| OBJECTIVE: Aim to measure Operationg Room(OR) safety management attitudes and influence factors among OR nurses from tertiary and secondary general hospitals in Chongqing area, and to detect their judgement of OR team member’s cooperation quality, their perception of medical error, leader ship and priority. Therefore, find out problems and give suggestions to improve safety culture.METHODS: Selected 350 OR nurses from 22 general hospitals in Chongqing area by means of optimal stratified random sampling method, and conducted a self-administered anonymous questionnaire survey with an adapted operating room safety management attitudes survey. Data entry was double checked to epidata3.1, and data was analysed by SPSS soft ware version 20.0.RESULTS: 1. The overall average score in this group is 154±20. Scores of the eight dimensions are listed in descending order as follows: confidence-assertion(3.00±1.00), work values(2.88±0.63), information sharing(2.70±1.00), leadership(2.67± 0.67), error(2.50±1.00), stress and fatigue(2.50± 0.50), team work(2.43±0.57) and team climate(2.33±0.44). 2. Significant difference was found in the total score between different employment groups(P<0.01). However, there is no statistic difference among hospital rank, gender, professional title, and years of working experience. As for the sub dimensions, information sharing score has significant difference between genders(P<0.05); confidence assertion score is obviously different between hospital ranks(P<0.01); and error dimension score has obvious diffenrence among employ groups(P<0.01). 3. Multiple logistic regression analysis revealed that hospital rank, gender, employment method, professional title, and years of working experience have no impact on dimensions of leadership, work confidence, and team work(P>0.05). In contrast, it is indicated that tertiary hospitals scores are higher than secondary hospitals(OR=1.853, 95%CI 1.022-3.357) in the dimension of information sharing, employment method and years of working experience were the influential factors. At the same time, temporary employee group got the lowest score; staff with more than 16 years of working experience had higher score than those with less than 10 years of working experience. The multi-factor regression analysis of stress and fatigue dimensions showed that temporary group had the lowest score again, which explained that the way of employment was the influence factor for stress and fatigue(OR=1.872,95%CI 1.150~3.046). The regression analysis of work value revealed that tertiary hospital OR nurse had a higher score than that of secondary hospital OR nurse(OR=1.872, 95%CI 1.150-3.046). As for error, tertiary hospital OR nurse got higher score than secondary hospital nurse(OR=2.657,95%CI 1.008~7.002),and the trainee’s group got higher score than that of the other two groups. Male nurses got higher score than female nurses in dimension of team climate. 4. It is showed that OR nurses have good comments for OR team members with different professional title and career, and they rate ―competent‖ for the trainee. 5. Medical error feedback showed that 62.8% of the OR nurses agreed with ―I rarely witness an error where one or more team members lack of knowledge to perform the needed action‖, 33.2% of them rated “Errors committed during patient management are not important, as long as the patient improves‖, 66.8% of the respondents admitted ―I make errors in theatre‖, while 84.1% of them reported ―Medical errors are discussed to prevent recurrence‖, 86.0% of them agreed ―A confidential reporting system that documents medical errors is important for safety‖. 6. The results of ―Leadership and prioritizing‖ revealed that OR nurses concerned ―patient safety‖(327,99.70%)as the most important aspects if they failed, yet the respondents indicated that OR managers concerned ―Saving costs‖(194,59.10%)the most. Respondents prefer leadership style of type C(168, 51.22%), type D(87, 26.52%), type B(52, 15.85%), and type A(21, 6.40%) in descending order.CONCLUSION: 1. Patient safety attitude in this group is relatively positive, but still need to be improved, especially in dimensions of organizational climate,team work,as well as stress and fatigue. Confidence assertion in OR nurses is pretty high, and it is suggested that OR manager should make good use of it, and pay much more attention to temporary stuff, junior nurses and female stuff. Tertiary general hospital nurses got better scores in dimensions of imformation sharing, work value, and error, compared with that of secondary general hospital nurses. 2. OR nurses are satisfied with OR team members, and it is suggested to carry out training programes on OR team, use communication tools to promote team work and effective communication. Building mutual respect culture is helpful to improve organizational climate. 3. More than half of the nurses believed that lacking of knowledge is not the key reason of errors in OR. 4. More than two-thirds of the respondents have the courage to admit mistakes, yet the result showed that anonymous reporting mechanism is necessary. It is indicated that managers need further effort to improve the reporting system and analys errors from systematic view. 5.Patient safety is the most concered priority in this group, and type C and type D leadership are preferred among OR nurses. It is suggestd that OR managers should perform type C and D leadership style. |
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