Taylor Jennifer A, Murray Regan M, Davis Andrea L, Shepler Lauren J, Harrison Cecelia K, Novinger Neva A, Allen Joseph A
Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA.
Rocky Mountain Center for Occupational & Environmental Health, University of Utah Health, Salt Lake City, UT, USA.
Occup Health Sci. 2019;3(3):265-295.
Between 57 and 93% of Emergency Medical Services (EMS) responders reported having experienced verbal or physical violence at least once in their career. Therefore, the primary goal of this study was to develop a systems-level checklist for violence against fire-based EMS responders using findings from a systematic literature review and outcomes from a national stakeholder meeting. First, a literature review of violence against EMS responders resulted in an extensive list of 162 academic and industrial publications. Second, from these sources, 318 potential candidate items were developed. Third, Q-methodology was employed to categorize, refine, and de-duplicate the items. Fourth, ThinkLet systems facilitated consensus-building, collaboration, and evaluation of the checklist with diverse subject matter experts representing 27 different EMS organizations, government, academia, labor unions, and fire departments during a two-day consensus conference. The final SAVER checklist contains 174 items organized by six phases of EMS response: pre-event, traveling to the scene, scene arrival, patient care, assessing readiness to return to service, and post-event. So called pause points for the individual EMS responder were incorporated at the end of each of phase. Overall, 47.5% of votes across all phases rated items as most feasible, 33.7% as less feasible, and 11.6% as extremely difficult. The SAVER systems-level Checklist is an innovative application of traditional checklists, designed to shift the onus of safety and health from that of the individual first responder to the organization by focusing on actions that leadership can institute through training, policy, and environmental modifications.
57%至93%的紧急医疗服务（EMS）响应人员报告称，他们在职业生涯中至少经历过一次言语或身体暴力。因此，本研究的主要目标是利用系统文献综述的结果和全国利益相关者会议的成果，为针对基于消防的EMS响应人员的暴力行为制定一份系统层面的清单。首先，对针对EMS响应人员的暴力行为进行文献综述，得出了一份包含162篇学术和行业出版物的详尽清单。其次，从这些来源中，制定了318个潜在的候选项目。第三，采用Q方法对这些项目进行分类、完善和去重。第四，在为期两天的共识会议期间，ThinkLet系统促进了与代表27个不同EMS组织、政府、学术界、工会和消防部门的不同主题专家就该清单进行共识建立、协作和评估。最终的SAVER清单包含174个项目，按EMS响应的六个阶段进行组织：事件前、前往现场途中、到达现场、患者护理、评估恢复服务准备情况以及事件后。在每个阶段结束时都纳入了针对个体EMS响应人员的所谓停顿点。总体而言，所有阶段中47.5%的投票将项目评为最可行，33.7%评为较不可行，11.6%评为极其困难。SAVER系统层面清单是传统清单的创新应用，旨在通过关注领导层可通过培训、政策和环境改造实施的行动，将安全与健康的责任从个体急救人员转移至组织。
