National Centre for Emergency Primary Health Care, Uni Health, Uni Research, Bergen, Norway.
BMC Health Serv Res. 2013 Oct 3;13:384. doi: 10.1186/1472-6963-13-384.
Employees in emergency primary care centres (EPCC) have raised personal safety as an issue. Despite a high risk of experiencing workplace violence at EPCCs in Norway, knowledge regarding applied preventive measures is limited. The description of existing safety measures is an important prerequisite to evaluate and make guidelines for the improvement of preventive practices on a national level. The objective of this study was to investigate to which extent general practitioners work alone in EPCCs in Norway, and to estimate the prevalence of other preventive measures against workplace violence.
A survey was sent to the managers of all 210 registered EPCCs in Norway. The questionnaire included 22 items on safety measures, including available staff, architecture and outfitting of the reception and consulting rooms, and the availability of electronic safety systems and training or monitoring systems. The data were analysed using descriptive statistics. Differences between EPCCs staffed by one general practitioner alone and EPCCs with more health personnel on duty were explored.
Sixty-one (30%) of the 203 participating EPCCs had more than one person on duty round-the-clock. These EPCCs reported the application of a significantly higher number of safety measures compared to the EPCCs with only one general practitioner on duty during some or part of the 24 hours. Examples of safety measures being more common in highly staffed EPCCs were automatic door locks (p < 0.001), arrangement of furniture in the consulting room ensuring that the patient is not seated between the clinician and the exit (p = 0.014), the possibility of bringing an extra person on emergency call-outs or home visits when needed for security reasons (p = 0.014), and having organised training regarding violence (p < 0.001).
This study shows considerable differences between Norwegian EPCCs regarding applied preventive measures, and a higher prevalence of such measures in EPCCs staffed with several health personnel around-the-clock. More research is needed to understand the reasons for, and the effects of, these differences.
急诊初级保健中心（EPCC）的员工提出了人身安全问题。尽管在挪威的 EPCC 中心工作时遭遇工作场所暴力的风险很高，但对已应用的预防措施的了解却有限。描述现有的安全措施是评估和制定国家层面预防措施改进指南的重要前提。本研究的目的是调查挪威 EPCC 中全科医生独自工作的程度，并估计针对工作场所暴力的其他预防措施的流行率。
向挪威所有 210 个注册的 EPCC 经理发送了一份调查问卷。问卷包括 22 个关于安全措施的项目，包括接待和咨询室的可用人员、建筑和设备，以及电子安全系统和培训或监测系统的可用性。使用描述性统计数据进行数据分析。探讨了仅有一名全科医生值班的 EPCC 与有更多卫生人员值班的 EPCC 之间的差异。
在 203 个参与的 EPCC 中，有 61 个（30%）有 24 小时值班的不止一名人员。与仅在某些或部分 24 小时内有一名全科医生值班的 EPCC 相比，这些 EPCC 报告了更多安全措施的应用。在人员配备充足的 EPCC 中更常见的安全措施包括自动门锁（p<0.001）、诊室家具的布置确保患者不会坐在医生和出口之间（p=0.014）、必要时可紧急呼叫或家访时增加额外人员以确保安全（p=0.014）以及有组织的暴力培训（p<0.001）。
本研究表明，挪威的 EPCC 在应用预防措施方面存在显著差异，并且在有多名卫生人员 24 小时值班的 EPCC 中，这些措施的流行率更高。需要进一步研究以了解这些差异的原因和影响。
