住户,被打断:对紧急医疗住户工作流程的盲目,前性观察性研究
Kayla H Nussbaum1, Joseph Turner1, Xiaochun Li1
1Indiana University School of Medicine Indianapolis Indiana USA.
AEM education and training
|June 24, 2025
概括
紧急医疗人员经常面临工作流程中断,其中医生是最常见的原因. 虽然性别没有影响中断频率,但高急性区域和订单输入特别具有破坏性,影响了患者安全和居民福祉.
科学领域:
- 医学教育 医学教育
- 紧急医疗 紧急医疗
- 患者安全 患者安全
背景情况:
- 紧急医疗 (EM) 医生经常经历工作流中断,可能导致错误和效率下降.
- 学术EM住院医生对于患者护理至关重要,并且受到中断的影响.
- 这项研究旨在量化和描述EM居民经历的中断,包括基于性别的分析.
研究的目的:
- 评估急诊医生在班次期间遇到的中断的数量和类型.
- 根据居民性别调查中断频率的潜在差异.
- 识别与更高中断率相关的特定任务和设置.
主要方法:
- 这是一项双盲时间运动观察研究,涉及70名住院医生 (PGY1-PGY5).
- 两名失明观察员在不同环境 (学术,县,儿科ED) 和敏度水平的4小时内收集的数据.
- 观察涵盖了ED的所有工作时间,包括夜班.
主要成果:
- 没有发现基于性别的中断频率有显著差异.
- 高急性区域比低急性区域 (p < 0.05) 经历的中断明显更多.
- 在订单输入 (37%) 和绘图 (41.5%) 期间经常发生中断,居民17%的时间无法恢复任务. 临床医生是最常见的中断来源 (p < 0.0001).
结论:
- 紧急医疗的住户面临着很大的中断负担.
- 虽然没有检测到性别偏见,但在关键任务 (如订单输入和绘制图表) 期间的中断会影响患者安全和居民健康.
- 未来的干预措施应侧重于改善居民的任务交换能力,并提高医生对工作流程和安全的影响的认识.
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