减少暴力和侵略:在急性精神卫生病房安全方面的质量改进项目
Katrina Kernaghan1,2, Kay Hurst3
1Department of Health Professions, Manchester Metropolitan University, Manchester, UK katrina.pommells@gmmh.nhs.uk.
BMJ open quality
|December 28, 2023
概括
质量改进方法在精神卫生病房的暴力和侵略 (V&A) 减少了20%. 干预措施包括安全通道捆绑和安全交叉,改善员工的安全感知.
科学领域:
- 心理健康护理 心理健康护理
- 提高质量 提高科学 提高质量
- 患者安全 患者安全
背景情况:
- 暴力和侵略 (V&A) 对患者,工作人员和精神卫生机构的护理质量构成重大风险.
- 在该项目之前,一个男性急性精神卫生病房平均每月发生21.3起V&A事件.
- 解决V&A对于改善治疗环境和患者结果至关重要.
研究的目的:
- 实施质量改进 (QI) 方法,在四个月内将V&A事件减少20%.
- 评估Safewards捆绑和安全交叉在缓解V&A方面的有效性.
- 提高急性精神卫生病房的员工和患者安全.
主要方法:
- 利用了QI方法,包括根本原因分析和计划-做-研究-行动 (PDSA) 周期.
- 实施了安全包 (培训,电子邮件,告示板) 和安全十字.
- 对V&A事件进行了基线和项目结束审计.
主要成果:
- 每周V&A事件减少了20%,从2.5降至2.0.
- 观察到记录的安全病房干预增加,工作人员报告的病房安全性有所改善.
- 在V&A事件和限制性做法之间发现了显著的相关性.
结论:
- 质量信息干预,特别是安全包,有助于减少V&A事件.
- 安全交叉需要进一步整合以影响V&A费率.
- 未来的项目应该监测患者变量和人员水平,并促进开放的沟通.
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