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对2009年至2013年期间英格兰西北部重症监护病房工作人员受伤的患者安全事件报告的分析。

An analysis of patient safety incident reports describing injuries to staff working in critical care in the North West of England between 2009 and 2013.

作者信息

Thomas Antony N, Horner Daniel, Taylor Robert J

机构信息

Critical Care Department, Salford Royal Hospitals NHS Foundation Trust, Salford, UK.

North West Deanery, UK.

出版信息

J Intensive Care Soc. 2015 Aug;16(3):208-214. doi: 10.1177/1751143715574510. Epub 2015 Mar 2.

Abstract

BACKGROUND

Critical care environments are potentially high-risk areas for staff harm due to procedural demand and increased incidence of delirium/dependence. The principal types of harm and temporal trends have not yet been quantified.

METHODS

Retrospective analysis of a multicentre dataset prospectively collected over a five-year period. All patient safety incidents reported to a regional network project were analysed; those recorded as staff harm were extracted, quantified and assessed by thematic analysis to identify key areas of harm, temporal trends and incident rates.

RESULTS

Staff harm accounted for 7% of all reported patient safety incidents over the study period. Incident rates remained static, ranging annually from 2.6 to 3.7 episodes/1000 patient days. Assaults on staff accounted for the highest proportional contribution on thematic analysis, which was a consistent annual finding. Sharps injuries and manual handling incidents were also notable contributions. Temporal trends for each theme remained static over the study period implying limited reduction in staff harm despite implementation of national guidance and local initiatives.

CONCLUSION

Staff harm is a consistent issue for those working in critical care. Assaults on staff appear to be the highest contributor on thematic analysis. These data imply significant reduction in harm can still be achieved and can be used to design and implement interventional measures.

摘要

背景

由于操作要求以及谵妄/依赖发生率增加,重症监护环境对工作人员来说可能是高风险区域。伤害的主要类型和时间趋势尚未得到量化。

方法

对一个在五年期间前瞻性收集的多中心数据集进行回顾性分析。分析了向一个区域网络项目报告的所有患者安全事件;提取记录为工作人员伤害的事件,通过主题分析进行量化和评估,以确定伤害的关键领域、时间趋势和事件发生率。

结果

在研究期间,工作人员伤害占所有报告的患者安全事件的7%。事件发生率保持稳定,每年为2.6至3.7起/1000患者日。在主题分析中,对工作人员的攻击占比最高,这是每年一致的发现。锐器伤和人工搬运事件也占相当比例。在研究期间,每个主题的时间趋势保持稳定,这意味着尽管实施了国家指南和地方举措,工作人员伤害的减少有限。

结论

对于在重症监护领域工作的人员来说,工作人员伤害是一个持续存在的问题。在主题分析中,对工作人员的攻击似乎是最大的促成因素。这些数据表明,仍然可以大幅减少伤害,并且可用于设计和实施干预措施。

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本文引用的文献

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Psychiatric consequences of needlestick injury.针刺伤的精神后果。
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