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新冠疫情期间手术中心的安全氛围:混合方法研究

Safety climate in the surgical center during the Covid-19 pandemic: mixed-method study.

作者信息

Azevedo Ana Regina Ramos, Fassarella Cintia Silva, de Andrade Lourenção Daniela Campos, Camerini Flavia Giron, de Mendonça Henrique Danielle, da Silva Renata Flavia Abreu

机构信息

State University of Rio de Janeiro, Rua Boulevard 28 de Setembro, 157, Vila Isabel. CEP: 20551030, Rio de Janeiro, RJ, Brasil.

State University of Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

出版信息

BMC Nurs. 2023 Jun 9;22(1):197. doi: 10.1186/s12912-023-01358-x.

Abstract

CONTEXT

The gradual impact of the Covid-19 pandemic had important effects on routines in surgical environments. In order to cope with the impact and re-establish anaesthesiology and surgery procedures, it was imperative to pursue in-depth studies with a view to ensuring safe surgical care, reducing hazards, as well as protecting the health, safety and wellbeing of the health personnel involved. The purpose of this study was to evaluate quantitative and qualitative approaches to domains of safety climate among multi-professional staffs of surgical centres during the Covid-19 pandemic and to identify intersections.

METHODS

This mixed-method project employed a concomitant triangulation strategy on a quantitative approach in an exploratory, descriptive, cross-sectional study, as well as a qualitative approach by way of a descriptive study. Data were collected using the validated, self-applicable Safety Attitudes Questionnaire/Operating Room (SAQ/OR) questionnaire and a semi-structured interview script. The 144 participants were the surgical, anaesthesiology, nursing and support teams working in the surgical centre during the Covid-19 pandemic.

RESULTS

The study found an overall safety climate score of 61.94, the highest-scoring domain being 'Communication in the surgical environment' (77.91) and the lowest, 'Perception of professional performance' (23.60). On integrating the results, a difference was found between the domains 'Communication in the surgical environment' and 'Working conditions'. However, there was intersection by the 'Perception of professional performance' domain, which permeated important categories of the qualitative analysis.

CONCLUSIONS

For care practice, it is hoped to encourage improved patient safety, educational interventions to strengthen the patient safety climate and promote in-job wellbeing on the job for health personnel working in surgical centres. It is suggested that further studies explore the subject in greater depth among several surgical centres with mixed methods, so as to permit future comparisons and to monitor the evolving maturity of safety climate.

摘要

背景

新冠疫情的逐渐影响对外科手术环境中的日常工作产生了重要影响。为应对这一影响并重新建立麻醉学和外科手术程序,开展深入研究以确保安全的手术护理、减少风险以及保护相关医护人员的健康、安全和福祉势在必行。本研究的目的是评估新冠疫情期间外科中心多专业工作人员安全氛围各领域的定量和定性方法,并确定交叉点。

方法

这个混合方法项目在一项探索性、描述性横断面研究中对定量方法采用了同步三角测量策略,并通过描述性研究采用了定性方法。使用经过验证的、可自行填写的《安全态度问卷/手术室》(SAQ/OR)问卷和一份半结构化访谈脚本收集数据。144名参与者是新冠疫情期间在外科中心工作的外科、麻醉、护理和支持团队成员。

结果

研究发现总体安全氛围得分为61.94,得分最高的领域是“外科手术环境中的沟通”(77.91),得分最低的是“对专业表现的认知”(23.60)。综合结果发现,“外科手术环境中的沟通”和“工作条件”领域之间存在差异。然而,“对专业表现的认知”领域存在交叉点,该领域渗透到了定性分析的重要类别中。

结论

对于护理实践,希望鼓励提高患者安全,开展教育干预以加强患者安全氛围,并促进外科中心医护人员的在职幸福感。建议进一步研究采用混合方法在多个外科中心更深入地探讨该主题,以便未来进行比较并监测安全氛围的不断发展成熟情况。

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本文引用的文献

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Nurse safety culture in the services of a university hospital.大学医院服务中的护士安全文化。
Rev Bras Enferm. 2019 Jun 27;72(3):767-773. doi: 10.1590/0034-7167-2018-0376.

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