Department of Psychology & Methods, Jacobs University Bremen GmbH, Campus Ring 1, 28759 Bremen, Germany.
German Coalition for Patient Safety (Aktionsbuendnis Patientensicherheit e.V.), Alte Jakob Str. 81, 10179 Berlin, Germany.
Int J Environ Res Public Health. 2021 Jan 21;18(3):915. doi: 10.3390/ijerph18030915.
Patient safety is an important objective in health care. Preventable adverse events (pAEs) as the counterpart to patient safety are harmful incidents that fell behind health care standards and have led to temporary or permanent harm or death. As safe communication and mutual understanding are of crucial importance for providing a high quality of care under everyday conditions, we aimed to identify barriers and facilitators that impact safe communication in obstetrics from the subjective perspective of health care workers. A qualitative study with 20 semi-structured interviews at two university hospitals in Germany was conducted to explore everyday perceptions from a subjective perspective (subjective theories). Physicians, midwives, and nurses in a wide span of professional experience and positions were enrolled. We identified a structural area of conflict at the professional interface between midwives and physicians. Mandatory interprofessional meetings, acceptance of subjective mistakes, mutual understanding, and debriefings of conflict situations are reported to improve collaboration. Additionally, emergency trainings, trainings in precise communication, and handovers are proposed to reduce risks for pAEs. Furthermore, the participants reported time-constraints and understaffing as a huge burden that hinders safe communication. Concluding, safety culture and organizational management are closely entwined and strategies should address various levels of which communication trainings are promising.
患者安全是医疗保健的重要目标。可预防的不良事件（pAEs）作为患者安全的对应物，是指违反医疗标准并导致暂时或永久性伤害或死亡的有害事件。由于安全沟通和相互理解对于在日常情况下提供高质量的护理至关重要，我们旨在从医疗保健工作者的主观角度确定影响产科安全沟通的障碍和促进因素。在德国的两家大学医院进行了一项定性研究，共进行了 20 次半结构化访谈，以从主观角度（主观理论）探索日常认知。招募了具有广泛专业经验和职位的医生、助产士和护士。我们在助产士和医生之间的专业界面发现了一个结构性冲突领域。报告说，必须举行跨专业会议、接受主观错误、相互理解和冲突情况的汇报，以改善协作。此外，还提出了紧急培训、精确沟通培训和交接，以降低可预防的不良事件的风险。此外，参与者报告说，时间限制和人手不足是阻碍安全沟通的巨大负担。总之，安全文化和组织管理紧密交织在一起，策略应该针对各个层面，其中沟通培训是有希望的。
