在养老院执行高风险居民护理活动的威胁:工作系统分析
Joel M Mumma1, Paige R Gannon1, Rachel Regina1
1Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.
Applied ergonomics
|April 23, 2025
概括
在养老院 (NHs) 中,多药耐药生物体 (MDRO) 的传播因额外的任务和长时间的护理活动而恶化. 改善NH工作系统对于支持医疗保健工作者 (HCW) 和居民至关重要,减少MDRO的传播.
科学领域:
- 与医疗保健相关的感染
- 在长期护理机构的感染控制.
- 患者安全工程 患者安全工程
背景情况:
- 多药耐药生物 (MDROs) 对养老院 (NH) 居民构成重大风险,增加了发病率和死亡率.
- 了解传播途径对于在NH环境中制定有效的感染控制策略至关重要.
研究的目的:
- 确定在NHs的居民护理活动中对MDRO传播的具体威胁和促成因素.
- 分析影响MDRO传输的已识别主题之间的相互关系.
- 为旨在减少国家公路中MDRO传播的干预措施提供信息.
主要方法:
- 与认证护理助理 (CNA) 进行焦点小组讨论,以确定最初的威胁.
- 应用患者安全系统工程倡议 (SEIPS) 工作系统模型.
- 使用模糊认知映射 (FCM) 来建模24个已识别的主题之间的因果关系.
主要成果:
- 两个突出的主题出现了:增加的身体接触和在高风险居民护理活动期间的预防性做法的缺失.
- 这些主题被额外或长时间的护理任务加剧了.
- 组织因素,居民特征和护理人员参与显著影响了这些促进传播的主题.
结论:
- 必须优化国家公路的工作系统,以更好地支持医疗保健工作者 (HCW) 和居民.
- 解决导致长期或复杂护理活动的因素是减少MDRO传播的关键.
- 干预措施应考虑HCW和居民的能力,局限性,需求和偏好,以提高安全性和降低感染风险.
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