医院护士和医生在识别病情恶化患者方面实施患者安全工作的经验：一项定性研究。
Hospital nurses and physicians' experiences practicing patient safety work to recognize deteriorating patients: a qualitative study.
机构信息
Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, Kunnskapsveien 55, 2006 Kjeller, Oslo, Norway.
Anesthesia Department, Akershus University Hospital (Ahus), P.O. Box 1000, Lørenskog, N-1478, Norway.
出版信息
BMC Health Serv Res. 2024 Nov 18;24(1):1429. doi: 10.1186/s12913-024-11908-x.
BACKGROUND
Measures to increase patient safety work aim to prevent patient harm and injuries in hospitals and are a priority worldwide. Several hospitals have implemented various rapid response systems to strengthen patient safety. Knowledge is limited concerning how health professionals interact and how they experience competence development and master emergency situations. The aim of the study was to explore and describe hospital nurses' and physicians' experiences with patient safety work, and the implications of this work for collaboration and competence in a hospital.
METHODS
We used a qualitative descriptive design and interviewed 21 nurses and physicians from a hospital in Norway. Data were analysed with systematic text condensation, a four-step thematic cross-case analysis. The study adheres to the COREQ guidelines for conducting qualitative research.
RESULTS
Through analysis, three categories were identified: strengthening a common clinical language for patient deterioration; sharing and transferring competencies across hospital wards and amongst professionals; and balancing time pressure and limited resources. The results showed that the patient safety work contributed to building bridges between health professionals and across hospital levels regarding deteriorating patients. It also provided structure and systematization to the hospital professionals' work with deteriorating patients. However, the results also demonstrated the complexity of maintaining patient safety, pointing to the need to balance limited time and resources in hospital.
CONCLUSIONS
The patient safety work presumably provides better emergency care, which may enhance patient safety in hospital. The complexity of hospital work, however, can influence the patient safety performance negatively, requiring health professionals to adopt robust, up-to-date skills and competencies in observing and assessing patient deterioration. In a busy hospital setting, the ability of health professionals to collaborate and communicate is important as they are faced with the challenges of balancing time-pressure and limited resources, which can potentially compromise patient safety work.
背景
提高患者安全工作的措施旨在预防医院患者伤害和损伤，这是全球范围内的优先事项。许多医院已经实施了各种快速反应系统来加强患者安全。关于卫生专业人员如何相互作用以及他们如何体验能力发展和掌握紧急情况，知识有限。本研究的目的是探讨和描述医院护士和医生在患者安全工作中的经验，以及这项工作对医院合作和能力的影响。
方法
我们采用定性描述性设计，对挪威一家医院的 21 名护士和医生进行了采访。数据采用系统文本浓缩法进行分析，即四步跨案例主题分析。该研究遵循 COREQ 进行定性研究的指南。
结果
通过分析，确定了三个类别：加强患者病情恶化的共同临床语言；在医院病房和专业人员之间共享和转移能力；平衡时间压力和有限资源。结果表明，患者安全工作有助于在卫生专业人员之间以及在医院各级之间建立关于病情恶化患者的桥梁。它还为医院专业人员对病情恶化患者的工作提供了结构和系统化。然而，结果还表明，维持患者安全的复杂性，需要在医院平衡有限的时间和资源。
结论
患者安全工作可能提供更好的急救护理，从而提高医院的患者安全性。然而，医院工作的复杂性可能会对患者安全绩效产生负面影响，需要卫生专业人员采用观察和评估患者恶化的强大、最新技能和能力。在繁忙的医院环境中，卫生专业人员的协作和沟通能力很重要，因为他们面临着平衡时间压力和有限资源的挑战，这可能会影响患者安全工作。
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