医院内部风险基金制度与病人安全初探

医疗活动本身存在着不确定性和相对确定性一对内在矛盾,由不确定性引发的医疗过失等是影响病人安全的主要因素。在目前以医院为管理主体的前提下,建立医院内部风险基金制度,提高医务人员的执业风险意识,减少医疗过失的发生,是保障病人安全的一种尝试。     

Self-reported Attitude Towards Speeding and Its Possible Consequences in Five Different Road Contexts

Driving above the permitted speed limit is a common violation on the roads of Great Britain. Moreover, speeding is associated with negative consequences in the form of damage, injury and fatal road traffic accidents. The aim of this study was to assess, by means of self-report, the prevalence of this social problem across five different contexts: a residential road, a busy shopping street, a dual carriageway, a winding country road, and a motorway. The extent to which speeding was perceived to be associated with negative consequences was also assessed. Results suggest that most drivers make judgements about the type of road on which they are driving and the degree of speeding that is acceptable, and that their intentions to speed vary accordingly. Some drivers reported a consistent intention to speed, however, and these people were characterized by greater general deviance on the road (e.g. high violation score), rather than by a stronger tendency to underestimate the negative consequences. In general, however, younger people and those with less regard for negative consequences reported stronger intentions to speed. These results are discussed with reference to strategies for addressing the problem of speeding. © 1997 John Wiley & Sons, Ltd.     

The tendency of drivers to pass other vehicles

The purpose of this study was to assess the speed differential threshold—if there is one—at which drivers decide to pass a lead vehicle. Drivers in a simulator encountered vehicles in front that were programmed to travel at speeds that were similar, slightly below, or even slightly above the drivers’ own speed. The study involved a total of 152 such passing opportunities. In almost all of the encounters with slower vehicles (traveling at speeds slower than 3 km/h of the driver) they passed them, and in two thirds of the encounters when the lead vehicles were moving at their speed they passed them too. Most surprising was that in 50% of the encounters drivers passed the lead vehicle when it was traveling faster than their average speed. In these situations drivers actually increased their own speed substantially to accomplish the passing maneuver, despite the fact that not passing the lead vehicle would not have caused any delays. The tendency to pass appears to be related to the drivers’ own speed variability: the more variable the driver’s speed the more likely he or she was to pass the vehicle ahead even when its speed was greater than their average speed. The results are interpreted in terms of (a) driver aggression, and (b) association of car following with added effort, attention overload, or risk. The latter explanation implies that the tendency to pass vehicles may be reduced with the introduction of in-vehicle technologies such as adaptive cruise control.     

Exploring the beliefs underpinning drivers’ intentions to comply with speed limits

Using the theory of planned behaviour (TPB; [Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl, J. Beckmann (Eds.), Action control: From cognition to behavior (pp. 11–39). Berlin: Springer-Verlag.]) as a theoretical framework, the present study was designed to: (a) identify the beliefs underpinning drivers’ intentions to comply with speed limits, and (b) test the expectancy-value theory held to underpin those beliefs. A sample of drivers (N = 598) completed questionnaires designed to measure TPB variables with respect to compliance with speed limits. The results of hierarchical multiple regression analyses provided support for the expectancy-value theory held to underpin each behavioural beliefs (outcome beliefs X outcome evaluations), normative beliefs (referent beliefs X motivation to comply), and control beliefs (control frequency beliefs X control power beliefs). Belief targets for road safety countermeasures that aim persuade drivers to comply with speed limits were also identified by selecting those beliefs that were the statistically significant predictors of direct TPB measures (attitudes, subjective norm, perceived control) and intention. Theoretical and practical implications of the results are discussed.     

When technology tells you how you drive––truck drivers’ attitudes towards feedback by technology

Behavior based safety approaches have proven effective in reducing accidents in industrial settings, but cannot easily be extended to commercial driving. For considerable periods of working time, truck drivers are alone, and do not interact with peers. It might be possible to use data gathered by new in-vehicle technology to provide real-time and post-shift feedback to drivers about their driving behavior. This paper reports the results of focus group interviews conducted with subject matter experts from the trucking industry (truck drivers, supervisors, managers, and other involved persons, such as insurance industry safety professionals). The focus groups discussed safety critical behaviors in commercial driving, the best way to provide feedback to truck drivers, and benefits of feedback by technology as well as concerns drivers and operators may have regarding monitoring and feedback systems. The focus group discussions showed that, in general, drivers would like to receive more feedback and that feedback by technology is acceptable, if designed and implemented properly. In addition, the participants had many suggestions on how to properly design and implement such systems.     

安全文化的内容、影响因素及作用机制

安全文化研究反映了现代安全管理向社会控制的发展。大多研究在态度与价值观水平上采用问卷调查的方式研究安全文化,也称安全气氛研究,不同研究中安全文化的维度结构差异很大;另一种研究取向则主张采用各种定性方法研究组织现象背后的基本意会。民族文化、生产特点与组织环境等因素都对安全文化产生影响,而安全文化则通过个体变量影响组织的安全绩效。该文进一步分析了研究分歧的原因以及组织水平研究中变量整合水平问题。文章认为,应该采用三角方法来测量安全文化,弄清它的原因及结果,以指导安全管理实践。     

工作压力与社会支持对安全绩效的影响

工作压力对安全绩效的影响虽然已经引起学者们的关注, 但迄今为止相关的实证研究却比较少见。本项目将以工作要求-控制-社会支持模型为理论基础, 探索工作压力和社会支持对安全绩效的影响。具体将探讨不同压力源(挑战型压力源和沮丧型的压力源)、安全控制、社会支持(主管支持和同事支持)和群体示范性规范对安全绩效的影响, 以及上述变量之间可能存在的交互作用。研究拟结合访谈、问卷和实验室模拟等方法对上述变量间进行相关和因果关系的探讨。研究结果一方面可拓展安全绩效研究的理论; 另一方面为安全管理实践提供理论依据, 对组织环境下个体与组织安全绩效的改善有积极的现实意义。     

Narcissistic personality and risk perception among Chinese aviators: The mediating role of promotion focus

Optimism bias is a crucial feature of risk perception that leads to increased risk‐taking behaviour, which is a particularly salient issue among pilots in aviation settings due to the high‐stakes nature of flight. The current study sought to address the roles of narcissism and promotion focus on optimism bias in risk perception in aviation context. Participants were 239 male flight cadets from the Civil Aviation Flight University of China who completed the Narcissistic Personality Inventory‐13, the Work Regulatory Focus Scale, and an indirect measure of unrealistic optimism in risk perception, which measured risk perception for the individual and the risk assumed by other individuals performing the same task. Higher narcissism increased the likelihood of underestimating personal risks, an effect that was mediated by high promotion focus motivation, such that high narcissism led to high promotion focus motivation. The findings have important implications for improving the accuracy of risk perception in aviation risks among aviators.     

Trust in Supervisor and Job Engagement: Mediating Effects of Psychological Safety and Felt Obligation

In the social context of job engagement, the role of trust in supervisor in predicting engagement of employees has received attention in research. Very limited research, however, has investigated the mechanisms mediating this dynamic relationship. To address this important gap in knowledge, the aim of this study was to examine psychological safety and felt obligation as two psychological mechanisms mediating the effect of trust in supervisor on job engagement. Drawing from job engagement and social exchange theories, the mediating roles of psychological safety and felt obligation in the trust-engagement relationship were empirically investigated in the Malaysian context. Using self-report questionnaires, data were collected from 337 nurses employed in a public hospital located near Kuala Lumpur, Malaysia. Results fully supported the proposed serial multiple mediator model. Trust in supervisor was indirectly related to job engagement via psychological safety followed by felt obligation. This study provides empirical evidence that trust in supervisor makes employees feel psychologically safe to employ and express their selves in their job roles. This satisfaction of the psychological safety need is interpreted by employees as an important socioemotional benefit that, in turn, makes them feel obligated to pay back to their organization through their enhanced level of job engagement. Implications for theory and practice were discussed.     

School Sense of Community,Teacher Support,and Students’ School Safety Perceptions

This study examined the association between two characteristics of school climate (sense of community and teacher support, measured both at the individual and at the school level) and students’ feelings of being unsafe at school. The study involved a sample of 49,638 students aged 10–18 years who participated in the 2010–2012 California Healthy Kids Survey. Using hierarchical linear modeling (HLM), our findings revealed that, at the individual level, students perceiving higher levels of sense of community and teacher support at school were less likely to feel unsafe within the school environment. At the school level, sense of community was negatively associated with unsafe feelings, whereas there was no association between school‐level teacher support and feelings of being unsafe at school.