Schmidt Michelle, Lambert Sophie Isabelle, Klasen Martin, Sandmeyer Benedikt, Lazarovici Marc, Jahns Franziska, Trefz Lara Charlott, Hempel Gunther, Sopka Saša
AIXTRA - Competence Center for Training and Patient Safety, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Department of Anaesthesiology, University Hospital RWTH Aachen, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Front Med (Lausanne). 2022 Oct 5;9:988746. doi: 10.3389/fmed.2022.988746. eCollection 2022.
The status of Safety Management is highly relevant to evaluate an organization's ability to deal with unexpected events or errors, especially in times of crisis. However, it remains unclear to what extent Safety Management was developed and sufficiently implemented within the healthcare system during the COVID-19 pandemic. Providing insights of potential for improvement is expected to be directional for ongoing Safety Management efforts, in times of crisis and beyond.
A nationwide survey study was conducted among healthcare professionals and auxiliary staff on German Intensive Care Units (ICUs) evaluating their experiences during the first wave of the COVID-19 pandemic. Error Management and Patient Safety Culture (PSC) measures served to operationalize Safety Management. Data were analyzed descriptively and by using quantitative content analysis (QCA).
Results for = 588 participants from 53 hospitals show that there is a gap between errors occurred, reported, documented, and addressed. QCA revealed that low quality of safety culture (27.8%) was the most mentioned reason for errors not being addressed. Overall, ratings of PSC ranged from 26.7 to 57.9% positive response with being the worst and being the best rated dimension. While assessments showed a similar pattern, medical staff rated PSC on ICUs more positively in comparison to nursing staff.
The status-analysis of Safety Management in times of crisis revealed relevant potential for improvement. Human Factor plays a crucial role in the occurrence and the way errors are dealt with on ICUs, but systemic factors should not be underestimated. Further intensified efforts specifically in the fields of staffing and error reporting, documentation and communication are needed to improve Safety Management on ICUs. These findings might also be applicable across nations and sectors beyond the medical field.
安全管理的状况与评估一个组织应对突发事件或错误的能力高度相关,尤其是在危机时期。然而,在新冠疫情期间,医疗系统内安全管理的发展程度和实施的充分程度仍不明确。提供改进潜力的见解有望为危机期间及之后正在进行的安全管理工作指明方向。
对德国重症监护病房(ICU)的医护人员和辅助人员进行了一项全国性调查研究,评估他们在新冠疫情第一波期间的经历。差错管理和患者安全文化(PSC)措施用于实施安全管理。对数据进行描述性分析并使用定量内容分析(QCA)。
来自53家医院的588名参与者的结果表明,在错误的发生、报告、记录和处理之间存在差距。QCA显示,安全文化质量低(27.8%)是错误未得到处理的最常提及原因。总体而言,PSC的评级中积极回应率在26.7%至57.9%之间,其中最差,是评级最好的维度。虽然评估显示出类似模式,但与护理人员相比,医务人员对ICU的PSC评价更积极。
危机时期安全管理的状态分析揭示了相关的改进潜力。人为因素在ICU错误的发生和处理方式中起着关键作用,但系统因素也不应被低估。需要在人员配备、差错报告、记录和沟通等领域进一步加大力度,以改善ICU的安全管理。这些发现可能也适用于医疗领域之外的其他国家和部门。