Hughes Ashley M, Patterson P Daniel, Weaver Matthew D, Gregory Megan E, Sonesh Shirley C, Landsittel Douglas P, Krackhardt David, Hostler David, Lazzara Elizabeth H, Wang Xiao, Vena John E, Salas Eduardo, Yealy Donald M
Houston, TX; Pittsburgh, PA; Buffalo, NY; Boston, MA; New Orleans, LA; Daytona Beach, FL; Charleston, SC.
Houston, TX; Pittsburgh, PA; Buffalo, NY; Boston, MA; New Orleans, LA; Daytona Beach, FL; Charleston, SC.
J Emerg Nurs. 2017 Jul;43(4):339-346. doi: 10.1016/j.jen.2016.11.007. Epub 2017 Mar 30.
Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury.
Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro.
We received 2566 completed surveys from 333 clinicians, of which 297 were retained. Mean participation was 40.5% (standard deviation [SD] = 20.5%) across EMS agencies. Survey respondents were primarily white (93.8%), male (67.3%), and ranged between 21-62 years of age (M = 37.4, SD = 9.7). Seventeen percent were prehospital nurses. Respondents worked a mean of 3 shifts with recent teammates in the 8 weeks preceding the survey (M = 3.06, SD = 4.4). We examined data at the team level, which suggest positive views of teamwork (M = 5.92, SD = 0.69). Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork was not supported. Teamwork factor Partner Adaptability and Backup Behavior is a likely mediator (odds ratio = 1.03, P = .05). When dyad familiarity is high and there are high levels of backup behavior, the likelihood of injury is increased.
The relationship between teammate familiarity and outcomes is complex. Teammate adaptation and backup behavior is a likely mediator of this relationship in EMS teams with greater familiarity.
在紧急医疗服务（EMS）中，团队成员之间更高的熟悉度有助于促进积极团队合作的发展，并预防工作场所受伤。
使用档案轮班记录、工作场所受伤数据以及对14个EMS机构进行的横断面调查收集相关数据，这些机构具有全国代表性，雇佣了护理人员、院前护士和其他EMS临床医生。随机挑选1000名EMS临床医生，让他们针对其最近的每一次合作关系完成一份团队合作调查问卷，并使用PROCESS宏测试团队合作作为队友熟悉度与受伤之间关系的中介的假设作用。
我们收到了来自333名临床医生的2566份完整调查问卷，其中297份被保留。各EMS机构的平均参与率为40.5%（标准差[SD]=20.5%）。调查对象主要为白人（93.8%）、男性（67.3%），年龄在21 - 62岁之间（均值M = 37.4，标准差SD = 9.7）。17%为院前护士。在调查前的8周内，受访者与最近的队友平均一起工作了3个班次（均值M = 3.06，标准差SD = 4.4）。我们在团队层面检查了数据，结果显示对团队合作持积极看法（均值M = 5.92，标准差SD = 0.69）。我们关于增加队友熟悉度通过发展积极的团队合作来预防不良安全结果的假设未得到支持。团队合作因素“伙伴适应性”和“后备行为”可能是一个中介因素（优势比=1.03，P = 0.05）。当二元组熟悉度高且存在高水平的后备行为时，受伤的可能性会增加。
队友熟悉度与结果之间的关系很复杂。在熟悉度更高的EMS团队中，队友适应性和后备行为可能是这种关系的一个中介因素。
