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“建立融洽关系”:澳大利亚医疗环境中,医护人员在实施传播防护措施下护理患者的切身感悟。

"Recognizing rapport": health professionals' lived experience of caring for patients under transmission-based precautions in an Australian health care setting.

机构信息

Western Australia Country Health Services, Bunbury, Australia.

出版信息

Am J Infect Control. 2013 Nov;41(11):971-5. doi: 10.1016/j.ajic.2013.05.022. Epub 2013 Sep 12.

DOI:10.1016/j.ajic.2013.05.022
PMID:24035657
Abstract

BACKGROUND

Preventing health care-associated infections is essential to the safety and quality of health care. Although patients' experience of care under isolation is well established, little is known of health care workers' experiences when providing such care. This study explored the health professionals; lived experience of caring for patients under transmission-based precautions.

METHODS

Interpretive phenomenology was used to examine 12 health care professionals' lived experience of providing care under transmission-based precautions in 3 health care facilities in Australia. Data were obtained from in-depth interviews and observations of health professionals.

FINDINGS

The essential phenomena of "recognizing rapport" represented the health professionals' lived experience. Three themes emerged starting with (1) relationships with others, their rapport and communication with patients, patients' families and visitors, and colleagues. These relationships are influenced by (2) barriers to practice, such as personal level of comfort when wearing personal protective equipment, physical limitations of the environment, and management of workload and resources. Such barriers influence (3) patient outcomes, namely the quality of the care provided and adverse events.

CONCLUSION

In the context of caring for patients under transmission-based precautions, the relationships between health professionals and their patients are critical to the quality and safety of health care with respect to infection prevention and control.

摘要

背景

预防医源性感染对于医疗保健的安全和质量至关重要。尽管已经充分了解隔离状态下患者的护理体验,但对于医护人员在提供此类护理时的体验却知之甚少。本研究旨在探讨卫生专业人员在基于传播预防措施下照顾患者的体验。

方法

采用解释现象学方法,在澳大利亚的 3 家医疗机构中,对 12 名卫生保健专业人员在基于传播预防措施下提供护理的体验进行了研究。通过深度访谈和对卫生专业人员的观察获得数据。

结果

“建立融洽关系”这一重要现象代表了卫生专业人员的亲身经历。由此产生了三个主题:(1)与他人的关系,包括与患者、患者家属和访客以及同事的融洽关系和沟通;(2)实践障碍,例如穿着个人防护设备时个人舒适度、环境的物理限制以及工作量和资源的管理;(3)患者结局,即提供的护理质量和不良事件。

结论

在基于传播预防措施下照顾患者的背景下,卫生专业人员与患者之间的关系对于感染预防和控制方面的医疗保健质量和安全至关重要。

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