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偏远地区护士在非常偏远的基层医疗诊所工作场所安全体验:一项定性研究。

Remote area nurses' experiences of workplace safety in very remote primary health clinics: A qualitative study.

机构信息

James Cook University, Murtupuni Centre for Rural and Remote Health, Mount Isa, Queensland, Australia.

The Australian National University, School of Demography, Canberra, Australian Capital Territory, Australia.

出版信息

J Adv Nurs. 2024 Aug;80(8):3298-3308. doi: 10.1111/jan.16028. Epub 2024 Jan 7.

Abstract

AIM

To explore Remote Area Nurses' experiences of the implementation of workplace health and safety policies and risk mitigation strategies in Australian very remote primary health clinics.

DESIGN

This qualitative study used online semi-structured interviews, with participants purposively sampled to maximize variation in work location and service type. Data were analysed using a reflexive thematic analysis approach. Coding was carried out inductively, with NVivo 12 aiding data management.

SETTING

The interviews were conducted from 24 Februrary 2021 to 06 March 2021 with Remote Area Nurses from very remote primary health clinics in Australia.

PARTICIPANTS

Fifteen Remote Area Nurses participated in the study.

RESULTS

Thematic analysis revealed varied approaches to workplace safety among the different health services and regions. While the spread of 'never alone' policies in many clinics addressed one of the significant risks faced by Remote Area Nurses, gaps remained even for hazards specifically highlighted in existing work health and safety legislation. Meaningful collaboration with staff and the community, local orientation, preparation for the role and providing quality care were protective factors for staff safety. Understaffing, unsafe infrastructure and inadequate equipment were common concerns among Remote Area Nurses.

CONCLUSION

Health services need to prioritize workplace safety and take a continuous quality improvement approach to its implementation. This will include ensuring safety strategies are appropriate for the local context, improving infrastructure maintenance, and establishing sustainable second responder systems such as a pool of drivers with local knowledge.

IMPLICATIONS FOR THE PROFESSION

Poor personal safety contributes to burnout and high turnover of staff. Nurses' insights into the barriers and enablers of current workplace safety strategies will aid policymakers and employers in future improvements.

REPORTING METHOD

COREQ reporting guidelines were followed.

PIPE STATEMENT

A panel of six Remote Area Nurses collaborated in the development of this project.

摘要

目的

探讨澳大利亚偏远地区初级保健诊所的远程护士在实施工作场所健康和安全政策以及降低风险策略方面的经验。

设计

本定性研究采用在线半结构式访谈,参与者是根据工作地点和服务类型的差异进行有目的抽样的。使用反思性主题分析方法对数据进行分析。编码采用归纳法,使用 NVivo 12 辅助数据管理。

设置

访谈于 2021 年 2 月 24 日至 3 月 6 日在澳大利亚偏远地区初级保健诊所的远程护士中进行。

参与者

15 名远程护士参加了这项研究。

结果

主题分析显示,不同的卫生服务和地区采取了不同的工作场所安全方法。虽然许多诊所广泛推行“从不单独”政策,以解决远程护士面临的一个重大风险,但即使是在现有工作健康和安全法规中特别强调的危害方面,仍存在差距。与员工和社区进行有意义的合作、当地定位、为角色做好准备和提供高质量的护理是员工安全的保护因素。人手不足、基础设施不安全和设备不足是远程护士共同关注的问题。

结论

卫生服务需要优先考虑工作场所安全,并采取持续质量改进的方法来实施。这将包括确保安全策略适合当地情况,改善基础设施维护,并建立可持续的第二响应者系统,例如具有当地知识的司机储备。

对专业的影响

个人安全状况不佳会导致倦怠和员工高流动率。护士对当前工作场所安全策略的障碍和促成因素的见解将有助于政策制定者和雇主在未来进行改进。

报告方法

遵循 COREQ 报告准则。

PI 声明:六位远程护士组成一个小组共同参与了该项目的开发。

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