Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
Prehosp Emerg Care. 2012 Jan-Mar;16(1):43-52. doi: 10.3109/10903127.2011.614048. Epub 2011 Sep 27.
Prior studies have highlighted wide variation in emergency medical services (EMS) workplace safety culture across agencies.
To determine the association between EMS workplace safety culture scores and patient or provider safety outcomes.
We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition, and job satisfaction. A panel of medical directors, emergency medical technicians and paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures.
Sixteen percent of all respondents reported experiencing an injury in the past three months, four of every 10 respondents reported an error or adverse event (AE), and 89% reported safety-compromising behaviors. Respondents reporting injury scored lower on five of the six domains of safety culture. Respondents reporting an error or AE scored lower for four of the six domains, while respondents reporting safety-compromising behavior had lower safety culture scores for five of the six domains.
Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes.
先前的研究强调了不同机构之间的紧急医疗服务（EMS）工作场所安全文化存在广泛差异。
确定 EMS 工作场所安全文化评分与患者或提供者安全结果之间的关联。
我们向隶属于便利抽样机构的 EMS 工作人员进行了横断面调查。我们从全国 EMS 管理组织招募这些机构。我们使用 EMS 安全态度问卷（EMS-SAQ）来衡量工作场所安全文化，以及 EMS 安全清单（EMS-SI），这是一种用于从 EMS 工作人员那里收集自我报告的安全结果的工具。EMS-SAQ 提供了六个领域的可靠和有效的衡量标准：安全氛围、团队合作氛围、管理层看法、工作条件、压力识别和工作满意度。一组医学主任、急诊医疗技术员和护理人员以及职业流行病学家开发了 EMS-SI 来衡量自我报告的伤害、医疗错误和不良事件以及危及安全的行为。我们使用分层线性模型来评估 EMS-SAQ 评分与 EMS-SI 安全结果测量之间的关联。
16%的受访者报告在过去三个月内经历过伤害，每 10 名受访者中有 4 人报告发生过错误或不良事件（AE），89%的受访者报告存在危及安全的行为。报告受伤的受访者在安全文化的六个领域中的五个领域的得分较低。报告发生错误或 AE 的受访者在六个领域中的四个领域的得分较低，而报告存在危及安全的行为的受访者在六个领域中的五个领域的安全文化得分较低。
个体 EMS 工作人员对工作场所安全文化的看法与患者和提供者安全结果的综合衡量标准相关。这项研究初步证明了安全文化与患者或提供者安全结果之间的关联。
