Penn State Health Milton S. Hershey Medical Center, Hershey, PA, United States.
Pediatric Endocrinology, Penn State Health, Children's Hospital, Hershey, PA, United States.
Appl Nurs Res. 2018 Feb;39:141-147. doi: 10.1016/j.apnr.2017.11.006. Epub 2017 Nov 6.
This study explored decision-making regarding use of safe patient handling and mobility (SPHM) technology among registered nurses (RN) and nursing assistants (NA).
Lifting injuries are common among healthcare workers. Despite development of standards for SPHM, the introduction of regulation for monitoring access to SPHM technology, and implementation of education programs and process improvements, threat of injury remains a concern. Although access to SPHM equipment is associated with decreased workplace injuries, access alone does not guarantee use. Questions remain concerning how healthcare workers make decisions to use SPHM equipment, and how they weigh decisions against personal safety.
A qualitative descriptive study was conducted. Data collection consisted of four 60min focus groups. Two focus groups consisted of all RNs (n=14) and two consisted of all NAs (n=11). Each focus group was audiotaped and transcribed verbatim. Transcripts were coded, repeating concepts identified, and codes collapsed into themes and subthemes.
Qualitative analysis revealed three major themes: barriers to use, perceived risk, and coordination of care. Barriers to use include subthemes of physical barriers, knowledge and skill, and unit culture. Perceived risk includes patient risk and perceived risk to self. Coordination of care includes patient factors and characteristics, assessment of patient needs and abilities, and interprofessional collaboration.
These findings provide new knowledge about the complexity of decision making among care providers in the use of SPHM technology. Interprofessional team approaches to patient assessment and care are important components of confident decision making in use of SPHM technology.
本研究探讨了注册护士（RN）和护理助理（NA）在使用安全患者搬运和移动（SPHM）技术方面的决策。
医疗保健工作者中常见的是抬举伤。尽管制定了 SPHM 标准，引入了监测 SPHM 技术使用的法规，并实施了教育计划和流程改进，但受伤的威胁仍然令人担忧。尽管获得 SPHM 设备与减少工作场所受伤有关，但仅获得设备并不能保证使用。人们仍然对医疗保健工作者如何做出使用 SPHM 设备的决策以及如何权衡个人安全与决策表示关注。
进行了定性描述性研究。数据收集包括四个 60 分钟的焦点小组。两个焦点小组由所有 RN（n=14）组成，两个焦点小组由所有 NA（n=11）组成。每个焦点小组都进行了录音并逐字记录。将记录进行编码，重复识别出的概念，并将代码合并为主题和子主题。
定性分析显示出三个主要主题：使用障碍、感知风险和护理协调。使用障碍的子主题包括物理障碍、知识和技能以及单位文化。感知风险包括患者风险和对自身的感知风险。护理协调包括患者因素和特征、评估患者的需求和能力以及跨专业合作。
这些发现为护理提供者在使用 SPHM 技术方面的决策复杂性提供了新的知识。以跨专业团队的方式进行患者评估和护理是自信地做出使用 SPHM 技术决策的重要组成部分。
