医护人员主动告知患者及其家属医疗安全不良事件的调查研究

doi:10.3761/j.issn.0254-1769.2020.01.017

摘要/Abstract

摘要：

目的了解医护人员对主动告知患者及其家属医疗安全不良事件的经历和态度。方法采用自编问卷对武汉市2所三级甲等医院的564名医护人员进行调查。结果告知经历：71.0%医生和50.4%护士有主动告知医疗安全不良事件的经历;68.3%的医生和57.1%的护士对告知结果感到满意;3.3%的医生和2.6%的护士表示主动告知对医患、护患关系有消极影响;55.2%的医生和59.3%的护士表示主动告知得到了领导支持;86.3%的医生和56.6%的护士赞成将主动告知作为一项规定。培训经历：74.3%的护士和86.3%的医生没有相关培训经历;64.5%的医生和87.1%的护士表示将来愿意参加相关培训。告知态度：对Ⅰ级事件（警告事件）、Ⅱ级事件（不良后果事件）、Ⅲ级事件（未造成后果事件）、Ⅳ级事件（隐患事件）,医护人员支持主动告知的人数和比例分别为378名（67.0%）、348名（61.7%）、327名（58.0%）、219名（38.8%）。告知程度：医护人员对Ⅰ~Ⅳ级事件选择部分告知的比例和人数分别为359名（63.7%）、384名（68.1%）、330名（58.5%）、237名（42.0%）。结论部分医护人员有过主动告知的经历且结果较好,医护人员对主动告知持支持态度,但仍有较多的医护人员有所顾虑。医院管理者应加强对医护人员进行关于主动告知医疗安全不良事件的培训。

关键词: 主动告知, 不良事件, 患者安全, 问卷调查, 横断面研究, 护理管理研究

Abstract:

Objective To understand experience and attitude of doctors and nurses for initiative disclosing medical adverse events. Methods A self-developed questionnaire was used to investigate 564 doctors and nurses from 2 tertiary hospitals in Wuhan. Results For the aspect of experience：71.0% of doctors and 50.4% of nurses indicated that they had experience of initiative disclosing medical adverse events;68.3% of doctors and 57.1% of nurses were satisfied with the results;3.3% of doctors and 2.6% of nurses indicated that disclosure had a negative impact on doctor-patient or nurse-patient relationship;55.2% of doctors and 59.3% of nurses indicated that they had the support from the leadership;86.3% of doctors and 56.6% of nurses were in favor of disclosure as a requirement. In the aspect of experience：74.3% of nurses and 86.3% of doctors had no training experience. 64.5% of doctors and 87.1% of nurses indicated their willingness to participate in the training in the future. For the aspect of attitude：for Grade Ⅰ events,Grade Ⅱ events,Grade Ⅲ events and Grade Ⅳ events,378（67.0%）,348（61.7%）,327（58.0%） and 219（38.8%） cases were in favor of initiative disclosure. For the aspect of degree：for Grade Ⅰ events,Grade Ⅱ events,Grade Ⅲ events and Grade Ⅳ events,359（63.7%）,384（68.1%）,330（58.5%） and 237（42.0%） cases supported partial disclosure. Conclusion Some doctors and nurses have initiative disclosure experience and the results are relatively positive. Doctors and nurses support initiative disclosure of medical adverse events but still have concerns. Hospital administrators should strengthen training for medical staff on initiative disclosing medical safety adverse events.

Key words: Disclosure, Adverse Events, Patient Safety, Questionnaires, Cross-Sectional Studies, Nursing Administration Research

余丽娜, 钱新毅, 盛静, 王婷, 余山桢, 罗翠, 陈小艳. 医护人员主动告知患者及其家属医疗安全不良事件的调查研究[J]. 中华护理杂志, 2020, 55(1): 102-106.

YU Lina, QIAN Xinyi, SHENG Jing, WANG Ting, YU Shanzhen, LUO Cui, CHEN Xiaoyan. Study on initiative disclosing medical adverse events by doctors and nurses[J]. Chinese Journal of Nursing, 2020, 55(1): 102-106.

图/表 4

表1 调查对象的一般资料及医护人员主动告知医疗安全不良事件态度的单因素分析结果（n=564）

表2 医护人员主动告知医疗安全不良事件的经历比较[名（百分比,%）,n=564]

表3 医护人员对主动告知不同级别医疗安全不良事件的态度[名（百分比,%）,n=564]

表4 医护人员主动告知不同级别医疗安全不良事件的程度[名（百分比,%）,n=564]

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