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手术中的干扰与多任务处理:一项关于医生和护士日常工作模式的多中心观察性研究

Interruptions and multitasking in surgery: a multicentre observational study of the daily work patterns of doctors and nurses.

作者信息

Bellandi Tommaso, Cerri Alessandro, Carreras Giulia, Walter Scott, Mengozzi Cipriana, Albolino Sara, Mastrominico Eleonora, Renzetti Fernando, Tartaglia Riccardo, Westbrook Johanna

机构信息

a Center for Patient Safety and Clinical Risk Management , Florence , Italy.

b Cancer Prevention and Research Institute (ISPO) , Florence , Italy.

出版信息

Ergonomics. 2018 Jan;61(1):40-47. doi: 10.1080/00140139.2017.1349934. Epub 2017 Jul 17.

Abstract

The aim of this study was to obtain baseline data on doctors' and nurses' work activities and rates of interruptions and multitasking to improve work organisation and processes. Data were collected in six surgical units with the WOMBAT (Work Observation Method by Activity Timing) tool. Results show that doctors and nurses received approximately 13 interruptions per hour, or one interruption every 4.5 min. Compared to doctors, nurses were more prone to interruptions in most activities, while doctors performed multitasking (33.47% of their time, 95% CI 31.84-35.17%) more than nurses (15.23%, 95% CI 14.24-16.25%). Overall, the time dedicated to patient care is relatively limited for both professions (37.21%, 95% CI 34.95-39.60% for doctors, 27.22%, 95% CI 25.18-29.60% for nurses) compared to the time spent for registration of data and professional communication, that accounts for two-thirds of doctors' time and nearly half of nurses' time. Further investigation is needed on strategies to manage job demands and professional communications. Practitioner Summary: This study offers further findings on the characteristics and frequency of multitasking and interruptions in surgery, with a comparison of how they affect doctors and nurses. Further investigation is needed to improve the management of job demands and communications according to the results.

摘要

本研究的目的是获取有关医生和护士工作活动、中断率和多任务处理率的基线数据,以改善工作组织和流程。使用WOMBAT(按活动时间进行工作观察法)工具在六个外科病房收集了数据。结果显示,医生和护士每小时大约会受到13次干扰,即每4.5分钟受到一次干扰。与医生相比,护士在大多数活动中更容易受到干扰,而医生进行多任务处理的时间(占其工作时间的33.47%,95%置信区间为31.84 - 35.17%)比护士(15.23%,95%置信区间为14.24 - 16.25%)更多。总体而言,与用于数据记录和专业交流的时间相比,这两个职业用于患者护理的时间相对有限(医生为37.21%,95%置信区间为34.95 - 39.60%;护士为27.22%,95%置信区间为25.18 - 29.60%),数据记录和专业交流时间占医生工作时间的三分之二,占护士工作时间的近一半。需要进一步研究管理工作需求和专业交流的策略。从业者总结:本研究提供了关于手术中多任务处理和干扰的特征及频率的进一步发现,并比较了它们对医生和护士的影响。根据研究结果,需要进一步研究以改善工作需求和交流的管理。

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