急诊科医护人员遭受的工作场所暴力--一项为期 10 年的单中心队列回顾性研究

Leo Benning, Gisbert W. Teepe, Jan Kleinekort, Jorun Thoma, Michael Clemens Röttger, Andrea Prunotto, Dominik Gottlieb, Stefan Klöppel, Hans-Jörg Busch, Felix P. Hans
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引用次数: 0

摘要

医务人员经常会遇到工作场所暴力 (WPV),这对医务人员和患者的安全都构成了威胁。针对急诊科(ED)工作人员的结构化降级培训(DET)已被证明会对 WPV 事件的报告产生积极影响,并有可能降低其影响。本研究旨在描述 WPV 事件的发生率、原因、手段、目标、地点、反应和时间的发展情况。此外,研究还探讨了接受过 DET 培训的人员对相应 WPV 事件的客观和主观严重性的影响。在一项回顾性、单中心队列研究中,我们使用员工观察侵犯量表-修订版(SOAS-R)的评分数据(0 至 22 分不等)分析了一家三级急诊室 2014 年至 2023 年十年间发生的 WPV 事件。这些事件由急诊室员工记录并存储在电子病历(EHR)中。2014年至2023年期间,160名工作人员记录了859起事件,平均感知严重程度为5.78(标度=2.65),SOAS-R评分为11.18(标度=4.21)。随着时间的推移,每万名患者的事件发生率呈上升趋势,但上升幅度不大。最常报告 WPV 事件的是护理人员,而攻击事件的原因往往无法辨别(n = 353,54.56%)。总共有 n = 273 起(31.78%)WPV 事件被归类为严重事件,而最常见的攻击行为目标是工作人员。WPV 事件最常发生在创伤科和戒毒室。虽然大多数事件都可以通过口头干预来解决,但在严重程度较高的 WPV 事件中,更多的情况下会采取更为强硬的干预措施。更多的 WPV 事件发生在非工作时间,其客观和主观严重程度也明显更高。总体而言,有完成 DET 的工作人员在场,SOAS-R 得分会明显提高,感知到的严重程度也会更高。研究结果强调了 WPV 事件与急诊室高风险环境的相关性。分析数据表明,DET 极大地促进了对 WPV 的认识。虽然大多数事件可以通过口头干预来解决,但 WPV 仍是一个需要通过组织措施和进一步研究来解决的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Workplace violence against healthcare workers in the emergency department — a 10-year retrospective single-center cohort study
Medical staff are regularly confronted with workplace violence (WPV), which poses a threat to the safety of both staff and patients. Structured de-escalation training (DET) for Emergency Department (ED) staff has been shown to positively affect the reporting of WPV incidents and possibly reduce its impact. This study aimed to describe the development of incidence rates, causes, means, targets, locations, responses, and the time of WPV events. Additionally, it explored the effect of the staff trained in DET on the objective and subjective severity of the respective WPV events. In a retrospective, single-center cohort study, we analyzed ten years of WPV events using the data of Staff Observation Aggression Scale-Revised (SOAS-R) score (ranging from 0 to 22) in a tertiary ED from 2014 to 2023. The events were documented by ED staff and stored in the electronic health record (EHR). Between 2014 and 2023, 160 staff members recorded 859 incidents, noting an average perceived severity of 5.78 (SD = 2.65) and SOAS-R score of 11.18 (SD = 4.21). Trends showed a non-significant rise in incident rates per 10,000 patients over time. The WPV events were most frequently reported by nursing staff, and the cause of the aggression was most often not discernible (n = 353, 54.56%). In total, n = 273 (31.78%) of the WPV events were categorized as severe, and the most frequent target of the aggressive behavior was the staff. WPV events occurred most frequently in the traumatology section and the detoxification rooms. While the majority of events could be addressed with verbal interventions, more forceful interventions were performed significantly more often for higher severity WPV events. More WPV events occurred during off-hours and were of a significantly higher objective and subjective severity. Overall, the presence of staff with completed DET led to significantly higher SOAS-R scores and higher perceived severity. The findings underline the relevance of WPV events in the high-risk environment of an ED. The analyzed data suggest that DET significantly fostered the awareness of WPV. While most events can be addressed with verbal interventions, WPV remains a concern that needs to be addressed through organizational measures and further research.
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