护士给药接近失误报告障碍的影响因素分析

doi:10.3761/j.issn.0254-1769.2020.09.004

中华护理杂志 ›› 2020, Vol. 55 ›› Issue (9): 1304-1309.DOI: 10.3761/j.issn.0254-1769.2020.09.004

护士给药接近失误报告障碍的影响因素分析

于淼(),王建辉(),刘学明,马佳慧,贾玉娜,白铁娟,李宇婷

063210唐山市华北理工大学护理与康复学院(于森,白铁娟,李宇婷);唐山市工人医院护理部(王建辉),神经内科(马佳慧),肝胆外科(贾玉娜);唐山市中心医院护理部(刘学明)

收稿日期:2019-09-23 出版日期:2020-09-15 发布日期:2020-09-03
通讯作者:
作者简介:于森:女,本科(硕士在读), E-mail:904355939@q.com
基金资助:
唐山市科技计划项目(19130203g)

The route cause analysis of nurse medication near-miss reporting barriers

YU Miao(),WANG Jianhui(),LIU Xueming,MA Jiahui,JIA Yuna,BAI Tiejuan,LI Yuting

Received:2019-09-23 Online:2020-09-15 Published:2020-09-03

摘要/Abstract

摘要：

目的探讨领导-成员交换关系、差错管理氛围在变革型领导对护士给药接近失误报告障碍影响机制中的多重中介作用。方法采用便利抽样方法,应用一般资料调查表、变革型领导量表、领导-成员交换关系量表、差错管理氛围量表、给药接近失误报告障碍量表对唐山市4所三级甲等医院的877名护士进行问卷调查,构建并检验链式中介模型。结果变革型领导对给药接近失误报告障碍的间接效应成立,总的间接效应值为0.126。领导-成员交换关系和差错管理氛围在变革型领导与给药接近失误报告障碍中的链式中介效应为0.011,占总间接效应的8.73%。结论领导-成员交换关系、差错管理氛围在变革型领导与给药接近失误报告障碍间的多重中介作用成立。护理管理者在工作中应重视塑造自身的变革型领导风格,改善与护士之间的关系,营造积极的差错管理氛围,降低护士给药接近失误报告障碍。

关键词: 变革型领导, 给药接近失误报告障碍, 领导-成员交换关系, 差错管理氛围

Abstract:

Objective To explore the multiple mediating roles of Leadership-Member Exchange（LMX）and error management climate in the influence mechanism of transformational leadership on nurses’ medication near-miss reporting barriers.Methods A total of 877 nurses in 4 tertiary hospitals in Tangshan were investigated by general information questionnaire,transformational leadership scale,leader-member exchange relationship scale,error management climate scale and the barriers to medication near-miss reporting scale. The chain mediation model was constructed and verified.Results The indirect effect of transformational leadership on the barriers to medication near-miss reporting was established,and the total indirect effect value was 0.126. The chain mediating effect of LMX and error management climate in transformational leadership and barriers to medication near-miss reporting was 0.011,accounting for 8.73% of the total indirect effect.Conclusion The LMX and error management climate were found with multiple mediating effects between transformational leaders and medication near-miss reporting barriers. The head nurses should pay attention to the shaping of their own transformational leadership style,improve the relationship with nurses,create a positive error management climate,and reduce the barriers to medication near-miss reporting.

Key words: Transformational Leadership, Barriers to Medication Near-Miss Reporting, Leader-Member Exchange, Error Management Climate

于淼,王建辉,刘学明,马佳慧,贾玉娜,白铁娟,李宇婷. 护士给药接近失误报告障碍的影响因素分析[J]. 中华护理杂志, 2020, 55(9): 1304-1309.

YU Miao,WANG Jianhui,LIU Xueming,MA Jiahui,JIA Yuna,BAI Tiejuan,LI Yuting. The route cause analysis of nurse medication near-miss reporting barriers[J]. Chinese Journal of Nursing, 2020, 55(9): 1304-1309.

图/表 5

表1 研究对象的一般资料(n=877)

表2 变革型领导、领导--成员交换关系、差错管理氛围和给药接近失误报告障碍总分及各维度得分(n=877)

表3 变革型领导、领导-成员交换关系、差错管理氛围与给药接近失误报告障碍的相关分析(r值)

图1 领导-成员交换关系和差错管理氛围的中介效应模型

表4 变革型领导与给药接近失误报告障碍之间的中介效应检验

参考文献 33

[1]	Van Spall H, Kassam A, Tollefson TT. Near-misses are an opportunity to improve patient safety:adapting strategies of high reliability organizations to healthcare[J]. Curr Opin Otolaryngol Head Neck Surg, 2015,23(4):292-296. DOI URL PMID
[2]	Pham JC, Story JL, Hicks RW, et al. National study on the frequency,types,causes,and consequences of voluntarily reported emergency department medication errors[J]. J Emerg Med, 2011,40(5):485-492. DOI URL
[3]	Hajibabaee F, Joolaee S, Peyravi H, et al. Medication error reporting in Tehran:a survey[J]. J Nurs Manag, 2014,22(3):304-310. DOI URL PMID
[4]	Haw C, Stubbs J, Dickens GL. Barriers to the reporting of medication administration errors and near misses:an interview study of nurses at a psychiatric hospital[J]. J Psychiatr Ment Heal Nurs, 2014,21(9):797-805.
[5]	WHO. Conceptual framework for the international classification for patien safety[EB/OL]. (2009-04)[2019-08-20]. http://www. mof. gov. cy/mof/cystat/statistics. nsf/All/F9690C2D35652CB5C2257726003DDA8F/$file/HEALTH_HOSPITAL_STATS_2008-170510. pdf? OpenElement],StatisticalService 2008 Health and Hospital Statistics.
[6]	夏志丹, 肖晓林, 吴一凡. 医院用药错误和接近失误分析与改进成效评价[J]. 中国药业, 2017,26(17):84-86.
[7]	Williamsen M. Near-miss reporting:a missing link in safety culture[J]. Prof Saf, 2013,58(5):46-50.
[8]	刘华平. 对开展接近失误管理以提高患者安全的思考[J]. 上海护理, 2018,18(3):5-9.
[9]	张欣, 韩冬韧, 冯淑菊, 等. NICU用药接近失误相关系统风险因素分析[J]. 中国护理管理, 2017,17(8):1087-1091.
[10]	李超平, 时勘. 变革型领导的结构与测量[J]. 心理学报, 2005,37(6):803-811.
[11]	王辉, 牛雄鹰, Kenneth S. Law. 领导-部属交换的多维结构及对工作绩效和情境绩效的影响[J]. 心理学报, 2004,36(2):179-185.
[12]	van Dyck C, Frese M, Baer M, et al. Organizational error management culture and its impact on performance:a two-study replication[J]. J Appl Psychol, 2005,90(6):1228-1240. DOI URL PMID
[13]	Cigularov KP, Chen PY, Rosecrance J. The effects of error management climate and safety communication on safety:a multi-level study[J]. Accid Anal Prev, 2010,42(5):1498-1506. DOI URL
[14]	Chiang HY. Factorial validity of the Chinese version of Barriers to Medication Administration[EB/OL]. (2006-07-21)[2019-09-10]. https://stti. confex. com/stti/congrs06/techprogram/paper_28097. htm.
[15]	蒋银芬. 医院安全氛围、工作环境及人口学特征与给药错误报告障碍的关系[D]. 苏州:苏州大学, 2011.
[16]	周浩, 龙立荣. 共同方法偏差的统计检验与控制方法[J]. 心理科学进展, 2004,12(6):942-942.
[17]	温忠麟, 叶宝娟. 中介效应分析:方法和模型发展[J]. 心理科学进展, 2014,22(5):731-745. DOI URL
[18]	王亚亚, 周伟娇, 万巧琴, 等. 科室管理者领导风格对医护合作的影响研究[J]. 护理学杂志, 2018,33(6):60-63.
[19]	黄茜茜, 蔡松妲. 领导-成员交换质量对护士伦理决策的影响[J]. 中华护理教育, 2016,13(8):596-599.
[20]	张宁俊, 袁梦莎, 付春香, 等. 差错管理氛围与员工创新行为的关系研究[J]. 科研管理, 2015,36(S1):94-101.
[21]	卫生部. 医疗质量安全事件报告暂行规定[EB/OL]. (2011-01-20)[2019-09-10]. http://www. nhc. gov. cn/yzygj/s3590/201101/08cb6408355047fd887f335894e4d7d2. shtml.
[22]	卫生部. 关于统一使用医疗质量安全事件信息报告系统的通知[EB/OL]. (2011-04-28)[2019-09-10]. http://www. nhc. gov. cn/yzygj/s3590/201104/9eac75707c964aab93bdd12d383d7df5. shtml.
[23]	管玉梅, 陶艳玲, 陈娟慧, 等. 护理人员给药错误报告障碍现状及其个人因素分析[J].护理研究(下旬版), 2016(4):1437-1441.
[24]	毛晋平, 谭美金. 变革型领导风格对中小学教师工作投入的影响:心理资本的中介和调节作用[J]. 教师教育研究, 2015,27(5):14-22.
[25]	刘泱, 朱伟, 赵曙明. 包容型领导风格对雇佣关系氛围和员工主动行为的影响研究[J]. 管理学报, 2016,13(10):1482-1489.
[26]	沈燕萍, 章燕红. 差错认知在护士感知的护士长变革型领导风格与护士创新行为的中介效应[J]. 护理学报, 2019,26(21):51-54.
[27]	Hashemi F, Nasrabadi AN, Asghari F. Iranian nurses’ concerns regarding error disclosure:a qualitative study[J]. Journal of Applied Sciences Research, 2013,17(17):1521-1525.
[32]	Naveh E, Katz-Navon T, Stern Z. Active learning climate and employee errors:the moderating effects of personality traits[J]. J Organiz Behav, 2015,36(3):441-459. DOI URL
[33]	Waters NF, Hall WA, Brown H, et al. Perceptions of Canadian labour and delivery nurses about incident reporting:a qualitative descriptive focus group study[J]. Int J Nurs Stud, 2012,49(7):811-821. DOI URL

护士给药接近失误报告障碍的影响因素分析

The route cause analysis of nurse medication near-miss reporting barriers

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 5

参考文献 33

相关文章 1

编辑推荐

Metrics