McInerney John, Lombardo Paul, Cowling Cynthia, Roberts Simone, Sim Jenny
Monash University, Clayton, VIC, Australia.
Ultrasound. 2023 Aug;31(3):186-194. doi: 10.1177/1742271X221131282. Epub 2022 Nov 16.
A lack of patient safety research hampers capacity to improve safety in healthcare.Ultrasound is often considered 'safe' as it does not use ionising radiation, a simplistic view of patient safety. Understanding sonographers' actions towards patient safety is crucial; however, self-reported measures cannot always predict behaviour. This study is part of a PhD exploring patient safety in medical diagnostic ultrasound. The aim of this paper is to explore sonographers' responses to the patient safety concerns identified in Part one of this study. The ultimate aim of the study is to inform the final phase of the doctoral study which will consider the next steps in improving the quality and safety of healthcare experienced by patients.
A qualitative study using semi-structured, one-on-one interviews. The Theory of Planned Behaviour (TPB) explained how sonographers respond to perceived patient safety risks in practice.
Thirty-one sonographers were interviewed. Based on the seven themes identified in Part one of the study, results showed that incongruences exist between identifying patient safety risks and the actions taken in practice to manage these risks.
The TPB showed that behavioural, normative and control beliefs impact sonographers' responses to perceived patient safety risks in practice and can lead to risk avoidance. Lack of regulation in ultrasound creates a challenge in dealing with Fitness to Practice issues. Collective actions are required to support sonographers in taking appropriate actions to enhance patient safety from multiple stakeholders including accreditation bodies, regulatory authorities, educational institutions and employers.
缺乏患者安全研究阻碍了提高医疗保健安全性的能力。超声通常被认为是“安全的”,因为它不使用电离辐射,这是对患者安全的一种简单化看法。了解超声检查人员在患者安全方面的行为至关重要;然而,自我报告的措施并不总能预测行为。本研究是一项探索医学诊断超声中患者安全的博士研究的一部分。本文的目的是探讨超声检查人员对本研究第一部分中确定的患者安全问题的反应。该研究的最终目的是为博士研究的最后阶段提供信息,该阶段将考虑改善患者所体验的医疗保健质量和安全性的下一步措施。
采用半结构化一对一访谈的定性研究。计划行为理论(TPB)解释了超声检查人员在实践中如何应对感知到的患者安全风险。
对31名超声检查人员进行了访谈。根据研究第一部分确定的七个主题,结果表明,在识别患者安全风险与实际采取的管理这些风险的行动之间存在不一致。
计划行为理论表明,行为、规范和控制信念会影响超声检查人员在实践中对感知到的患者安全风险的反应,并可能导致风险规避。超声领域缺乏监管给处理执业资格问题带来了挑战。需要采取集体行动,以支持超声检查人员采取适当行动,从包括认证机构、监管当局、教育机构和雇主在内的多个利益相关者那里提高患者安全。