School of Healthcare, University of Leeds, Leeds, UK.
Social Spider CIC, London, UK.
Health Expect. 2018 Dec;21(6):1085-1094. doi: 10.1111/hex.12805. Epub 2018 Aug 17.
Establishing patient safety priorities in psychiatry has received less international attention than in other areas of health care. This study aimed to identify safety issues as described by people in the United Kingdom identifying as mental health service users, carers and professionals.
A cross-sectional online survey was distributed via social media. Identified safety issues were mapped onto the Yorkshire Contributory Factors Framework (YCFF) which categorizes factors that contribute to patient safety incidents in general hospital settings. Service user and carer responses were described separately from professional responses using descriptive statistics.
One hundred and eighty-five responses from 95 service users and carers and 90 professionals were analysed. Seventy different safety issues were identified. These were mapped onto the 17 existing categories of the YCFF and two additional categories created to form the YCFF-MH. Most frequently identified issues were as follows: "Individual characteristics" (of staff) which included competence and listening skills; "Service process" that contained concerns about waiting times; "Management of staff and staffing levels" dominated by staffing levels; and "External policy context" which included the overall resourcing of services. Professionals identified staffing levels and inadequate community provision more frequently than service users and carers, who in turn identified crisis care more frequently.
This study updates knowledge on stakeholder perceived safety issues across mental health care. It shows a far broader range of issues relating to safety than has previously been described. The YCFF was successfully modified to describe these issues and areas for further coproduced research are suggested.
与其他医疗保健领域相比,精神科的患者安全优先事项在国际上受到的关注较少。本研究旨在确定英国精神卫生服务使用者、护理人员和专业人员所描述的安全问题。
通过社交媒体分发了一项横断面在线调查。将确定的安全问题映射到约克郡促成因素框架(YCFF)上,该框架将导致一般医院环境中患者安全事件的因素进行分类。使用描述性统计数据分别描述服务使用者和护理人员与专业人员的反应。
分析了来自 95 名服务使用者和护理人员以及 90 名专业人员的 185 份回复。确定了 70 种不同的安全问题。这些问题被映射到 YCFF 的 17 个现有类别和另外两个创建的类别上,以形成 YCFF-MH。最常被识别的问题如下:“个体特征”(员工),包括能力和倾听技巧;“服务流程”,包含对等待时间的担忧;“员工管理和人员配备水平”,以人员配备水平为主;以及“外部政策环境”,包括服务的整体资源配置。专业人员比服务使用者和护理人员更频繁地识别出人员配备水平和不足的社区服务,而服务使用者和护理人员则更频繁地识别出危机护理。
本研究更新了关于精神卫生保健利益相关者感知安全问题的知识。它展示了与安全相关的问题比以前描述的要广泛得多。YCFF 成功地进行了修改以描述这些问题,并提出了进一步coproduced 研究的领域。