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急诊医师对急诊部门执法活动的观察和态度。

Emergency Physician Observations and Attitudes on Law Enforcement Activities in the Emergency Department.

机构信息

Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York.

Icahn School of Medicine at Mount Sinai, Institute for Health Equity Research, Department of Population Health Science and Policy, New York, New York.

出版信息

West J Emerg Med. 2023 Feb 20;24(2):160-168. doi: 10.5811/westjem.2022.12.57098.

Abstract

INTRODUCTION

Law enforcement officers (LEO) interact with patients and clinicians in the emergency department (ED) for many reasons. There is no current consensus on what should comprise, or how to best enact, guidelines that ideally balance LEO activities in the service of public safety with patient health, autonomy, and privacy. The purpose of this study was to explore how a national sample of emergency physicians (EP) perceives activities of LEOs during the delivery of emergency medical care.

METHODS

Members of the Emergency Medicine Practice Research Network (EMPRN) were recruited via an email-delivered, anonymous survey that elicited experiences, perceptions, and knowledge of policies that guide interactions with LEOs in the ED. The survey included multiple-choice items, which we analyzed descriptively, and open-ended questions, which we analyzed using qualitative content analysis.

RESULTS

Of 765 EPs in the EMPRN, 141 (18.4%) completed the survey. Respondents represented diverse locations and years in practice. A total of 113 (82%) respondents were White, and 114 (81%) were male. Over a third reported LEO presence in the ED on a daily basis. A majority (62%) perceived LEO presence as helpful for clinicians and clinical practice. When asked about the factors deemed highly important in allowing LEOs to access patients during care, 75% reported patients' potential as a threat to public safety. A small minority of respondents (12%) considered the patients' consent or preference to interact with LEOs. While 86% of EPs felt that information-gathering by LEO was appropriate in the ED setting, only 13% were aware of policy to guide these decisions. Perceived barriers to implementation of policy in this area included: issues of enforcement; leadership; education; operational challenges; and potential negative consequences.

CONCLUSION

Future research is warranted to explore how policies and practices that guide intersections between emergency medical care and law enforcement impact patients, clinicians, and the communities that health systems serve.

摘要

简介

执法人员(LEO)出于多种原因在急诊科(ED)与患者和临床医生互动。目前还没有达成共识,即哪些内容应构成理想的平衡公共安全与患者健康、自主权和隐私的准则,以及如何最好地制定这些准则。本研究的目的是探讨全国范围内急诊医师(EP)如何看待 LEO 在提供紧急医疗服务时的活动。

方法

通过电子邮件发送匿名调查,向急诊医学实践研究网络(EMPRN)的成员招募人员,该调查征集了他们在 ED 与 LEO 互动时的经验、看法和政策知识。该调查包括多项选择题,我们对其进行了描述性分析,并对开放式问题进行了定性内容分析。

结果

在 EMPRN 中的 765 名 EP 中,有 141 名(18.4%)完成了调查。受访者代表了不同的地点和执业年限。共有 113 名(82%)受访者为白人,114 名(81%)为男性。超过三分之一的人报告称,他们每天在 ED 中都有 LEO 的存在。大多数(62%)人认为 LEO 的存在对临床医生和临床实践有帮助。当被问及认为哪些因素对允许 LEO 在护理期间接触患者非常重要时,75%的人报告称患者对公共安全构成潜在威胁。只有少数受访者(12%)认为患者同意或希望与 LEO 互动。虽然 86%的 EP 认为 LEO 在 ED 环境中收集信息是合适的,但只有 13%的人了解指导这些决策的政策。在这一领域实施政策的感知障碍包括:执行问题;领导;教育;运营挑战;以及潜在的负面后果。

结论

需要进一步研究,以探讨指导紧急医疗保健和执法交叉点的政策和实践如何影响患者、临床医生和医疗系统服务的社区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4626/10047729/d2ec1dfeda0c/wjem-24-160-g001.jpg

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