Emergency Department, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Sydney Nursing School, The University of Sydney, Sydney, New South Wales, Australia.
Emerg Med Australas. 2020 Oct;32(5):793-800. doi: 10.1111/1742-6723.13511. Epub 2020 Apr 30.
This multi-site study aimed to give voice to the views and experiences of security staff in assisting with the response to the growing number of people with mental health, drug health and behavioural problems attending EDs.
Explorative qualitative research design, using semi-structured interviews were conducted with security staff (n = 26) working in three different emergency settings across New South Wales, Australia. The data were analysed thematically.
Participants recognised that long waiting times in the ED 'guarding' patients frequently accounted for escalating behaviour and increased the likelihood of restrictive interventions. Security staff expressed concerns about safety and were uncomfortable with a sense of uncertainty regarding their legal position. They voiced frustration over limited communication and lack of information provided by clinical staff on patient background, and the coordination of incidents and ongoing patient care. There was a perception that security staff are not treated with respect and their input was not valued.
Expecting non-clinicians to undertake a clinical role (often under stressful circumstances involving close patient contact) places security staff and patients in a precarious position. Greater clarity regarding the role of security staff and information that allows them to adequately and safely undertake their work is required. If security staff are expected to participate in patient care then access to relevant information and the ability to document their activities and patient interactions should be provided. The vital support role that security staff perform needs to be valued and respected.
本多地点研究旨在倾听安保人员在协助应对越来越多因心理健康、药物滥用和行为问题而就诊于急症室的患者方面的意见和经验。
采用探索性定性研究设计,对澳大利亚新南威尔士州三个不同急症环境中工作的 26 名安保人员进行了半结构化访谈。对数据进行了主题分析。
参与者认识到,急诊室中长时间等待“监护”患者经常导致行为升级,并增加了实施限制干预的可能性。安保人员对安全表示担忧,并对其法律地位感到不确定。他们对沟通不畅和临床工作人员对患者背景信息以及事件协调和持续患者护理提供的信息有限感到不满。有一种看法认为,安保人员没有得到尊重,他们的意见没有得到重视。
期望非临床人员承担临床角色(通常在涉及密切患者接触的紧张情况下)使安保人员和患者处于不稳定的境地。需要更加明确安保人员的角色,并提供相关信息,使他们能够充分、安全地开展工作。如果期望安保人员参与患者护理,则应提供相关信息,并允许他们记录其活动和与患者的互动。需要重视和尊重安保人员所发挥的重要支持作用。