University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Division of Prevention, Rehabilitation and Community Medicine, Occupational and Environmental Medicine Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
BMC Health Serv Res. 2021 May 27;21(1):511. doi: 10.1186/s12913-021-06517-x.
Health care workers (HCWs) are at high risk of occupational injuries and approximately 10-15% of patients are affected by an adverse event during their hospital stay. There is scarce scientific literature about how HCWs manage these risks in practice and what support they need. This knowledge is needed to improve safety for patients and HCWs. This study explores HCWs' experiences of workplace incidents that led to injury or posed a risk of patient and worker injury, with focus on HCWs' emotions and actions.
This study employed a qualitative design using the critical incident technique. Semi-structured individual interviews were held with 34 HCWs from three regions in Sweden. Data were analysed using inductive category development.
Altogether 71 workplace incidents were reported. The analysis of two dimensions - the emotions HCWs feel and the actions team members and managers take when a workplace incident occurs - yielded two categories each: Anxiety during the incident, Persistent distress after the incident, Team interplay for safety actions and Support and ratification from managers and colleagues. Health care workers risked their own safety and health to provide patient safety. Teamwork and trustful relationships were critical for patient and worker safety. Support and validation from colleagues and managers were important for closure; unsatisfactory manager response and insufficient opportunities to debrief the incident could lead to persistent negative emotions. Participants described insecurity and fear, sadness over being injured at work, and shame and self-regret when the patient or themselves were injured. When the workplace had not taken the expected action, they felt anger and resignation, often turning into long-term distress.
Work situations leading to injury or risk of patient and worker injury are emotionally distressing for HCWs. Team interplay may facilitate safe and dynamic practices and help HCWs overcome negative emotions. Organizational support is imperative for individual closure. For safety in health care, employers need to develop strategies for active management of risks, avoiding injuries and providing support after an injury.
医护人员（HCWs）面临着职业伤害的高风险，大约有 10-15%的患者在住院期间会遭受不良事件的影响。关于 HCWs 在实践中如何管理这些风险以及他们需要什么支持，相关科学文献很少。这方面的知识对于提高患者和 HCWs 的安全性是必要的。本研究探讨了 HCWs 遭遇导致受伤或对患者和工人受伤构成风险的工作场所事件的经历，重点关注 HCWs 的情绪和行为。
本研究采用定性设计，使用关键事件技术。对来自瑞典三个地区的 34 名 HCWs 进行了半结构化的个体访谈。使用归纳类别开发对数据进行分析。
共报告了 71 起工作场所事件。对 HCWs 在工作场所事件发生时感受到的情绪和团队成员及管理人员采取的行动这两个维度的分析，分别得出了两个类别：事件发生时的焦虑、事件发生后的持续困扰、团队为安全行动而进行的互动以及来自管理人员和同事的支持和认可。HCWs 冒着自身安全和健康的风险来保障患者安全。团队合作和信任关系对患者和工人的安全至关重要。同事和管理人员的支持和认可对于事件的结束至关重要；管理人员反应不佳和没有足够的机会对事件进行反思可能会导致持续的负面情绪。参与者描述了他们在工作场所没有采取预期行动时感到的愤怒和无奈，以及在自己或患者受伤时感到的悲伤、内疚和自责。
导致受伤或患者和工人受伤风险的工作情况会给 HCWs 带来情绪困扰。团队互动可以促进安全和动态的实践，并帮助 HCWs 克服负面情绪。组织支持对于个人结束事件至关重要。为了保证医疗保健的安全，雇主需要制定积极管理风险、避免伤害以及在受伤后提供支持的策略。
