Weigl Matthias, Müller Andreas, Angerer Peter, Hoffmann Florian
Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany.
BMC Health Serv Res. 2014 Sep 24;14:433. doi: 10.1186/1472-6963-14-433.
Pediatricians' workload is increasingly thought to affect pediatricians' quality of work life and patient safety. Workflow interruptions are a frequent stressor in clinical work, impeding clinicians' attention and contributing to clinical malpractice. We aimed to investigate prospective associations of workflow interruptions with multiple dimensions of mental workload in pediatricians during clinical day shifts.
In an Academic Children's Hospital a prospective study of 28 full shift observations was conducted among pediatricians providing ward coverage. The prevalence of workflow interruptions was based on expert observation using a validated observation instrument. Concurrently, Pediatricians' workload ratings were assessed with three workload dimensions of the well-validated NASA-Task Load Index: mental demands, effort, and frustration.
Observed pediatricians were, on average, disrupted 4.7 times per hour. Most frequent were interruptions by colleagues (30.2%), nursing staff (29.7%), and by telephone/beeper calls (16.3%). Interruption measures were correlated with two workload outcomes of interest: frequent workflow interruptions were related to less cognitive demands, but frequent interruptions were associated with increased frustration. With regard to single sources, interruptions by colleagues showed the strongest associations to workload.
The findings provide insights into specific pathways between different types of interruptions and pediatricians' mental workload. These findings suggest further research and yield a number of work and organization re-design suggestions for pediatric care.
越来越多的人认为儿科医生的工作量会影响其工作生活质量和患者安全。工作流程中断是临床工作中常见的压力源，会干扰临床医生的注意力并导致医疗事故。我们旨在调查临床日班期间工作流程中断与儿科医生心理工作量多个维度之间的前瞻性关联。
在一家学术儿童医院，对28名提供病房护理的儿科医生进行了为期一整天的前瞻性观察研究。工作流程中断的发生率基于使用经过验证的观察工具进行的专家观察。同时，使用经过充分验证的美国国家航空航天局任务负荷指数（NASA-Task Load Index）的三个工作量维度对儿科医生的工作量评级进行评估：心理需求、努力程度和挫败感。
观察到的儿科医生平均每小时被打断4.7次。最常见的干扰来自同事（30.2%）、护理人员（29.7%）以及电话/传呼机呼叫（16.3%）。干扰措施与两个感兴趣的工作量结果相关：频繁的工作流程中断与较低的认知需求相关，但频繁的中断与增加的挫败感相关。就单一来源而言，同事的干扰与工作量的关联最为强烈。
这些发现为不同类型的干扰与儿科医生心理工作量之间的特定途径提供了见解。这些发现建议进一步开展研究，并为儿科护理提出一些工作和组织重新设计的建议。
