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Samantha Boettcher1, Jamie Aranda1, Ashley Pavlic1
1Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, USA.
临床医生适应实践以确保患者安全,使用协作和灵活性来克服挑战. 这种主动的方法,称为安全II,强调了复杂的医疗保健环境中实践变化的必要性.
科学领域:
- 医疗保健的质量和安全
- 临床实践适应 临床实践适应
- 紧急医疗 紧急医疗
背景情况:
- 传统的"安全I"观点将实践的变化视为威胁.
- 新兴的"安全II"范式承认可变性对于满足患者需求至关重要.
- 紧急诊所 (ED) 呈现复杂的环境,需要适应性临床实践.
研究的目的:
- 调查ED环境中临床医生使用的主动适应和实践可变性.
- 测试临床医生利用实践变性来提高患者安全的假设.
- 探索适应性实践,政策和临床医生的情感经验之间的关系.
主要方法:
- 在高等保健学术ED中对临床团队成员进行横截面调查研究.
- 关于主动安全和诱导反应分析的实例的定性数据收集.
- 使用利克特尺度进行定量数据收集,用于政策支持和在实践变化期间的情感体验.
主要成果:
- 报告了128个预防伤害的案例,其中合作是最常见的 (36.72%).
- 超过92%的受访者觉得能够适应患者的需求.
- 负面情绪 (自我怀疑,焦虑) 在遵守患者需求政策 (48.78%) 时是最高的.
结论:
- 临床团队成员积极采用适应性行为,特别是合作,以确保患者的安全.
- 治疗ED的临床医生通常感觉得到政策的支持,并能够适应患者的需求.
- 坚持严格的政策,尽管有患者的需要,可能会导致临床医生负面的情感体验.
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