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医护人员使用患者升降机的障碍与促进因素:一项范围综述

Barriers and Facilitators for the Use of Patient Lifts by Healthcare Workers: A Scoping Review.

作者信息

Khairallah Ghassan M, Mowafi Hani, Al-Hajj Samar, Brackett Alexandria, Sakr Carine J

机构信息

Employee Health Unit, Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Beirut P.O. Box 11-0236, Lebanon.

Department of Emergency Medicine, Faculty of Medicine, Yale University, Yale-New Haven Hospital, New Haven, CT 06501, USA.

出版信息

Int J Environ Res Public Health. 2024 Dec 12;21(12):1659. doi: 10.3390/ijerph21121659.

Abstract

(1) Background: Patient lifts are evidence-based engineering controls used in Safe Patient Handling Programs to assist healthcare workers in moving patients. They have been shown to be beneficial for both healthcare workers and patients. However, these devices are not consistently used. This review aims to determine the scope of the literature and examine the barriers and facilitators for the use of patient lifts by healthcare workers, on a global level. (2) Methods: Electronic databases, including MEDLINE (Ovid), Embase (Ovid), Global Health (Ovid), CINAHL, Scopus, Web of Science-Core Collection, Cochrane CENTRAL, Trials Register of Promoting Health Interventions, PAIS Index (Proquest), and the gray literature were reviewed. Duplicates were removed, titles and abstracts were screened, full texts were assessed, and the quality of the studies were checked. The analysis was carried out qualitatively using thematic analysis. (3) Results: A total of 57 articles were included in this review. Most studies (71.9%) originated in the US alone, and none originated in low- and middle-income countries. The majority were quantitative studies and were conducted in acute care hospitals. The main identified barriers were equipment-related (e.g., time constraints, device unavailability, and inconvenient storage), followed by cultural and behavioral factors (peer pressure, resistance to change, and occupational socialization), followed by organizational factors (staff shortage and workload). The main identified facilitators were mostly organizational factors (leadership support, minimal lift policy, standardized protocols), followed by cultural and behavioral factors (safety culture and worker's empowerment), then equipment-related factors (device availability and accessibility). Patient- and worker-related factors were the least mentioned. (4) Conclusion: There is a complex interplay of organizational, equipment-related, and cultural factors shaping the use of lifts by healthcare workers. A multifaceted approach that focuses on enhancing organizational support, fostering a robust safety culture, and ensuring equipment availability is warranted.

摘要

(1) 背景:患者搬运设备是安全患者搬运计划中基于证据的工程控制措施,用于协助医护人员移动患者。已证明这些设备对医护人员和患者都有益处。然而,这些设备并未得到持续使用。本综述旨在确定文献范围,并在全球层面研究医护人员使用患者搬运设备的障碍和促进因素。(2) 方法:对电子数据库进行了检索,包括MEDLINE(Ovid)、Embase(Ovid)、Global Health(Ovid)、CINAHL、Scopus、Web of Science核心合集、Cochrane CENTRAL、促进健康干预试验注册库、PAIS Index(Proquest)以及灰色文献。去除重复文献,筛选标题和摘要,评估全文,并检查研究质量。采用主题分析法进行定性分析。(3) 结果:本综述共纳入57篇文章。大多数研究(71.9%)仅来自美国,没有来自低收入和中等收入国家的研究。大多数是定量研究,且在急症护理医院进行。确定的主要障碍是与设备相关的(如时间限制、设备不可用和储存不便),其次是文化和行为因素(同伴压力、对变革的抵触和职业社会化),然后是组织因素(人员短缺和工作量)。确定的主要促进因素大多是组织因素(领导支持、最小化搬运政策、标准化规程),其次是文化和行为因素(安全文化和员工赋权),然后是与设备相关的因素(设备可用性和可及性)。与患者和工作人员相关的因素提及最少。(4) 结论:组织、设备相关和文化因素之间存在复杂的相互作用,影响着医护人员对搬运设备的使用。需要采取多方面的方法,重点是加强组织支持、培育强大的安全文化并确保设备可用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e7e/11675142/bf4b08152440/ijerph-21-01659-g001.jpg

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