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Assessment of safety culture in selected hospitals in the Ústí nad Labem and Liberec regions
VOLENÍKOVÁ, Kateřina
Current status: The issue of medical errors has recently gotten considerable attention among organizations at the global and national levels. In its report the Institute of Medicine recommended the development of a safety culture where employees want to provide the safest health care. Assessing the current culture of safety is the first stage in the development of patient safety. Subject: The main purpose of the research was "to evaluate the safety culture in select hospitals." Method: A standardized method was chosen for the research: The AHRQ Hospital Survey on Patient Safety Culture. A quantitative method was implemented using polling. Obtained data were tested in SPSS version 16.0. For statistical testing Person's chi-square and sign scheme was elected. Research group: The research survey addressed 301 non-medical staff of Krajské zdravotní a.s. Masarykova nemocnice, o. z. (Regional Health a.s. Masaryk Hospital) in Ústí nad Labem and Krajské nemocnici Liberec, a.s. (Liberec Regional Hospital) Results: The survey results showed that the surveyed health care professionals assess the organizational culture as friendly. The respondents indicated that they are praised by the manager for conducting their work safely and that they can suggest changes in management practices. The results showed that addressed health care professionals support each other (58.1%) and cooperate better (72.4%). According to the respondents, better teamwork leads to better patient safety. An analysis of the results shows that health professionals have an active approach to safe care (82.7%) and in their opinion, errors and mistakes lead to improved patient safety (40.9%). Paramedics have confirmed that they receive feedback on reported incidents (37.9%). Based on team discussion about errors the respondents' evaluation of patient safety has significantly improved. An analysis of respondents' answers revealed a lack of reporting of adverse events. Most respondents consider the number of staff in the workplace deficient (42.5%). Conclusion: Hospital management should be involved in changing the detection of individual errors from individual to systemic. In order to improve the safety culture there should be regular supervision or teambuilding activities that support the development of teamwork. Feedback on the results of reporting errors must be given in an appropriate way to motivate staff to continue to report future errors. The results require a change in how medical staff report errors and greater consistency among management when checking reports. Complaints of work overload by medical personnel must be taken seriously. Improvements can be brought about by changes to work organization or the use of temporary workers.
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Organization of nursing care as determinant of job satisfaction among hospitál nurses
VOLENÍKOVÁ, Kateřina
Effect of a treatment and care organisation on nurses' satisfaction Treatment and care organisations and systems of provided treatment and care are decisive for provision of quality care and for nurses' satisfaction. The presented Bachelor's work is devoted to this issue at both the theoretical and practical levels. The theoretical part explains the types of systems through which care can be organised and the factors most influencing nurses' satisfaction. The practical part examines systems of care and their effect on nurses' satisfaction. A research study was carried out using a quantitative research method, which included collection of data using a questionnaire. Two objectives were set. Objective 1: to determine what type of system nurses use the most for organisation of treatment and care. Objective 2 - to determine how the system of treatment and care influences nurses' satisfaction with their working conditions. For clarification of the objective we formulated three hypotheses. Hypothesis 1: Nurses working in hospital facilities mainly use a group system of care; this has been confirmed. Nearly 75% of the respondents work under a group system (at standard departments and at intensive care units). Hypothesis 2: The implemented system of provided treatment and care influences nurses' work satisfaction; this has been confirmed. Overall respondents working under a combination of systems (88.9%) are more satisfied. Major opinion differences among respondents working under a functioning system have revealed dissatisfaction among nurses using this system (80% of respondents were satisfied and 20% were dissatisfied). Partial indicators of satisfaction supported the results. Hypothesis 3: Nurses working in a standard department are more satisfied with the organisation of care than nurses working at intensive care units; this has been confirmed. Respondents from standard departments (80.7%) were more satisfied overall with the organisation of treatment and care and with their working conditions, unlike respondents working in intensive care units, 9.3% of whom expressed dissatisfaction. The satisfaction of nurses from standard departments was also supported by predominance of partial indicators of satisfaction with the organisation of work and working conditions. The results of the research will subsequently be submitted to KZ - MN (Krajská zdravotní a.s. ? Masarykova nemocnice o. z. [Masaryk Hospital]) in Ústí nad Labem as a potential contribution to improving the quality of care by increasing nurses' satisfaction. I will make recommendations to management employees of the organisation for implementation in practice, which will be based on the research survey (table 26). The results of the survey showed that it is necessary to monitor the organisation of nurses' work and their working conditions as well as the systems under which care is provided, because in some departments care is still being organised under an obsolete system, which today is disadvantageous. The survey presented the results of a treatment and care organisation's influence on nurses' satisfaction. Another studied phenomenon was the cause of nurses' fluctuations at various departments. The proposed examination should help uncover the causes of satisfaction and dissatisfaction of nurses with the organisation of their work.
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