توسعه و اعتبارسنجي الگوي استقرار نظام مديريت ايمني در بيمارستانهاي آموزشي ايران: يك مطالعه آميخته
ارتقای ایمنی و پیشگیری از مصدومیت ها,
دوره 13 شماره 3 (1404),
28 مرداد 2026
,
صفحه 34-48
https://doi.org/10.22037/iipm.v13i3.52703
چکیده
سابقه و هدف: بیمارستانهای آموزشی به دلیل پیچیدگی عملیاتی با مخاطرات ایمنی متعددی مواجهاند. فقدان یک الگوی جامع بومی، استقرار نظاممند مدیریت ایمنی را با چالش روبهرو کرده است. این پژوهش با استفاده از روش آمیخته، به توسعه و اعتبارسنجی الگوی استقرار نظام مدیریت ایمنی در بیمارستانهای آموزشی ایران پرداخت.
روش کار: این پژوهش از نظر هدف کاربردی و از نظر روش، آمیخته (کیفی–کمی) است. در بخش کیفی، 14 نفر از خبرگان حوزه سلامت و اساتید متخصص با نمونهگیری هدفمند و گلولهبرفی (اشباع در مصاحبه دوازدهم) انتخاب شدند. دادهها از طریق مصاحبه گردآوری و با روش نظریه دادهبنیاد تحلیل شد. پایایی بازآزمون و توافق بین کدگذاران بهترتیب 90 و 82 درصد بود. در بخش کمی، جامعه آماری شامل کارکنان درمانی و بیماران بستری در 10 بیمارستان آموزشی واقع در 9 شهر ایران طی سالهای 1400 تا 1402 بود. با نمونهگیری تصادفی طبقهای و بر اساس جدول مورگان، 337 نفر انتخاب شدند. دادهها با پرسشنامه محققساخته گردآوری و مدل با استفاده از مدلسازی معادلات ساختاری و نرمافزار PLS اعتبارسنجی شد..
یافتهها: نتایج تحلیل کیفی به شناسایی 33 کد در قالب پنج محور اصلی شامل عوامل علی، زمینهای، مداخلهگر، راهبردها و پیامدها منجر شد. نتایج تحلیل کمی نیز نشان داد که مدل پیشنهادی از برازش مطلوبی برخوردار است (GOF=0.495، IFI=0.95، CFI=0.95 و SRMR=0.074) همچنین، مقادیر AVE (>0.50) و CR (>0.70) روایی همگرا و پایایی سازههای مدل را تأیید کردند.
نتیجهگیری: استقرار موفق نظام مدیریت ایمنی در بیمارستانهای آموزشی مستلزم تعامل همزمان عوامل فردی سازمانی و مالی است. مدل اعتبارسنجی شده چارچوبی مستند وکاربردی برای کاهش خطاهای پزشکی و ارتقای ایمنی در بیمارستانهای آموزشی ایران ارائه میدهد.
- نظام مدیریت ایمنی
- نظریه داده بنیاد
- مدلسازی معادلات ساختار تفسیری
- بیمارستانهای آموزشی
- ایمنی بیمار
ارجاع به مقاله
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