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应急反应驾驶和患者转运安全检查表:来自紧急医疗服务的经验。

Safety Checklists for Emergency Response Driving and Patient Transport: Experiences from Emergency Medical Services.

出版信息

Jt Comm J Qual Patient Saf. 2021 Sep;47(9):572-580. doi: 10.1016/j.jcjq.2021.05.008. Epub 2021 Jun 1.

Abstract

BACKGROUND

Emergency response driving (ERD) is considered one of the most significant occupational risk factors affecting both patient and traffic safety in emergency medical services (EMS). The majority of the risk factors in ERD are crew related and could be affected positively with crew resource management (CRM). The aim of this study was to examine how the safety checklists developed for ERD and patient transport are experienced in practical work in EMS by paramedics.

METHODS

Safety checklists for ERD and patient transport were developed and then piloted in practical work among 30 paramedics in five different EMS areas around Finland for a two-month period in fall 2019. Afterward, semistructured thematic interviews were performed with the pilot participants, and the material was analyzed using inductive content analysis.

RESULTS

Paramedics experienced that use of ERD and patient transport safety checklists improved safety, and deployment of the checklists required systematic planning. Use of the safety checklists was seen as changing the mindset of the ERD drivers to a more safety critical stance and increasing a systematic approach to ERD. Paramedics also stated that when deploying the checklists in EMS, their use should be standardized as a nationwide operating model and that service-dependent fine-tuning is required.

CONCLUSION

This study's findings support the use of ERD and patient transport safety checklists in practical work in EMS for promoting safety. In addition to safety checklists, other sections of CRM and its applications to EMS should also be studied.

摘要

背景

应急驾驶(ERD)被认为是影响紧急医疗服务(EMS)中患者和交通安全的最重要职业风险因素之一。应急驾驶中的大多数风险因素与机组人员有关,并且可以通过机组资源管理(CRM)来积极影响。本研究的目的是检查急救人员在实际工作中如何体验为应急驾驶和患者转运开发的安全检查表。

方法

在 2019 年秋季,在芬兰五个不同的 EMS 区域中,有 30 名护理人员在实际工作中对 ERD 和患者转运安全检查表进行了试点。之后,对试点参与者进行了半结构化主题访谈,并使用归纳内容分析对材料进行了分析。

结果

护理人员体验到使用 ERD 和患者转运安全检查表提高了安全性,并且部署检查表需要系统的规划。使用安全检查表被视为将 ERD 驾驶员的思维方式转变为更注重安全的立场,并增加了对 ERD 的系统方法。护理人员还表示,在部署 EMS 中的检查表时,应将其作为全国性的操作模式进行标准化,并需要根据服务进行微调。

结论

本研究的结果支持在 EMS 的实际工作中使用 ERD 和患者转运安全检查表来促进安全。除了安全检查表之外,还应研究 CRM 的其他部分及其在 EMS 中的应用。

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