[[alternative]]An Exploration of Medical Staffs' Perception of Patient Safety Culture and its Relationship with Self-evaluative Hospital Patient Safety Outcome

[[abstract]]目的：本研究目的旨在探討醫師及護理人員對病人安全文化的知覺差異及這些差異與其自評醫院病人安全表現的關係，並比較兩種專業人員預測模式之異同。方法：以相關性的研究設計蒐集10家北區聯盟之署立醫院，共計2,409位醫師及護理人員之問卷調查資料，期間為2008年8月至9月。自變項是醫護專業人員對病人安全文化的知覺，以中文版之美國健康照護研究與品質機構發展的醫院病人安全文化量表（Hospital Survey On Patient Safety Culture, HSOPS）測量。依變項是自評醫院病人安全表現，以該工具之結果面題項測得。結果：醫師平均回收率為57.68%；護理人員平均回收率為84.94%。經線性迴歸分析後，發現醫師在「持續改善之組織學習」、「對錯誤之回饋及溝通」與「醫院管理者對病人安全的支持度」三個病人安全知覺構面共解釋32%的自評醫院病人安全表現之變異量；除護理人員與醫師一致的三構面外，護理人員知覺還包括「單位內的團隊運作」、「開放性溝通」、「單位間的團隊運作」與「醫院內的交班及資訊傳遞」，共解釋32%之自評醫院病人安全表現的變異量。兩者的預測模式有差異。結論：研究結果顯示，影響醫護人員對其醫院病人安全表現有不同的預測因子。未來醫療機構可依據不同專業人員重視的病人安全文化知覺，提供適合他們的安全教育及建置合宜的獎懲措施，以利提升安全的照護服務。[[abstract]]Objective: The purpose of this study was to examine the relationship between the perception of patient safety culture and hospital performance on patient safety by physicians and nurses, and to compare the differences of two regression models of these two professionals.Method: A correlation design was conducted by using questionnaire to collect data of 2,409 medical staffs from ten hospitals of North Region Alliance, Department of Health during August to September, 2008. The perception of patient safety culture, refer to independent variable, was measured by using a Chinese version of Hospital Survey On Patient Safety Culture, which was originally developed by the Agency for Healthcare Research and Quality in the United State. The hospital performance on patient safety, refer to dependent variable, was measured by the outcome item of Patient Safety Grade on the same questionnaire. Results: The responses rate of physicians and nurses were 57.68% and 84.94% respectively. There were some differences in patient safety culture scores between physicians and nurses. With multiple regression analysis, 32% of variance in hospital performance perceived by physicians accounted for by three dimensions of patient safety culture--Organizational Learning/Continuous Improvement, Feedback and Communication About Error, and Hospital Management Support for Patient Safety. In addition to above three dimensions, other four dimensions of patient safety culture perceived by nurses accounted for 32% of the variance in hospital performance, which included the predictors of Teamwork Within Units, Communication Openness, Teamwork Across Hospital Units, and Hospital Handoffs and Transitions. Two regression models had some different predictors.Conclusion: The predictor variables of two regression models were varied between two professionals. According to patient safety culture perceptions which valued by different professionals, health care organizations can provide applicable education of safety and establish appropriate reward-and-punishment mechanisms to update caring services and safety measures in the future