医療リスクマネジメント・システムの制度化における課題を検討することを目的として、
山陰地方の看護師224名を対象に、リスクマネジメントに関する意識調査を行った。
　その結果、リスクマネジメントの基本的な考え方について職位別に差がみられ、中間管理職
の看護師の方がスタッフの看護師に比べて.有意にリスクマネジメントの理念をよく理解していた。また、病院の規模別にリスクマネジメントの定着についての受け止め方にも差がみ
られ、300床以上の病院の看護師の方が300床未満の病院の看護師に比べて有意にリスクマネ
ジメントの理念をよく理解し、システムの整備や組織的な取り組みがなされていると受け止
めていた。
　以上より、リスクマネジメント・システムが病院組織の末端にまで浸透して安全に関する
文化が熟成するには、長時間を要するものと推測された。特に小規模の病院に対して、システ
ムの整備も含めた支援の必要性が示唆された。
Although the development of a risk management system has been required for hospital safety management, it has not yet been sufficiently established in many hospitals, which suggested that several problems should exist on its institutionalizalion.
In order to clarify the problems with the institutionalization of medical risk management, a survey of attitude was conducted by interviewing 224 nurses in the San-in district.
The following statistically significant differences were observed:
(1) Middle managers understood the idea of risk management better than staff nurses.(2) Nurses in a large hospital with 300 beds and above understood the concepts of risk management better than ones in a hospital with less than 300 beds. (3) Nurses in a large hospital accepted that the development of risk management system in their hospitals and its organizational efforts had already been made.
These results suggested that it should take a long time not only for the concept of a risk management system to have pervaded all the staff in a hospital, but also for the attitude on safety to have been established. They also suggested that vigorous support is crucial to develop a risk management system in a small-scale hospital.