Fuller Sarah, Sheridan Emerie, Tan Jacinta, Nicholls Dasha
Imperial College London, London, UK
Northamptonshire Healthcare NHS Foundation Trust, Kettering, UK.
BMJ Open. 2024 Dec 20;14(12):e085955. doi: 10.1136/bmjopen-2024-085955.
To gain insights into the experience, and impact, of using security staff to facilitate physical restraints for nasogastric tube feeding.
A cross-sectional design using 39 individual interviews, three online focus groups and three written submissions involving young people with lived experience (PWLE), parents/carers, paediatric staff and security staff involved in nasogastric feeding under restraint in paediatric settings in England. Qualitative semistructured interviews were transcribed and thematically analysed.
53 individuals participated: seven security staff (all men); nine PWLE who experienced the intervention between the ages of 9 and 17 (all female); 20 parents (15 mothers, 5 fathers) and 20 paediatric staff (5 men, 15 women).
Regarding the involvement of security staff, participants spoke in relation to two primary themes (1) short-term impact and (2) long-term impact. Short-term themes included that the intervention felt inappropriate and traumatic while also recognising its lifesaving nature and the fact that involving security guards preserved positive relationships with nursing staff. Longer-term themes included the development of trauma symptoms, while also acknowledging the skill development and improved professional relationships that could result from delivering the intervention.
This lifesaving clinical intervention can negatively impact security staff as much as the patient, parents/carers and paediatric staff. A prebrief and debrief should be seen as part of the 'process'. Further research is needed to better understand what else can mitigate negative impacts.
深入了解使用安保人员协助对鼻饲管喂食进行身体约束的经验及影响。
采用横断面设计，进行了39次个人访谈、3次在线焦点小组讨论以及3份书面意见征集，参与者包括在英格兰儿科环境中经历过约束下鼻饲喂养的有实际经验的年轻人（PWLE）、父母/照顾者、儿科工作人员和安保人员。对定性半结构化访谈进行了转录和主题分析。
53人参与，其中7名安保人员（均为男性）；9名PWLE，年龄在9至17岁之间经历过该干预措施（均为女性）；20名父母（15名母亲，5名父亲）和20名儿科工作人员（5名男性，15名女性）。
关于安保人员的参与，参与者谈到了两个主要主题：（1）短期影响和（2）长期影响。短期主题包括该干预措施感觉不适当且具有创伤性，同时也认识到其挽救生命的性质以及安保人员的参与维护了与护理人员的良好关系。长期主题包括创伤症状的出现，同时也承认实施该干预措施可能带来技能发展和改善职业关系。
这种挽救生命的临床干预措施对安保人员以及患者、父母/照顾者和儿科工作人员可能产生同样大的负面影响。预简报和后简报应被视为“过程”的一部分。需要进一步研究以更好地了解还有哪些措施可以减轻负面影响。
