手术室护士风险预警能力现状及影响因素分析

摘要/Abstract

摘要： 目的了解手术室护士风险预警能力的现状,并分析其影响因素。方法于2021年9—12月,采用一般资料调查表、手术室护士风险预警能力量表、护士道德勇气量表及差错反感文化量表对海南省三级甲等医院的手术室护士进行调查,并对数据进行分析。结果手术室护士的风险预警能力得分为（88.25±9.19）分,道德勇气得分为（72.49±8.24）分,差错反感文化得分为（20.46±6.04）分。手术室护士的风险预警能力与其道德勇气间呈正相关（r=0.573,P<0.01）,与其差错反感文化间呈负相关（r=-0.534,P<0.01）。影响手术室护士风险预警能力得分的主要因素有护士道德勇气、差错反感文化、职务、工作年限（β=-0.247~0.387,均P<0.05）,可解释其得分变异的46.8%。结论手术室护士风险预警能力处于中等水平。护理管理者可从护士道德勇气、差错反感文化等层面出发,并重点关注职务较低、工作年限较短的护士,进一步加强手术室护理人员的风险预警能力。

关键词: 手术室护士, 手术室风险, 风险预警能力, 道德勇气, 差错反感文化

Abstract: Objective To understand the status quo of risk warning ability of operating room nurses and analyze its influencing factors. Methods From September to December 2021,the general data questionnaire,the risk warning ability scale,the moral courage scale and the error aversion culture scale were used to investigate the operating room nurses in the grade-A tertiary hospitals in Hainan Province,and the data were analyzed. Results The score of risk warning ability of operating room nurses was （88.25±9.19）points,the moral courage score was （72.49±8.24）points,and the error aversion culture score was （20.46±6.04）points. There was a positive correlation between risk warning ability and moral courage of operating room nurses（r=0.573,P<0.01）. There was a negative correlation between risk warning ability and error aversion culture（r=-0.534,P<0.01）. The main factors influencing the score of risk warning ability of operating room nurses were moral courage,error aversion culture,position and nursing age of nurses in operating room（β=-0.247-0.387,all P<0.05）,which could explain 46.8% of its variation. Conclusions The risk warning ability of operating room nurses is at medium level. The nursing managers can start from the aspects of moral courage and error aversion culture of nurses,and focus on the nurses with lower posts and shorter nursing experience,so as to further strengthen the risk warning ability of operating room nursing staff.

Key words: Operating room nurse, Operating room risk, Risk warning ability, Moral courage, Culture of error aversion

中图分类号:

R192.6

王波, 符霞, 林敏, 吕丛海, 尹春芳. 手术室护士风险预警能力现状及影响因素分析. [J]职业与健康, 2023, 39(20): 2781-2784.

WANG Bo, FU Xia, LIN Min, LYU Conghai, YIN Chunfang. Analysis on status and influencing factors of risk warning ability of operating room nurses. [J]OCCUPATION AND HEALTH, 2023, 39(20): 2781-2784.

参考文献

[1] 曹建芬,石兰萍,刘畅,等.智能化护理风险防控系统的建立与应用[J].护理学杂志,2021,36(24):53-56.
[2] TSFDA B,FOUAYZI M H,SC A,et al.The Association of Nursing Home Characteristics and Quality With Adverse Events After a Hospitalization[J].J Am Med Dir Assoc,2021,6(4):1-5.
[3] 戴晴,胡少华,李伦兰,等.三位一体患者安全管理项目的构建与实施[J].护理学杂志,2020,35(19):52-55.
[4] 孙葵丽,陶红兵,夏述燕.综合医院手术室护士对患者安全事件报告意向的调查[J].护理学杂志,2021,36(14):48-51.
[5] 马莉芳,张雅琦,牛彦斌,等.手术室护士组织支持、风险感知对其职业枯竭的影响研究[J].护理研究,2018,32(7):1159-1162.
[6] GYAR A,RB NILGUN AKSOY.The Relationship Between Organizational Stress Levels and Patient Safety Attitudes in Operating Room Staff[J].J Perianesth Nurs,2021,23(36):499-506.
[7] 霍燕萍,蔡伟,许文燕.手术室护理管理中应用三级质控小组的价值分析[J].中国卫生标准管理,2021,12(23):157-161.
[8] 黄立娜. 手术室压疮风险因素评估量表在预防手术肿瘤患者压疮中的运用[J].中华肿瘤防治杂志,2018,25(S2):271-272.
[9] 吕小康,姜鹤,褚伟可,等.医护合作对工作投入的影响:风险感知与职业认同的链式中介作用[J].心理科学,2020,43(4):937-942.
[10] 何俊,王冬华.护士道德勇气研究进展[J].中国护理管理,2021,21(9):1427-1430.
[11] 刘世卿,王烨华.差错反感文化与护士建言行为的相关性研究[J].中华护理教育,2019,16(4):306-309.
[12] MESKIN,LAWRENCE H.A Perception of Risk[J].J Am Dent Assoc,1991,122(3):10.
[13] 申媛. 手术室护士风险预警能力评价指标体系的构建与应用[D].青岛:青岛大学,2020.
[14] 王丝瑶,魏丽丽,张艳,等.护士道德勇气量表的汉化及信效度检验[J].护理学杂志,2019,34(21):92-95.
[15] VAN DYCK C,FRESC M,BACR M,et al.Organizational error man-agement culture and its impact on performance;a two study replication[J].J Appl Psychol,2005,90(6):1228-1240.
[16] 王月玥. 差错反感文化对员工创新行为的影响机制研究[D].合肥:安徽大学,2016.
[17] GROUP I.Assessing,grading,and reporting intraoperative adverse events during and after surgery[J].Brit J Surg,2022,12(109):301-302.
[18] 郭燕,李亚敏,张丹.Time out程序在手术安全核查中的应用研究进展[J].护理研究,2022,36(16):2928-2931.
[19] 刘秀梅. 控制医院手术室感染风险性和护理质量的影响——评《手术室护理操作指南》[J].中国实验方剂学杂志,2021,27(24):91.
[20] 夏涛,汤军,张纯,等.基于前馈控制理念的风险预警在确保手术室护理安全中的应用效果分析[J].川北医学院学报,2021,36(11):1528-1531.
[21] 李云飞,廖芯,张佩嘉,等.手术室护理安全管理理论与方法研究进展[J].护理研究,2019,33(12):2092-2096.
[22] 宋美玉. 道德勇气研究[D].长沙:湖南师范大学,2020.
[23] 何俊,杨小路,夏晗月,等.差错反感文化在护士内部人身份认知与道德勇气间的中介作用[J].护理学杂志,2021,36(13):47-50.
[24] 杨帅,鄢斌,李映兰.护理安全文化研究现状[J].中国护理管理,2018,18(3):400-403.
[25] 尤利芬,陈敏,陈红英,等.新护士角色转换压力与护理工作环境精神气候的相关性分析[J].中华现代护理杂志,2020,26(34):4779-4782.
[26] WANG C,HOLMBERG S,SADRIZADEH S.Impact of door opening on the risk of surgical site infections in an operating room with mixing ventilation[J].Indoor Built Environ,2021,30(2):166-179.