Menedžment kakovosti v bolnišnici: kriteriji za doseganje varnosti
DOI:
https://doi.org/10.14528/snr.2015.49.2.39Ključne besede:
zdravstvena nega, načini dela, rezultati delaPovzetek
Uvod: Sistem kakovosti in varnosti je sistem odgovornosti in je danes glavni pogoj za pridobitev, nudenje in izvajanje zdravstvenih storitev. Prvi korak na poti kakovosti in varnosti je uveljavitev kulture varnosti za paciente v celotnem zdravstvenem sistemu. Namen raziskave je analizirati, kakšno vlogo zaposleni pripisujejo posameznim kriterijem za doseganje večje varnosti pacientov v bolnišnici. Metode: V kvantitativni raziskavi je sodelovalo 17,6 % (n = 256) zaposlenih v zdravstveni negi v večjem zdravstvenem zavodu v Sloveniji. Raziskovalni instrument je bil vprašalnik 112 vprašanj zaprtega tipa, z rangiranjem po Likertovi lestvici. Za zanesljivost instrumenta je bil za različne spremenljivke izračunan koeficient alfa, znašal je od 0,717 do 0,839. Podatki so bili obdelani z deskriptivno statistiko, t-testom, korelacijsko ter regresijsko analizo. Statistična značilnost je bila p < 0,05. Rezultati: Po mnenju zaposlenih so kriteriji za doseganje varnosti človeški viri (x = 27,09), novi načini dela (x = 21,34), rezultati dela (x = 27,39) in učinkovitost (x = 24,92). Na doseganje varnosti statistično pomembno vpliva izobrazba. Diskusija in zaključek: Raziskava pokaže, da anketiranci med kriteriji za doseganje varnosti kot najpomembnejše v največji meri ocenjujejo rezultate dela in najmanj nove načine dela. Varnost pacienta pripomore k porastu kakovosti življenja. Največji vpliv na izboljšanje varnosti pacientov ima menedžment z doseganjem kriterijev za varnost pacientov.Prenosi
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Armellino, D., Quinn Griffin, M.T. & Fitzpatrick, J.J., 2010. Structural empowerment and patient safety culture among registered nurses working in adult critical care units. Journal of Nursing Management, 18(7), pp. 796–803. http://dx.doi.org/10.1111/j.1365-2834.2010.01130.x PMid:20946215
Arnetz, J.E., Zhdanova, L.S., Elsouhag, D., Lichtenberg, P., Luborsky, M.R., et al., 2011. Organizational climate determinants of resident safety culture in nursing homes. Gerontologist, 51(6), pp. 739–749. http://dx.doi.org/10.1093/geront/gnr053 PMid:21708985
Basole, R., & Rouse, W.B., 2008. Complexity of service value networks: conceptualization and empirical investigation. IBM Systems Journal, 47(1), pp. 53–70. http://dx.doi.org/10.1147/sj.471.0053
Beugré, C., 2005. Reacting aggressively to injustice at work: a cognitive stage model. Journal of Business and Psychology, 20(2), pp. 291–301.
Bohmer, R.M.J., 2009. Designing care: aligning the nature and management of health care. Boston (MA): Harvard Business Press, pp. 115–151.
Cameron, K.S. & Quinn, R.E., 1999. Diagnosing and changing organizational culture: based on the competing values framework. Reading (MA): Addison-Wesley, pp. 10–15.
Cohen, K.R., 2011. The case for evidence-based human capital management. Healthcare Financial Management, 65(8), pp. 102–107. PMid:21866727
Colquitt, J.A., Conlon, D.E., Wesson, M.J, Porter, C.O & Ng, K.Y., 2001. Justice at the millennium: a meta-analytic review of 25 years of organizational justice research. Journal of Applied Psychology, 86(3), pp. 425–445. http://dx.doi.org/10.1037/0021-9010.86.3.425 PMid:11419803
Elovainio, M., Kivimäki, M. & Vahtera, J., 2002. Organizational justice: evidence of a new psychosocial predictor of health. American Journal of Public Health, 92(1), pp. 105–108. http://dx.doi.org/10.2105/AJPH.92.1.105 PMid:11772771; PMCid:PMC1447369
Feng, X.Q., Acord, L., Cheng, Y.J., Zeng, J.H. & Song, J.P., 2011. The relationship between management safety commitment and patient safety culture. International Nursing Review, 58(2), pp. 249–254. http://dx.doi.org/10.1111/j.1466-7657.2011.00891.x PMid:21554300
Forret, M. & Love, M.S., 2007. Employee justice perceptions and coworker relationships. Leadership & Organization Development Journal, 29(3), pp. 248–60. http://dx.doi.org/10.1108/01437730810861308
González-Formoso, C., Martín-Miguel, M.V., Fernández-Domínguez, M.J., Rial, A., Lago-Deibe, F.I., Ramil-Hermida, L., et al. 2011. Adverse events analysis as an educational tool to improve patient safety culture in primary care: a randomized trial. BMC Family Practice. 12, p. 50. http://dx.doi.org/10.1186/1471-2296-12-50 PMid:21672197; PMCid:PMC3142500
Gormley, D.K., 2011. Are we on the same page? Staff nurse and manager perceptions of work environment, quality of care and anticipated nurse turnover. Journal of Nursing Management, 19(1), pp. 33–40. http://dx.doi.org/10.1111/j.1365-2834.2010.01163.x PMid:21223403
Groves, P.S., Meisenbach, R.J. & Scott-Cawiezell, J., 2011. Keeping patients safe in healthcare organizations: a structuration theory of safety culture. Journal of Advanced Nursing, 67(8), pp. 1846–1855. http://dx.doi.org/10.1111/j.1365-2648.2011.05619.x PMid:21477115
Jones, R.A., Jimmieson, N.L. & Griffiths, A., 2005. The impact of organizational culture and reshaping capabilities on change implementation success: the mediating role of readiness for change. Journal of Manangement Studies, 42(2), p. 361.
Kalisch, B.J., Tschannen, D., Lee, H. & Friese, C.R., 2011. Hospital variation in missed nursing care. American Journal of Medical Quality, 26(4), pp. 291–299. http://dx.doi.org/10.1177/1062860610395929 PMid:21642601; PMCid:PMC3137698
Kline, T.J.B., Willness, C. & Ghali, W.A., 2008. Determinants of adverse events in hospitals – the potential role of patient safety culture. Journal for Healthcare Quality, 30(1), pp. 11–17. http://dx.doi.org/10.1111/j.1945-1474.2008.tb01122.x PMid:18257452
Konteh, F.H., Mannion, R. & Davies, H.T., 2011. Understanding culture and culture management in the English NHS: a comparison of professional and patient perspectives. Journal of Evaluation in Clinical Practice, 17(1), pp. 111–117. http://dx.doi.org/10.1111/j.1365-2753.2010.01376.x PMid:20825537
Lake, E.T., Shang, J., Klaus, S. & Dunton, N.E., 2010. Patient falls: association with hospital Magnet status and nursing unit staffing. Research Nursing Health, 33(5), pp. 413–425. http://dx.doi.org/10.1002/nur.20399 PMid:20824686; PMCid:PMC2974438
Laschinger, S.H., 2004. Hospital nurses' perceptions of respect and organizational justice. Journal of Nursing Administration, 34(7), pp. 354–364.
Lenthall, S., Wakerman, J., Opie, T., Dollard, M., Dunn, S., Knight, S., et al., 2009. What stresses remote area nurses? Current knowledge and future action. Australian Journal of Rural Health, 17(4), pp. 208–213. http://dx.doi.org/10.1111/j.1440-1584.2009.01073.x PMid:19664086
Lewicki, R., Wiethoff, C. & Tomlinson, E.C., 2005. What is the role of trust in organizational justice. Mahwah (NJ): Lawrence Erlbaum Associates Publishers, pp. 247–270.
Mayer, C., & Cronin, D., 2008. Organizational accountability in a just culture. Urologic Nursing, 28(6), pp. 427–430. PMid:19241780
Moffa, M., Piesieki, P. & Polomano, R.C., 2010. Engaging clinical nurses in quality and performance improvement activities. Nursing Administration Quarterly, 34(3), pp. 226–245. http://dx.doi.org/10.1097/NAQ.0b013e3181e702ca PMid:20562572
Mostafa, G.M.A., 2009. Enhancing nurses' knowledge and awareness about risk management: system design. Eastern Mediterranean Health Journal, 15(5), p. 1135. PMid:20214127
Nowakowski, J., & Conlon, D., 2005. Organizational justice: looking back, looking forward. International Journal of Conflict Management, 16(1), pp. 4–29. http://dx.doi.org/10.1108/eb022921
Oliver, D., Healey, F. & Haines, T., 2010. Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26(4), pp. 645–692. http://dx.doi.org/10.1016/j.cger.2010.06.005 PMid:20934615
Oliver, D. & Healey, F., 2009. Falls risk prediction tools for hospital inpatients: do they work? Nursing Times, 105(7), pp. 18–21. PMid:19326648
Otero, P., Leyton, A., Mariani, G. & Cernadas, J.M., 2008. Medication errors in pediatric inpatients: prevalence and results of a prevention program. Pediatrics, 122(3), pp. 737–743. http://dx.doi.org/10.1542/peds.2008-0014 PMid:18762510
Posthuma, R., Maertz, C. & Dworkin, J., 2007. Procedural justice's relationship with turnover: explaining past inconsistent findings. Journal of Organizational Behavior, 28(4), pp. 281–398.http://dx.doi.org/10.1002/job.427
Redding, J., 2012. 4 pitfalls to clinical integration. Healthcare Financial Management, 66(11), pp. 104–110. PMid:23173368
Robida, A., 2010. Varnost pacientov, napake, sindrom ranljivega sistema in pravična kultura. In: Berkopec, M. ed. Vrednote v zdravstveni negi. 2. dnevi Marije Tomšič, Novo mesto, 20. in 21. januar 2010. Novo mesto: Splošna bolnišnica Novo mesto, pp. 16–20.
Robida, A., 2011. Kako priti do večje varnosti pacientov v zdravstvu. In: Bregar, B. ed. Varnostni zapleti pri pacientu – priložnost za učenje: zbornik predavanj z recenzijo, Maribor, 12. oktober 2012. Ljubljana: Zbornica zdravstvene in babiške nege – Zveza strokovnih društev medicinskih sester, babic in zdravstvenih tehnikov Slovenije in Sekcija medicinskih sester in zdravstvenih tehnikov v psihiatriji, pp. 1–8.
Robida, A., Skela-Savič, B. & Trunk, A., 2007. Opredelitev znanj in kompetenc za srednjo upravljaljsko raven v bolnišnici: zaključno poročilo raziskovalne skupine. Ljubljana: Mednarodni institut za razvoj managementa v zdravstvu.
Skela-Savič, B., & Pagon, M., 2008. Individual involvement in health care organizations: differences between professional groups, leaders and employees. Stress and Health, 24(1), pp. 71–84.
http://dx.doi.org/10.1002/smi.1164
Skela-Savič, B., 2007. Dejavniki uspešnega izvajanja sprememb v slovenskem zdravstvu: doktorska disertacija. Maribor: Univerza v Mariboru, Fakulteta za organizacijske vede, pp. 51–52.
Valentine, M.A., Nembhard, I.M. & Edmondson, A.C., 2012. Measuring teamwork in health care settings: a review of survey instruments. Boston (MA): Harvard Buisiness School, pp. 2–23.
Vermunt, R., & Steensma, H., 2005. How can justice be used to.manage stress in organization? In handbook of organizational. NJ: Lawrence Erlbaum Associates, pp. 383–410.
Weiner, B.J., Hobgood, C., & Lewis, M.A., 2008. The meaning of justice in safety incident reporting. Social Science and Medicine, 66 (2), pp. 403–413.http://dx.doi.org/10.1016/j.socscimed.2007.08.013 PMid:17949876
Wheeler, N. & Grice, D., 2009. Management in health care. London: Nelson Thornes.
Williams, L.L., 2006. The fair factor in matters of trust. Nursing Administration Quarterly, 30(1), pp. 30–37. http://dx.doi.org/10.1097/00006216-200601000-00006 PMid:16449882
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