英国国民医疗服务体系（NHS）救护车服务中工作人员对患者安全的认知：一项探索性定性研究。
Staff perceptions of patient safety in the NHS ambulance services: an exploratory qualitative study.
作者信息
Shepard Keegan, Spencer Sally, Kelly Carol, Wankhade Paresh
机构信息
University of Oxford ORCID iD: https://orcid.org/0000-0003-3867-9752.
Edge Hill University.
出版信息
Br Paramed J. 2022 Mar 1;6(4):18-25. doi: 10.29045/14784726.2022.03.6.4.18.
OBJECTIVES
Most research investigating staff perceptions of patient safety has been based in primary care or hospitals, with little research on emergency services. Therefore, this study aimed to explore staff perceptions of patient safety in the NHS ambulance services.
DESIGN
A stratified qualitative study using semi-structured interviews.
SETTING
Three urban or rural ambulance service NHS trusts in England.
PARTICIPANTS
A total of 44 participants from three organisational levels, including executives, managers and operational staff.
METHODS
The semi-structured interviews explored the interpretation and definition of patient safety, perceived risks, incident reporting, communication and organisational culture. The framework method of qualitative data analysis was used to analyse the interviews and NVivo software was used to manage and organise the data.
RESULTS
We identified five dominant themes: varied interpretation of patient safety; significant patient safety risks; reporting culture shift; communication; and organisational culture. The findings demonstrated that staff perceptions of patient safety ranged widely across the three organisational levels, while they remained consistent within those levels across the participating ambulance service NHS trusts in England.
CONCLUSIONS
The findings suggest that participants from all organisational levels perceive that the NHS ambulance services have become much safer for patients over recent years, which signifies an awareness of the historical issues and how they have been addressed. The inclusion of three distinct ambulance service NHS trusts and organisational levels provides deepened insight into the perceptions of patient safety by staff. As the responses of participants were consistent across the three NHS trusts, the identified issues may be generic and have application in other ambulance and emergency service settings, with implications for health policy on a national basis.
目标
大多数关于员工对患者安全认知的研究都基于初级医疗保健或医院，对紧急服务的研究较少。因此，本研究旨在探讨英国国民保健制度（NHS）救护车服务中员工对患者安全的认知。
设计
采用半结构化访谈的分层定性研究。
地点
英格兰的三个城市或农村的NHS救护车服务信托机构。
参与者
共有44名来自三个组织层面的参与者，包括管理人员、经理和运营人员。
方法
半结构化访谈探讨了患者安全的解释和定义、感知风险、事件报告、沟通和组织文化。采用定性数据分析的框架方法对访谈进行分析，并使用NVivo软件管理和组织数据。
结果
我们确定了五个主要主题：对患者安全的不同解释；重大的患者安全风险；报告文化的转变；沟通；以及组织文化。研究结果表明，员工对患者安全的认知在三个组织层面上差异很大，而在英格兰参与研究的NHS救护车服务信托机构中，这些层面内的认知保持一致。
结论
研究结果表明，所有组织层面的参与者都认为，近年来NHS救护车服务对患者来说变得更加安全了，这表明人们意识到了历史问题以及这些问题是如何得到解决的。纳入三个不同的NHS救护车服务信托机构和组织层面，能更深入地了解员工对患者安全认知的情况。由于参与者在三个NHS信托机构中的回答一致，所确定的问题可能具有普遍性，适用于其他救护车和紧急服务环境，对国家层面的卫生政策具有启示意义。
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