3%) were adequate response group, 1,484 (29.3%) were inadequate response group, and 529 (10.4%) were no response group. In multivariable adjusted model, compared with adequate response group, the odds ratio of inadequate response group and no response group were 1.80 (95% CI: 1.56-2.08) and 2.63 (95% CI: 2.15-3.22), respectively.
    UNASSIGNED: Our results suggested that there was a relationship between companies\' responses to the near-miss reports and turnover intentions of workers. It is important not only to collect near-misses but also to respond appropriately to the reports and provide feedback to workers.
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  • 文章类型: Journal Article
    本研究旨在探讨安全控制在心理健康护士安全氛围与患者安全管理活动之间的中介作用。从2023年7月28日至2023年8月15日,对在G-do精神病院工作的177名护士进行了调查。使用SPSS/WIN27.0和Sobel检验分析数据。发现安全气候和安全控制之间存在显著关系(r=0.40,p<0.001),安全气候和患者安全管理活动(r=0.40,p<0.001),以及安全控制和患者安全管理活动(r=0.43,p<0.001)。此外,安全控制部分介导了安全气候和患者安全管理活动(Z=3.63,p<0.001)。因此,需要制定增加安全控制和创造安全氛围的计划,以促进心理健康护士的患者安全活动。
    This study aimed to investigate the mediating effect of safety control on the relationship between safety climate and patient safety management activities for mental health nurses. A survey was conducted on 177 nurses working at mental hospitals in G-do from 28 July 2023 to 15 August 2023. Data were analyzed using the SPSS/WIN 27.0 and Sobel test. Significant relationships were found between safety climate and safety control (r = 0.40, p < 0.001), safety climate and patient safety management activities(r = 0.40, p < 0.001), and safety control and patient safety management activities (r = 0.43, p < 0.001). Additionally, safety control partially mediated the safety climate and the patient safety management activities (Z = 3.63, p < 0.001). Therefore, programs that increase safety control and create a safety climate need to be developed to promote patient safety activities of mental health nurses.
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  • 文章类型: Journal Article
    机动车事故或设备碰撞是美国消防员死亡的主要原因。不使用安全带与其中一些死亡有关。这项研究旨在了解安全气候与消防员使用安全带之间的关系,因为调查结果将提供对可能加强安全带使用和保护消防员的因素的见解。
    数据来自美国东南部为城市消防部门工作的208名职业消防员。结构方程模型用于测试假设模型,并评估组织安全气候之间的关系,工作组安全气候和安全带的使用。
    确定对工作组安全气候的积极看法,作为高阶因子,由主管支持组成,横向凝聚力,和垂直凝聚力,与消防员样本中的安全带使用呈正相关。组织级别的安全气候与安全带的使用没有显着关系,但确实对工作组的安全气候观念产生了积极影响。
    安全气候与安全合规和参与行为有关,但是需要更多的研究来具体检查安全气候对消防员使用安全带的影响。研究结果表明,安全气候作为安全带使用的主要指标和预测指标的重要性。通过安全计划巩固安全氛围,对安全的承诺,有效沟通,支持性监督者和凝聚力最终应有助于加强消防员之间的安全带使用,这对减少消防员的伤亡很重要。
    UNASSIGNED: Motor vehicle incidents or apparatus crashes are a leading cause of firefighter fatalities in the United States. Nonuse of seat belts has been linked to some of these fatalities. This research seeks to understand the relationship between safety climate and seat belt use among firefighters, as findings will provide insights into factors that may bolster seat belt use and protect firefighters.
    UNASSIGNED: Data were collected from 208 career firefighters working for a city fire department in the southeastern United States. Structural equation modeling was used to test a hypothesized model and to assess the relationships between organizational safety climate, work group safety climate and seat belt use.
    UNASSIGNED: It was determined that positive perceptions of workgroup safety climate, as a higher order factor, comprised of supervisor support, horizontal cohesion, and vertical cohesion, was positively associated with seat belt use within a sample of firefighters. Organizational level safety climate did not have a significant relationship with seat belt use but did positively influence workgroup safety climate perceptions.
    UNASSIGNED: Safety climate has been associated with safety compliance and participation behaviors, but more research was needed to specifically examine the impact of safety climate on seat belt use in firefighters. The findings point to the importance of safety climate as a leading indicator and predictor of seat belt use. Bolstering safety climate through safety programs, commitment to safety, effective communication, supportive supervisors and cohesion should ultimately aid in bolstering seat belt use among firefighters, which is important to curtailing firefighter injuries and fatalities.
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  • 文章类型: Journal Article
    背景:预防职业事故是一项重大的全球挑战,员工安全实践在预防事故中起着至关重要的作用。尽管感知的组织支持(POS)与安全实践有关,目前没有足够的证据支持POS和职业事故之间的关系。我们调查了POS与职业事故和未遂事件之间的关系,这些事故和未遂事件可能导致次年日本各行业工人之间的事故。
    方法:这项前瞻性队列研究于2022年3月至2023年3月使用问卷调查进行。总的来说,对完成随访调查并符合我们纳入标准的9916名参与者进行了分析。后续调查向参与者询问了基线评估后一年中发生的职业事故和未遂事件。使用“感知组织支持调查”的八项版本在基线上对POS进行了评估。使用按行业嵌套的多水平逻辑回归分析来估计POS与职业事故和未遂事件之间关系的赔率(OR)。
    结果:中度者自我报告职业事故的OR值明显更高(OR=1.41,95%置信区间[CI]:1.10-1.82),低(OR=1.49,95CI:1.18-1.89),和极低组(OR=2.03,95CI:1.61-2.56)POS与极高组比较。中度患者自我报告的近错过事件的OR也显着较高(OR=1.21,95CI:1.03-1.43),低(OR=1.20,95CI:1.03-1.40),且极低组(OR=1.56,95CI:1.34-1.82)比极高组。
    结论:我们的研究结果表明,较低的POS与第二年职业事故和未遂事件的较高发生率有关。组织应考虑加强员工的POS,以减少职业事故和未遂事件。
    结论:为了提高员工的POS,组织应解决已确定的POS的前身(例如,公平,主管支持,奖励,良好的工作条件,和人力资源实践)。
    BACKGROUND: Preventing occupational accidents is a major global challenge, and employee safety practices play a crucial role in accident prevention. Although perceived organizational support (POS) is related to safety practices, there is currently insufficient evidence supporting a relationship between POS and occupational accidents. We investigated the relationships between POS and both occupational accidents and near-miss events that can lead to accidents in the following year among workers in various industries in Japan.
    METHODS: This prospective cohort study was conducted from March 2022 to March 2023 using a questionnaire survey. In total, 9916 participants who completed the follow-up survey and met our inclusion criteria were analyzed. The follow-up survey asked participants about both occupational accidents and near-miss events experienced in the year following the baseline assessment. POS was evaluated at baseline using the eight-item version of the Survey of Perceived Organizational Support. Odds ratios (ORs) for the relationships between POS and occupational accidents and near-miss events were estimated using multilevel logistic regression analyses nested by industries.
    RESULTS: The ORs for self-reported occupational accidents were significantly higher for the moderate (OR = 1.41, 95% confidence interval [CI]: 1.10-1.82), low (OR = 1.49, 95%CI: 1.18-1.89), and very low (OR = 2.03, 95%CI: 1.61-2.56) POS groups compared with the very high group. The ORs for self-reported near-miss events were also significantly higher for the moderate (OR = 1.21, 95%CI: 1.03-1.43), low (OR = 1.20, 95%CI: 1.03-1.40), and very low (OR = 1.56, 95%CI: 1.34-1.82) groups than the very high group.
    CONCLUSIONS: Our findings suggest lower POS is related to a higher occurrence of occupational accidents and near-miss events in the following year. Organizations should consider enhancing employees\' POS to reduce occupational accidents and near-miss events.
    CONCLUSIONS: To enhance employees\' POS, organizations should address identified antecedents of POS (e.g., fairness, supervisor support, rewards, favorable job conditions, and human resource practices).
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  • 文章类型: Journal Article
    背景:消防组织安全文化(FOCUS)调查是一种评估工具,由经过心理测量验证的安全气候指标组成,安全行为,以及特定于美国消防和救援服务的下游结果(组织和伤害)。
    方法:该分析由两个独立调查波(FOCUS1.0和2.0)的描述性摘要组成。这些调查浪潮中包括的消防部门来自便利抽样(n1.0=275;n2.0=170)。除了部门层面的特点,我们检查了参与部门的消防员和EMS提供者的个体水平特征(n1.0=22,719;n2.0=16,882).我们进行了回归分析,以检查安全气候和安全行为之间的关联,组织成果,和安全结果。所有分析均按组织类型分层(职业,志愿者)。
    结果:我们的分析表明,大多数受访者是男性(90.7%的FOCUS1.0;90.4%的FOCUS2.0),非官员(68.4%FOCUS1.0;66.4%FOCUS2.0),和非西班牙裔白人(70.8%FOCUS1.0;69.5%FOCUS2.0)。对于这两个样本,职业部门(nFOCUS1.0=3778[17.5%];nFOCUS2.0=3072[18.7%])的个人受伤率高于志愿部门(nFOCUS1.0=103[8.8%];nFOCUS2.0=34[7.4%])。我们观察到两个样本中职业和志愿者部门的管理对安全的承诺的平均得分之间大约有10分的差异。我们观察到两个组织成果的关联,安全行为和工作满意度,管理层对安全的承诺和主管对整体安全的支持,并按组织类型分层。我们观察到与安全管理承诺(OR1.0总体:0.98,95%CI0.97-0.99;OR2.0志愿者:0.90,95%CI0.85-0.95)和安全主管支持(OR1.0总体:0.95,95%CI0.93-0.97;OR1.0职业:0.95,95%CI0.92-0.98)增加相关的受伤几率降低。
    结论:从我们目前的研究来看,并对美国消防部门的地理分层随机样本进行了事先分析,我们从所有的组织成果中发现,工作满意度与重点安全气候最相关。Further,在我们的样本中,消防员始终将主管安全支持评为高于管理层对安全的承诺。未来的干预措施应支持消防部门改善其部门管理安全承诺并保持其安全监督员。
    BACKGROUND: The Fire service Organizational Culture of Safety (FOCUS) survey is an assessment tool comprised of psychometrically validated metrics of safety climate, safety behavior, and downstream outcomes (organizational and injury) that are specific to the U.S. fire and rescue service.
    METHODS: This analysis consists of a descriptive summary of two independent survey waves (FOCUS 1.0 and 2.0). The fire departments included in these survey waves were from convenience sampling (n1.0 = 275; n2.0 = 170). In addition to department level characteristics, we examined individual level characteristics for firefighters and EMS providers in participating departments (n1.0 = 22,719; n2.0 = 16,882). We conducted regression analyses to examine the associations between safety climate and safety behaviors, organizational outcomes, and safety outcomes. All analyses were stratified by organization type (career, volunteer).
    RESULTS: Our analysis indicated that a majority of respondents were males (90.7%FOCUS 1.0; 90.4%FOCUS 2.0), non-officers (68.4%FOCUS 1.0; 66.4%FOCUS 2.0), and non-Hispanic Whites (70.8%FOCUS 1.0; 69.5%FOCUS 2.0). For both samples there was a higher prevalence of injuries among individuals in career departments (nFOCUS 1.0 = 3778 [17.5%]; nFOCUS 2.0 = 3072 [18.7%]) than volunteer departments (nFOCUS 1.0 = 103 [8.8%]; nFOCUS 2.0 = 34 [7.4%]). We observed an approximate 10-point difference between the mean scores of Management Commitment to Safety for career and volunteer departments in both samples. We observed associations for two organizational outcomes, Safety Behavior and Job Satisfaction, with Management Commitment to Safety and Supervisor Support for Safety overall and when stratified by organization type. We observed a decrease in the odds of injuries associated with a one-unit increase in Management Commitment to Safety (OR1.0 overall: 0.98, 95% CI 0.97-0.99; OR2.0 volunteer: 0.90, 95% CI 0.85-0.95) and Supervisor Support for Safety (OR1.0 overall: 0.95, 95% CI 0.93-0.97; OR1.0 career: 0.95, 95% CI 0.92-0.98).
    CONCLUSIONS: From our current study, and a prior analysis of a geographically stratified random sample of U.S. fire departments, we identified that from all the organizational outcomes, job satisfaction was most consistently associated with FOCUS safety climate. Further, firefighters in our samples consistently rated Supervisor Support for Safety higher than Management Commitment to Safety. Future interventions should support fire departments in improving their departmental Management Commitment to Safety and maintaining their Supervisor for Safety.
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  • 文章类型: Journal Article
    组织学习(OL)和跨专业协作(IPC)据说可以增强医院的医疗安全性,但是这些变量之间的关系还没有被定量检验。
    本研究考察了IPC对OL和安全气候之间关系的中介作用(改进,合规,和患者/家庭参与)。
    从2021年11月至2022年1月,对1,495名医护人员进行了匿名自我报告问卷。这些问题考虑了医院的安全气候,OL,和IPC。使用结构方程模型进行了中介分析,以检查IPC对OL与三种安全气候之间关系的中介作用。使用2,000个bootstrap样本估计了间接效应。
    分析了643名医护人员的反应。OL对改善和参与的直接影响为?=.74,75(p<.001),对依从性的直接影响为?=0.1(p>.05)。IPC对改善和参与的间接影响为?=.14(95CI:.00~.06)和?=.37(95CI:.04~.09),分别。
    这项研究确定了增强医院安全氛围的机制,证明IPC介导了OL和改善与患者/家庭参与之间的关系。然而,OL和IPC与合规无关。
    UNASSIGNED: Organizational learning (OL) and interprofessional collaboration (IPC) are said to enhance medical safety in hospitals, but the relationship between these variables has not been quantitatively tested.
    UNASSIGNED: This study examines the mediating effects of IPC on the relationship between OL and safety climate (improvement, compliance, and patient/family involvement).
    UNASSIGNED: An anonymous self-reporting questionnaire was administered to 1,495 healthcare workers from November 2021 to January 2022. The questions regarded the hospital\'s safety climate, OL, and IPC. A mediation analysis using structural equation modeling was conducted to examine the mediating role of IPC on the relationship between OL and the three safety climates. The indirect effect was estimated using 2,000 bootstrap samples.
    UNASSIGNED: Responses from 643 healthcare workers were analyzed. The direct effects of OL were 𝛽 = .74, 75 (p < .001) on improvement and involvement and 𝛽 = 0.1 (p > .05) on compliance. The indirect effects of IPC on improvement and involvement were 𝛽 = .14 (95%CI: .00 ∼ .06) and 𝛽 = .37 (95%CI: .04 ∼ .09), respectively.
    UNASSIGNED: This study determined the mechanisms that enhance a hospital\'s safety climate, demonstrating that IPC mediates the relationship between OL and improvement and patient/family involvement. However, OL and IPC are not related to compliance.
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  • 文章类型: Journal Article
    背景:这项研究分析了大流行期间韩国中小型医院护士的个人和环境因素对感染控制实践的影响。
    方法:我们从韩国大都市地区的五家传染病专科医院招募了171名护士,这些医院有200到299张病床。个别因素,包括一般特征,COVID-19知识,态度,和风险感知,和环境因素,包括COVID-19安全气候,使用自我报告问卷收集。采用多因素logistic回归分析个体和环境因素。
    结果:与COVID-19相关的安全气候(β=.423)与感染控制措施的关联最大,其次是与COVID-19相关的态度(β=.174)。较高的安全气候和态度评分与较高的感染控制实践评分相关。这些变量的解释能力为30.6%。
    结论:这项研究表明,安全气候和与COVID-19相关的态度显著影响中小型医院的感染控制实践。这为建立中小型医院新发传染病的应对政策提供了依据,并有助于一致的指导方针。
    BACKGROUND: This study analyzed the influence of individual and environmental factors on infection control practices among nurses in small to medium-sized hospitals of South Korea during the pandemic.
    METHODS: We enrolled 171 nurses from 5 infectious disease-specialized hospitals with 200 to 299 beds located in metropolitan areas of South Korea. Individual factors, including general characteristics, coronavirus disease 2019 (COVID-19) knowledge, attitude, and risk perception, and environmental factors including COVID-19 safety climate, were collected using self-report questionnaires. Individual and environmental factors were analyzed using multiple logistic regression.
    RESULTS: COVID-19-related safety climate (β = 0.423) had the greatest association with infection control practices, followed by COVID-19-related attitude (β = 0.174). Higher safety climate and attitude scores were associated with higher scores in infection control practices. The explanatory power of these variables was 30.6%.
    CONCLUSIONS: This study indicated that safety climate and COVID-19-related attitudes significantly influence infection control practices in small to medium-sized hospitals. This provides a basis to establish policies for responses to emerging infectious diseases in small to medium-sized hospitals and contributes to consistent guidelines.
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  • 文章类型: Journal Article
    医疗保健组织在确保患者安全和减少临床医生离职方面面临着顽固的挑战。本文旨在通过阐明如何通过联合解决问题的导向(JPS)来增强心理安全在患者安全中的作用,从而推进有关患者安全的理论和研究。我们假设并测试了JPS和心理安全与安全改进之间的相互作用,利用来自14943名面向患者的医护人员样本的纵向调查数据。我们发现了一种调节作用,其中心理安全与安全改善呈正相关,在JPS的存在下,这种关系更加牢固。心理安全和JPS在预测临床医生留在组织的意图方面也有积极的互动。为了理论和研究,我们的研究结果指出,JPS是一个可衡量的因素,可以提高心理安全对患者安全改善的价值-也许是因为对患者安全的担忧通常需要共同解决问题才能产生有意义的改变.为了实践,我们的概念框架,将心理安全和JPS视为互补因素,可以帮助组织采用更细粒度的方法来评估其安全环境的人际关系方面。这将使组织能够对其安全环境有更细致的了解,并相应地确定需要改进的领域。
    Healthcare organizations face stubborn challenges in ensuring patient safety and mitigating clinician turnover. This paper aims to advance theory and research on patient safety by elucidating how the role of psychological safety in patient safety can be enhanced with joint problem-solving orientation (JPS). We hypothesized and tested for an interaction between JPS and psychological safety in relation to safety improvement, leveraging longitudinal survey data from a sample of 14,943 patient-facing healthcare workers. We found a moderation effect, in which psychological safety was positively associated with safety improvement, and the relationship was stronger in the presence of JPS. Psychological safety and JPS also interacted positively in predicting clinicians\' intent to stay with the organization. For theory and research, our findings point to JPS as a measurable factor that may enhance the value of psychological safety for patient safety improvement-perhaps because voiced concerns about patient safety often require joint problem-solving to produce meaningful change. For practice, our conceptual framework, viewing psychological safety and JPS as complementary factors, can help organizations adopt a more granular approach towards assessing the interpersonal aspect of their safety climate. This will enable organizations to obtain a more nuanced understanding of their safety climate and identify areas for improvement accordingly.
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