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从医护人员视角看警惕性高的工作场所:提高医疗机构警惕性和警觉性的行为及环境策略

Alert Workplace From Healthcare Workers' Perspective: Behavioral and Environmental Strategies to Improve Vigilance and Alertness in Healthcare Settings.

作者信息

Sagah Zadeh Rana, Shepley Mardelle, Sadatsafavi Hessam, Owora Arthur Hamie, Krieger Ana C

机构信息

1 Health Design Innovations Lab, Department of Design and Environmental Analysis, Cornell University, Ithaca, NY, USA.

2 Cornell Institute for Healthy Futures, Department of Design and Environmental Analysis, Cornell University, Itahca, NY, USA.

出版信息

HERD. 2018 Apr;11(2):72-88. doi: 10.1177/1937586717729349. Epub 2017 Oct 10.

Abstract

OBJECTIVE

This study aims to identify the behavioral and environmental strategies that healthcare workers view as helpful for managing sleepiness, improving alertness, and therefore optimizing workplace safety.

BACKGROUND

Reduced alertness is a common issue in healthcare work environments and is associated with impaired cognitive performance and decision-making ability as well as increased errors and injuries.

METHOD

We surveyed 136 healthcare professionals at a primary care clinic, an acute care hospital, and a mental health clinic. Nonstructured, semistructured, and structured questionnaires were used to elicit relevant information which was analyzed using qualitative content analysis and logistic regression models, respectively.

RESULTS

In order by frequency of endorsement: dietary intervention; physical mobility; cognitive, sensory, or social stimulation; personal lifestyle strategies; and rest/nap opportunities were reported as behavioral strategies used to address workplace alertness. Compared to other environmental features, daylight and thermal comfort were perceived to be more important to addressing workplace alertness ( p < .05).

CONCLUSIONS

By optimizing the physical environment and organizational policies and providing education programs, we have an opportunity to support healthcare professionals in managing sleepiness and maintaining alertness at work. In addition, such system level interventions may reduce unhealthy choices such as frequent caffeine intake to keep alert. The development of multidisciplinary evidence-based guidelines is needed to address sleepiness and alertness to improve workplace safety in healthcare facilities.

摘要

目的

本研究旨在确定医护人员认为有助于管理困倦、提高警觉性从而优化工作场所安全性的行为和环境策略。

背景

警觉性降低是医疗工作环境中的常见问题,与认知能力和决策能力受损以及错误和伤害增加有关。

方法

我们对一家初级保健诊所、一家急症医院和一家心理健康诊所的136名医护专业人员进行了调查。分别使用非结构化、半结构化和结构化问卷来获取相关信息,并分别采用定性内容分析和逻辑回归模型进行分析。

结果

按认可频率排序:饮食干预;身体活动;认知、感官或社交刺激;个人生活方式策略;以及休息/小睡机会被报告为用于解决工作场所警觉性的行为策略。与其他环境特征相比,日光和热舒适度被认为对解决工作场所警觉性更为重要(p < .05)。

结论

通过优化物理环境和组织政策并提供教育项目,我们有机会支持医护专业人员管理困倦并在工作中保持警觉。此外,此类系统层面的干预措施可能会减少为保持警觉而频繁摄入咖啡因等不健康选择。需要制定多学科循证指南来解决困倦和警觉性问题,以改善医疗机构的工作场所安全性。

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