Edrees Hanan H, Morlock Laura, Wu Albert W
Jt Comm J Qual Patient Saf. 2017 Sep;43(9):471-483. doi: 10.1016/j.jcjq.2017.01.008. Epub 2017 Jun 28.
Second victims-defined as health care providers who are emotionally traumatized after a patient adverse event-may not receive needed emotional support. Although most health care organizations have an employee assistance program (EAP), second victims may be reluctant to access this service because of worries about confidentiality. A study was conducted to describe the extent to which organizational support for second victims is perceived as desirable by patient safety officers in acute care hospitals in Maryland and to identify existing support programs.
Semistructured interviews (using existing and newly developed questions) were conducted with 43 patient safety representatives from 38 of the 46 acute care hospitals in Maryland (83% response rate).
All but one of the responding hospitals offered EAP services to their employees, but there were gaps in the services provided related to timeliness, EAP staff's ability to relate to clinical providers, and physical accessibility. There were no valid measures in place to assess the effectiveness of EAP services. Participants identified a need for peer support, both for the second victim and potentially for individuals who provide that support. Six (16%) of the 38 hospitals had second victim support programs, which varied in structure, accessibility, and outcomes, while an additional 5 hospitals (13%) were developing such a program.
Patient safety officers thought their organizations should reevaluate the support currently provided by their EAPs, and consider additional peer support mechanisms. Future research is needed to evaluate the effectiveness of these programs.
“二次受害者”被定义为在患者发生不良事件后遭受情感创伤的医疗保健提供者,他们可能无法获得所需的情感支持。尽管大多数医疗保健机构都设有员工援助计划(EAP),但二次受害者可能因担心保密性而不愿使用这项服务。开展了一项研究,以描述马里兰州急症医院的患者安全官员认为组织对二次受害者的支持在多大程度上是可取的,并确定现有的支持计划。
对马里兰州46家急症医院中38家医院的43名患者安全代表进行了半结构化访谈(使用现有的和新开发的问题)(回复率为83%)。
除一家回复的医院外,其他所有医院都为员工提供了EAP服务,但在服务的及时性、EAP工作人员与临床提供者的沟通能力以及实际可及性方面存在差距。没有有效的措施来评估EAP服务的效果。参与者认为需要为二次受害者以及可能提供支持的个人提供同伴支持。38家医院中有6家(16%)设有二次受害者支持计划,这些计划在结构、可及性和效果方面各不相同,另有5家医院(13%)正在制定此类计划。
患者安全官员认为其所在组织应重新评估目前由EAP提供的支持,并考虑增加同伴支持机制。需要未来的研究来评估这些计划的效果。