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大流行和灾害中的重症监护人员配置:大规模重症监护任务组一个小组委员会的共识报告-维持卫生保健劳动力的系统策略。

Critical Care Staffing in Pandemics and Disasters: A Consensus Report From a Subcommittee of the Task Force for Mass Critical Care - Systems Strategies to Sustain the Health Care Workforce.

机构信息

Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Sharp Coronado Hospital, Coronado, CA.

出版信息

Chest. 2023 Jul;164(1):124-136. doi: 10.1016/j.chest.2023.03.008. Epub 2023 Mar 11.

Abstract

BACKGROUND

The COVID-19 pandemic has led to unprecedented mental health disturbances, burnout, and moral distress among health care workers, affecting their ability to care for themselves and their patients.

RESEARCH QUESTION

In health care workers, what are key systemic factors and interventions impacting mental health and burnout?

STUDY DESIGN AND METHODS

The Workforce Sustainment subcommittee of the Task Force for Mass Critical Care (TFMCC) utilized a consensus development process, incorporating evidence from literature review with expert opinion through a modified Delphi approach to determine factors affecting mental health, burnout, and moral distress in health care workers, to propose necessary actions to help prevent these issues and enhance workforce resilience, sustainment, and retention.

RESULTS

Consolidation of evidence gathered from literature review and expert opinion resulted in 197 total statements that were synthesized into 14 major suggestions. These suggestions were organized into three categories: (1) mental health and well-being for staff in medical settings; (2) system-level support and leadership; and (3) research priorities and gaps. Suggestions include both general and specific occupational interventions to support health care worker basic physical needs, lower psychological distress, reduce moral distress and burnout, and foster mental health and resilience.

INTERPRETATION

The Workforce Sustainment subcommittee of the TFMCC offers evidence-informed operational strategies to assist health care workers and hospitals plan, prevent, and treat the factors affecting health care worker mental health, burnout, and moral distress to improve resilience and retention following the COVID-19 pandemic.

摘要

背景

COVID-19 大流行导致医护人员出现前所未有的心理健康紊乱、倦怠和道德困境,影响他们照顾自己和患者的能力。

研究问题

在医护人员中,哪些是影响心理健康和倦怠的关键系统因素和干预措施?

研究设计和方法

大规模关键护理任务组(TFMCC)的人员维持小组委员会利用共识发展过程,通过改良 Delphi 方法将文献综述中的证据与专家意见相结合,以确定影响医护人员心理健康、倦怠和道德困境的因素,提出必要的行动来帮助预防这些问题并增强劳动力的适应力、维持和保留。

结果

从文献综述和专家意见中收集的证据进行综合,共得到 197 条陈述,这些陈述被综合为 14 条主要建议。这些建议分为三类:(1)医疗环境中员工的心理健康和福祉;(2)系统层面的支持和领导;(3)研究重点和差距。建议包括支持医护人员基本生理需求、降低心理困扰、减少道德困境和倦怠、促进心理健康和适应力的一般性和特定职业干预措施。

解释

TFMCC 的人员维持小组委员会提供循证操作策略,以帮助医护人员和医院规划、预防和治疗影响医护人员心理健康、倦怠和道德困境的因素,以提高大流行后劳动力的适应力和保留。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/668b/10007715/7654097396c2/gr1_lrg.jpg

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