HASTA GÜVENLİĞİ KÜLTÜRÜ: BİR EĞİTİM ARAŞTIRMA HASTANESİ ÖRNEĞİ

Bu çalışmanın amacı bir eğitim araştırma hastanesi sağlık çalışanlarının hasta güvenliği kültürü olumlu algı düzeylerini incelemektir. Bu çalışma kesitsel ve tanımlayıcı türde bir araştırmadır. Araştırma İstanbul ilinde bir eğitim ve araştırma hastanesinde çalışan yaşları 19 ile 63 yaş arasında değişen 326 sağlık çalışanı ile yürütülmüştür. Hastanedeki güvenlik kültürü, Sağlık Araştırma ve Kalite Ajansı (AHRQ) tarafından geliştirilen ve Hasta Güvenliği Kültürü Hastane Anketi Türkçe versiyonu kullanılarak değerlendirilmiştir. Çalışma grubunun seçiminde olasılığa dayalı olmayan kolayda örnekleme yöntemi seçilmiştir. Araştırma öncesinde gerekli örneklem büyüklüğü G*Power (3.1.9.7) programı kullanılarak incelenmiştir. Güç analizinde %95 güven (1-α), 0,05 (α) anlamlılık düzeyinde, %95 test gücü (1-β) ve d=0.56 (orta etki) etki büyüklüğü, çift kuyruklu iki bağımsız ortalamalar arasındaki fark t testi (iki grup) analizine göre en küçük örnek sayısı 104 olarak belirlenmiştir. Eksik veri veya düzensiz yanıt beklentisine dayanarak 326 katılımcıdan veri toplanmıştır. Tüm istatistiksel analizler için Windows için IBM SPSS (Statistical Package for Social Sciences) 24 sürümü paket programı kullanılmıştır. Sonuçlar %95’lik güven aralığında, α=0.05 anlamlılık düzeyinde değerlendirilmiştir. Hasta güvenliği kültürüne ilişkin olumlu algı için genel ortalama puan %50,62±13,3(%95 güven aralığı: 50,62-52,07). 12 boyut arasında tek güçlü yön olarak tanımlayan olumlu yanıt yüzdesinin en yüksek olduğu boyut, hastane ünite içi ekip çalışmasıdır. Zayıf yönler olarak tanımlanan boyutlar ise sırası ile personel sağlama, hataya karşı cezalandırıcı olmayan yanıt, hataların raporlanma sıklığı, iletişimin açık tutulması, hastane müdahaleleri ve değişim ile hatalar hakkında geribildirim ve iletişimdir. Birçok sağlık çalışanı, kurumlarındaki hasta güvenliği kültürüne yönelik olumsuz algılara sahiptir. Hastane yöneticilerinin, hasta güvenliğine en yüksek önceliğin verilmesi ve önleyici yaklaşımların teşvik edilmesi yoluyla karşılıklı güvene dayalı, açık iletişimi esas alan pozitif bir güvenlik kültürü yaratmaları gerekir.

Anahtar Kelimeler:

Güvenlik Kültürü, Hasta Güvenliği, Olay Raporlama, Sağlık Profesyonelleri

PATIENT SAFETY CULTURE: THE CASE OF AN EDUCATION AND RESEARCH HOSPITAL

This study aims to examine the positive perception levels of patient safety culture among the healthcare workers of a training and research hospital. This study is research in cross-sectional and descriptive design. The study was conducted with 326 healthcare workers aged 19 to 63 years at a training and research hospital in İstanbul. Safety culture in the hospital was assessed using the Turkish version of the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ). Convenience sampling method was used to select the study group. Before the research, the required sample size was examined using G*Power (3.1.9.7) program. According to the power analysis (95% confidence (1-α), 0.05 (α) significance level, 95% test power (1-β) and effect size=0.56, two-tailed), the smallest sample size was determined as 104. Based on the expectation of missing data or irregular response, data were collected from 326 participants. IBM’s SPSS version 24 package program for Windows was used for all statistical analyses. The results were evaluated at 95% confidence interval and α=0.05 significance level. The overall mean score for positive perception of patient safety culture was 50.62±13.3% (95% confidence interval: 50.62-52.07). Among the 12 dimensions, the dimension with the highest percentage of positive responses defining it as the only strength was teamwork within hospital units. The dimensions identified as weaknesses were staffing, non-punitive response to errors, frequency of reporting errors, keeping communication open, hospital interventions and change, and feedback and communication about errors, respectively. Many healthcare workers have negative perceptions of the patient safety culture in their organizations. Hospital managers must create a positive safety culture based on mutual trust and open communication, prioritizing patient safety and promoting preventive approaches.

Keywords:

Safety Culture, Patient Safety, Incident Reporting, Health professionals,

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