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放射肿瘤学中的安全实践、认知和行为:一项针对放射治疗师的全国性调查。

Safety practices, perceptions, and behaviors in radiation oncology: A national survey of radiation therapists.

机构信息

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston Texas.

Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston Texas.

出版信息

Pract Radiat Oncol. 2018 Jan-Feb;8(1):48-57. doi: 10.1016/j.prro.2017.06.003. Epub 2017 Jun 15.

Abstract

PURPOSE

Radiation therapy is complex and demands high vigilance and precise coordination. Radiation therapists (RTTs) directly deliver radiation and are often the first to discover an error. Yet, few studies have examined the practices of RTTs regarding patient safety. We conducted a national survey to explore the perspectives of RTTs related to quality and safety.

METHODS AND MATERIALS

In 2016, an electronic survey was sent to a random sample of 1500 RTTs in the United States. The survey assessed department safety, error reporting, safety knowledge, and culture. Questions were multiple choice or recorded on a Likert scale. Results were summarized using descriptive statistics and analyzed using multivariate logistic regression.

RESULTS

A total of 702 RTTs from 49 states (47% response rate) completed the survey. Respondents represented a broad distribution across practice settings. Most RTTs rated department patient safety as excellent (61%) or very good (32%), especially if they had an incident learning system (ILS) (odds ratio, 2.0). Only 21% reported using an ILS despite 58% reporting an accessible ILS in their department. RTTs felt errors were most likely to occur with longer shifts and poor multidisciplinary communication; 40% reported that burnout and anxiety negatively affected their ability to deliver care. Workplace bullying was also reported among 17%. Overall, there was interest (62%) in improving knowledge in patient safety.

CONCLUSIONS

Although most RTTs reported excellent safety cultures within their facilities, overall, there was limited access to and utilization of ILSs by RTTs. Workplace issues identified may also represent barriers to delivering quality care. RTTs were also interested in additional resources regarding quality and safety. These results will further enhance safety initiatives and inform future innovative educational efforts in radiation oncology.

摘要

目的

放射治疗复杂,需要高度警惕和精确协调。放射治疗师(RTT)直接提供放射治疗,并且通常是第一个发现错误的人。然而,很少有研究探讨 RTT 与患者安全相关的实践。我们进行了一项全国性调查,以探讨 RTT 对质量和安全的看法。

方法和材料

2016 年,向美国的 1500 名 RTT 随机抽样发送了一份电子调查。该调查评估了部门安全、错误报告、安全知识和文化。问题是多项选择或记录在李克特量表上。结果使用描述性统计进行总结,并使用多变量逻辑回归进行分析。

结果

来自 49 个州的 702 名 RTT 完成了调查(47%的回应率)。受访者在实践环境中分布广泛。大多数 RTT 将部门的患者安全评为优秀(61%)或非常好(32%),尤其是如果他们有事故学习系统(ILS)(优势比,2.0)。尽管 58%的受访者报告其部门有可用的 ILS,但只有 21%的人报告使用 ILS。RTT 认为错误最有可能发生在轮班时间较长和多学科沟通不畅的情况下;40%的人报告说,倦怠和焦虑会对他们提供护理的能力产生负面影响。17%的人还报告了工作场所欺凌行为。总体而言,有 62%的人有兴趣提高患者安全方面的知识。

结论

尽管大多数 RTT 报告在其设施内具有出色的安全文化,但总体而言,RTT 对 ILS 的获取和使用有限。确定的工作场所问题也可能是提供高质量护理的障碍。RTT 还对质量和安全方面的其他资源感兴趣。这些结果将进一步加强安全计划,并为放射肿瘤学领域的未来创新教育努力提供信息。

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