基于儿科神经精神病学攻击性行为的员工个人防护装备选择
Selection of employee personal protective equipment based on aggressive behavior in pediatric neuropsychiatry.
作者信息
Daraiseh Nancy M, Summerville Lauren A, Lin Li, Tucker DaVona, Hill Adam K, Salisbury Katherine, Lind Michael A
机构信息
a Research in Patient Services , Cincinnati Children's Hospital Medical Center , Cincinnati , Ohio , USA.
b James M. Anderson Center for Health Systems Excellence , Cincinnati Children's Hospital Medical Center , Cincinnati , Ohio , USA.
出版信息
Dev Neurorehabil. 2018 Jan;21(1):32-39. doi: 10.1080/17518423.2016.1238968. Epub 2016 Oct 28.
PURPOSE
Hospitalized patients with a developmental or intellectual disability and a psychiatric disorder (dual-diagnosis) often pose a risk to themselves or others leading to high injury rates for their providers. Therefore, evidence-based strategies to reduce employee injuries resulting from interactions are necessary.
METHODS
To reduce injuries resulting from interactions with dual-diagnosis patients, the Initial Behavioural Assessment (IBA) and Protective Equipment Decision Key (PEDK) were used in inpatient neuropsychiatry. The IBA-PEDK identify patients' aggressive behaviors to provide employees with personal protective equipment (PPE). Inter-rater reliability, validity, and adherence were examined.
RESULTS
Injuries significantly decreased after implementing the IBA-PEDK. The average kappa coefficient was 0.64 with a 90.6% agreement. Ninety-three percent of respondents reported wearing PPE at the time of injury.
CONCLUSIONS
A quick, user-friendly tool that provides a standardized method for determining PPE based on patient-specific behavior can significantly reduce aggression-related injuries.
目的
患有发育障碍或智力残疾以及精神疾病（双重诊断）的住院患者常常会对自己或他人构成风险，导致其医护人员受伤率很高。因此，有必要采用基于证据的策略来减少因互动导致的员工受伤情况。
方法
为减少与双重诊断患者互动导致的伤害，在住院神经精神病学中使用了初始行为评估（IBA）和防护设备决策关键（PEDK）。IBA - PEDK识别患者的攻击性行为，以便为员工提供个人防护设备（PPE）。对评分者间信度、效度和依从性进行了检查。
结果
实施IBA - PEDK后，受伤情况显著减少。平均kappa系数为0.64，一致性为90.6%。93%的受访者报告在受伤时佩戴了PPE。
结论
一种快速、用户友好的工具，基于患者特定行为提供确定PPE的标准化方法，可显著减少与攻击相关的伤害。
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