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提高大型儿科医院医护人员对伤害和险兆事件的察觉能力。

Enhancing the detection of injuries and near-misses among patient care staff in a large pediatric hospital.

机构信息

Research in Patient Services; Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave. Cincinnati, OH 45229, USA. MLC 7014.

出版信息

Scand J Work Environ Health. 2018 Jul 1;44(4):377-384. doi: 10.5271/sjweh.3739. Epub 2018 May 7.

Abstract

Objectives Compared to other industries, healthcare has one of the highest rates of non-fatal occupational injury/illness. Evidence indicates these rates are underestimated, highlighting the need for improved injury surveillance. This study aims to demonstrate the feasibility of integrating active data collection in a passive injury surveillance system to improve detection of injuries in a healthcare establishment. Methods Using digital voice recorders (DVR), pediatric healthcare providers prospectively recorded events throughout their shift for two weeks. This sample-based active injury surveillance was then integrated into an institutional surveillance system (ISS) centered on passive data collection initiated by employee reports. Results Injuries reported using DVR during two-week intervals from February 2014 to July 2015 were 40.7 times more frequent than what would be expected on the basis of the usual ISS reports. Psychological injuries (eg, stress, conflict) and near-misses were captured at a rate of 16.1 per 1000 days [95% confidence interval (CI) 14.1-18.3] and 35.6 per 1000 days (95% CI 32.7-38.8), respectively. Finally, 68% (95% CI 65-72%) of participants preferred using DVR either as an alternative or complement to the existing ISS. Conclusions This study showed that it is feasible to improve injury surveillance in a healthcare establishment by integrating active data collection based on voice recording within a passive injury surveillance system. Enhanced surveillance provides richer information that can guide the development of effective injury prevention strategies.

摘要

目的 相较于其他行业,医疗保健行业的非致命性职业伤害/疾病发生率最高。有证据表明,这些数据被低估了,这凸显了改进伤害监测的必要性。本研究旨在展示在被动伤害监测系统中整合主动数据收集以提高医疗机构中伤害检测的可行性。

方法 使用数字语音记录器(DVR),儿科医护人员在两周内的轮班期间前瞻性地记录事件。这种基于样本的主动伤害监测随后被整合到以员工报告为基础的被动数据收集为中心的机构监测系统(ISS)中。

结果 2014 年 2 月至 2015 年 7 月期间,通过 DVR 在两周间隔内报告的伤害比基于常规 ISS 报告的预期发生率高出 40.7 倍。心理伤害(例如,压力、冲突)和未遂事件的发生率分别为每 1000 天 16.1 例(95%置信区间 [CI] 14.1-18.3)和 35.6 例(95% CI 32.7-38.8)。最后,68%(95% CI 65-72%)的参与者表示更喜欢使用 DVR 作为现有 ISS 的替代或补充方法。

结论 本研究表明,通过在被动伤害监测系统中整合基于语音记录的主动数据收集,可以提高医疗机构的伤害监测。增强的监测提供了更丰富的信息,可指导制定有效的伤害预防策略。

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