Abstract:

Objective To explore the effects of hospital patient safety culture on distress of nurses as second victims. Methods This study used convenience sampling method to investigate 2 897 nurses who had experience of patient safety incidents in 6 tertiary hospitals in central and west China from October 2018 to January 2019. The Hospital Survey on Patient Safety Culture（HSOPSC）,and the Second Victim Experience and Support Tool （SVEST） were used. Results The hospital patient safety culture had significant impact on psychological distress,physical distress,and professional self-efficacy of nurses as second victims. The associated factors of nurses’ psychological distress were non-punitive response to error,handoffs and transitions,teamwork across units,feedback and communication about error,overall perceptions of patient safety. The associated factors of physical distress were non-punitive response to error,handoffs and transitions,teamwork across units,staffing and nurses’ position. The associated factors of professional self-efficacy were non-punitive response to error,teamwork across units,overall perceptions of patient safety,handoffs and transitions,and nurses’ working years. Conclusion Distress of nurses as second victims is affected by the hospital patient safety culture,among which the non-punitive safety culture,teamwork across units and patient handoff were important influencing factors.

Key words: Patient Safety Culture, Second Victim, Cross-Sectional Studies, Root Cause Analysis, Nursing Administration Research, Safety Management

摘要：

目的 探索患者安全文化对护士第二受害者痛苦的影响。 方法 于2018年10月—2019年1月便利选取中国中西部3个省6所三级甲等医院经历患者安全事件的执业护士2 897名作为调查对象,采用一般资料问卷、医院患者安全文化调查问卷、第二受害者经验及支持量表进行调查。 结果 患者安全文化影响护士作为第二受害者的心理痛苦、生理痛苦和职业自我效能。护士心理痛苦的主要影响因素有差错的非惩罚性反应、交接班与转科、不同科室间合作、对差错的沟通反馈和安全的整体感知;生理痛苦的主要影响因素有差错的非惩罚性反应、交接班与转科、不同科室间合作、员工配置和护士职务;职业自我效能的主要影响因素有差错的非惩罚性反应、不同科室间合作、安全的整体感知、交接班与转科和护士工作年限。 结论 护士的第二受害者痛苦受到患者安全文化的影响,其中非惩罚性安全文化、医院跨科室的团队合作、患者交接对护士作为第二受害者的痛苦有重要影响。

关键词: 患者安全文化, 第二受害者, 横断面研究, 影响因素分析, 护理管理研究, 安全管理