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Fekonja Z, Kmetec S, Mlinar Reljić N, Černe Kolarič J, Pajnkihar M, Strnad M. Perceptions of Patient Safety Culture among Triage Nurses in the Emergency Department: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:3155. [PMID: 38132045 PMCID: PMC10742489 DOI: 10.3390/healthcare11243155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 11/23/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
The patient safety culture is key to ensuring patient safety in healthcare organizations. The triage environment is inherently demanding for patient safety and is characterized by high stress, rapid decision-making, and quick action. In several countries, including Slovenia, there is a lack of studies on the patient safety culture among triage nurses. This study aimed to assess the perceptions of the patient safety culture among triage nurses. A cross-sectional survey design was used. The Emergency Medical Services-Safety Attitudes Questionnaire, distributed to triage nurses, was used to collect data. A total of 201 triage nurses participated in this study. The results revealed that the overall average perception of the patient safety culture was 57.27% (SD = 57.27), indicating that the perception of the patient safety culture among triage nurses in the emergency department was non-positive and requires improvement. "Job Satisfaction" received the highest score (63.18%; SD = 17.19), while "Working Conditions" received the lowest (49.91%; SD = 17.37). The perception of positive and negative safety culture responses was statistically significant for age (χ2 (3) = 17.750, p ≤ 0.001), education (χ2 (2) = 6.957, p = 0.031) and length of working experience (χ2 (3) = 8.875, p = 0.031). The findings emphasize the significance of improving the safety culture in relation to several areas of patient care during the triage process. This research serves as a crucial foundation for enhancing patient safety in triage, providing quality care, and reducing adverse events.
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Affiliation(s)
- Zvonka Fekonja
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (S.K.); (N.M.R.); (J.Č.K.); (M.P.)
| | - Sergej Kmetec
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (S.K.); (N.M.R.); (J.Č.K.); (M.P.)
| | - Nataša Mlinar Reljić
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (S.K.); (N.M.R.); (J.Č.K.); (M.P.)
| | - Jožica Černe Kolarič
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (S.K.); (N.M.R.); (J.Č.K.); (M.P.)
| | - Majda Pajnkihar
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia; (S.K.); (N.M.R.); (J.Č.K.); (M.P.)
| | - Matej Strnad
- Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia;
- Emergency Department, University Clinical Centre Maribor, 2000 Maribor, Slovenia
- Center for Emergency Medicine, Prehospital Unit, Community Healthcare Center, 2000 Maribor, Slovenia
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Kosydar-Bochenek J, Religa D, Knap M, Czop M, Knap B, Mędrzycka-Dąbrowska W, Krupa S. Safety climate perceived by pre-hospital emergency care personnel-an international cross-sectional study. Front Public Health 2023; 11:1192315. [PMID: 37529436 PMCID: PMC10390026 DOI: 10.3389/fpubh.2023.1192315] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/23/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction Improving patient safety is one of the most critical components of modern healthcare. Emergency medical services (EMS) are, by nature, a challenging environment for ensuring patient safety. It is fast-paced, physically dangerous, and highly stressful, requiring rapid decision-making and action. This can create risks not only for patients but also for employees. We assessed variations in perceptions of safety culture in prehospital emergency care among an international sample of paramedics and nurses. Methods The Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) was used for the study. The instrument measures six domains of safety culture in the workplace: teamwork climate, job satisfaction, safety climate, working conditions, stress recognition, and perceptions of management. A total of 1,128 EMS from 9 countries participated in this study. Results Safety Climate was 81.32/100 (SD 6.90), Teamwork Climate 84.14/100 (SD 8.74), Perceptions of Management 76.30/100 (SD 10.54), Stress Recognition 89.86/100 (SD 5.70), Working Conditions 81.07/100 (SD 9.75), and Job Satisfaction 70.71/100 (SD 7.21). There was significant variation in safety culture scores across countries for teamwork climate (TWC), working conditions (WC), and job satisfaction (JS). Among the individual variables (age, gender, level of education, and work experience), variations in safety culture scores were unaffected by age, gender, or work experience. Organizational characteristics: employment status and position type were linked to significant variations in safety culture domain scores. Conclusion Participants' perceptions of the patient safety climate were not particularly satisfactory, confirming that there is still a need to develop a culture of patient safety in prehospital emergency care.
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Affiliation(s)
- Justyna Kosydar-Bochenek
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Rzeszów, Poland
| | - Dorota Religa
- Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, Stockholm, Sweden
| | - Małgorzata Knap
- Institute of Health Sciences, Collegium Medicum of the Jan Kochanowski University of Kielce, Kielce, Poland
| | - Marcin Czop
- Department of Clinical Genetics, Medical University of Lublin, Lublin, Poland
| | - Bartosz Knap
- Doctoral School, Medical University of Lublin, Lublin, Poland
- Chair and Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anesthesiology Nursing and Intensive Care, Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | - Sabina Krupa
- Institute of Health Sciences, College of Medical Sciences of the University of Rzeszow, Rzeszów, Poland
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Thielmann B, Schwarze R, Böckelmann I. A Systematic Review of Associations and Predictors for Job Satisfaction and Work Engagement in Prehospital Emergency Medical Services-Challenges for the Future. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4578. [PMID: 36901586 PMCID: PMC10002026 DOI: 10.3390/ijerph20054578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Ambulance services are changing, and the SARS-CoV-2 pandemic has been a major challenge in the past three years. Job satisfaction and work engagement are important characteristics for a healthy organization and success in one's profession. The purpose of the current systematic review was to evaluate the predictors of job satisfaction and work engagement in prehospital emergency medical service personnel. Electronic databases, such as PubMed, Ovid Medline, Cochrane Library, Scopus, Web of Science, PsycINFO, PSYNDEX, and Embase, were utilized in this review. Predictors (ß coefficient, odds ratio, rho) of higher job satisfaction and work engagement were examined. Only prehospital emergency medical service personnel were considered. The review included 10 studies worldwide with 8358 prehospital emergency medical service personnel (24.9% female). The main predictor for job satisfaction was supervisors' support. Other predictors were younger or middle age and work experience. Emotional exhaustion and depersonalization, as burnout dimensions, were negative predictors for higher job satisfaction or work engagement. Quality demands for health care systems are a significant challenge for future emergency medical services. The psychological and physical strengthening of employees is necessary and includes constant supervision of managers or facilitators.
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Patterson PD, Martin SE, Brassil BN, Hsiao WH, Weaver MD, Okerman TS, Seitz SN, Patterson CG, Robinson K. The Emergency Medical Services Sleep Health Study: A cluster-randomized trial. Sleep Health 2023; 9:64-76. [PMID: 36372657 DOI: 10.1016/j.sleh.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Greater than half of emergency medical services (EMS) clinician shift workers report poor sleep, fatigue, and inadequate recovery between shifts. We hypothesized that EMS clinicians randomized to receive tailored sleep health education would have improved sleep quality and less fatigue compared to wait-list controls after 3 months. METHODS We used a cluster-randomized, 2-arm, wait-list control study design (clinicaltrials.gov identifier: NCT04218279). Recruitment of EMS agencies (clusters) was nationwide. Our study was powered at 88% to detect a 0.4 standard deviation difference in sleep quality with 20 agencies per arm and a minimum of 10 individuals per agency. The primary outcome was measured using the Pittsburgh Sleep Quality Index (PSQI) at 3-month follow-up. Our intervention was accessible in an online, asynchronous format and comprised of 10 brief education modules that address fatigue mitigation topics prescribed by the American College of Occupational Environmental Medicine. RESULTS In total, 36 EMS agencies and 678 individuals enrolled. Attrition at 3 months did not differ by study group (Intervention = 17.4% vs. Wait-list control = 18.2%; p = .37). Intention-to-treat analyses detected no differences in PSQI and fatigue scores at 3 months. Per protocol analyses showed the greater the number of education modules viewed, the greater the improvement in sleep quality and the greater the reduction in fatigue (p < .05). CONCLUSIONS While intention-to-treat analyses revealed no differences in sleep quality or fatigue at 3 months, per protocol findings identified select groups of EMS clinician shift workers who may benefit from sleep health education. Our findings may inform fatigue risk management programs.
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Affiliation(s)
- P Daniel Patterson
- University of Pittsburgh, School of Medicine, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USA; University of Pittsburgh, School of Health and Rehabilitation Sciences, Division of Community Health Services, Emergency Medicine Program, Pittsburgh, Pennsylvania, USA.
| | - Sarah E Martin
- University of Pittsburgh, School of Medicine, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Bridget N Brassil
- University of Pittsburgh, School of Medicine, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Wei-Hsin Hsiao
- University of Pittsburgh, School of Medicine, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Matthew D Weaver
- Brigham and Women's Hospital, Division of Sleep and Circadian Disorders, Boston, Massachusetts, USA; Harvard Medical School, Division of Sleep Medicine, Boston, Massachusetts, USA
| | - Tiffany S Okerman
- University of Pittsburgh, School of Medicine, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Staci N Seitz
- University of Pittsburgh, School of Medicine, Department of Emergency Medicine, Pittsburgh, Pennsylvania, USA
| | - Charity G Patterson
- University of Pittsburgh, School of Health and Rehabilitation Sciences, Department of Physical Therapy, Pittsburgh, Pennsylvania, USA
| | - Kathy Robinson
- National Association of State EMS Officials (NASEMSO), Falls Church, Virginia, USA
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Alacahan ÖF, Güllüoğlu AN, Karagöz N. Occupational safety perceptions of prehospital emergency health services employees: A sample of Sivas central district. Work 2023; 76:1441-1453. [PMID: 37393470 DOI: 10.3233/wor-220425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Prehospital emergency health services ambulance workers are in the risky class in terms of occupational health and safety, and they are faced with more risks due to the fact that they are the first responders to the events, especially regarding COVID-19. OBJECTIVE The aim of the present study is to determine the occupational risk perceptions of health care workers and their relations with demographic variables. METHODS A literature review was performed to develop a questionnaire. This questionnaire was used in a survey with 250 respondents. The collected data was analysed through factor analysis. Cronbach's Alpha was calculated to verify the reliability of the data. RESULTS The risk perceptions of the employees (Factor 1 and Factor 3) differ significantly according to gender. Another important point is that 60.3% of the participants stated that they "agree" with the statement that health workers "experience violence" during work. CONCLUSION The risk perception of women was found to be higher, and the reason for this is that women are less physically strong than men along with social gender roles and gender discrimination.
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Affiliation(s)
| | - Arif Nihat Güllüoğlu
- Metallurgy and Materials Engineering Department, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Naim Karagöz
- Public Health Department, School of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Han S, Park HJ, Jeong WJ, Kim GW, Choi HJ, Moon HJ, Lee K, Choi HJ, Park YJ, Cho JS, Lee CA. Application of the Team Emergency Assessment Measure for Prehospital Cardiopulmonary Resuscitation. J Clin Med 2022; 11:jcm11185390. [PMID: 36143045 PMCID: PMC9502771 DOI: 10.3390/jcm11185390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/10/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction: Communication and teamwork are critical for ensuring patient safety, particularly during prehospital cardiopulmonary resuscitation (CPR). The Team Emergency Assessment Measure (TEAM) is a tool applicable to such situations. This study aimed to validate the TEAM efficiency as a suitable tool even in prehospital CPR. Methods: A multi-centric observational study was conducted using the data of all non-traumatic out-of-hospital cardiac arrest patients aged over 18 years who were treated using video communication-based medical direction in 2018. From the extracted data of 1494 eligible patients, 67 sample cases were randomly selected. Two experienced raters were assigned to each case. Each rater reviewed 13 or 14 videos and scored the TEAM items for each field cardiopulmonary resuscitation performance. The internal consistency, concurrent validity, and inter-rater reliability were measured. Results: The TEAM showed high reliability with a Cronbach’s alpha value of 0.939, with a mean interitem correlation of 0.584. The mean item–total correlation was 0.789, indicating significant associations. The mean correlation coefficient between each item and the global score range was 0.682, indicating good concurrent validity. The mean intra-class correlation coefficient was 0.804, indicating excellent agreement. Discussion: The TEAM can be a valid and reliable tool to evaluate the non-technical skills of a team of paramedics performing CPR.
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Affiliation(s)
- Sangsoo Han
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Hye Ji Park
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea
| | - Won Jung Jeong
- Department of Emergency Medicine, Catholic University of Korea, St. Vincent’s Hospital, Seoul 06591, Korea
| | - Gi Woon Kim
- Department of Emergency Medicine, Soonchunhyang University Bucheon Hospital, Bucheon 14584, Korea
| | - Han Joo Choi
- Department of Emergency Medicine, Dankook University Hospital, Cheonan 31116, Korea
| | - Hyung Jun Moon
- Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Cheonan 31151, Korea
| | - Kyoungmi Lee
- Department of Emergency Medicine, Myongji Hospital, Goyang 10475, Korea
| | - Hyuk Joong Choi
- Department of Emergency Medicine, Hanyang University Guri Hospital, Guri 11923, Korea
| | - Yong Jin Park
- Department of Emergency Medicine, Chosun University Hospital, Gwangju 61453, Korea
| | - Jin Seong Cho
- Department of Emergency Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
| | - Choung Ah Lee
- Department of Emergency Medicine, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea
- Correspondence: ; Tel.: +82-31-8086-2611
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Taylor JA, Murray RM, Davis AL, Brandt-Rauf S, Allen JA, Borse R, Pellechia D, Picone D. Model Policies to Protect U.S. Fire-Based EMS Responders From Workplace Stress and Violence. New Solut 2022; 32:119-131. [PMID: 35322702 PMCID: PMC9280702 DOI: 10.1177/10482911221085728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The stress and violence to fire-based emergency medical service responders (SAVER) Systems-Level Checklist is an organizational-level intervention to address stress and violence in emergency medical service (EMS), focused on the development of policy and training. Fire and EMS leadership, first responders, dispatchers, and labor union representatives participated in the SAVER Model Policy Collaborative to develop model policies that resulted from the most feasible checklist items. ThinkLets technology was employed to achieve consensus on the model policies, and an Action SWOT analysis was then conducted to assess facilitators and barriers to policy implementation. The resultant model policies are a systems-level workplace violence intervention for the U.S. fire and rescue service that is ready for implementation. Expected improvements to organizational outcomes such as burnout, job engagement, and job satisfaction are anticipated, as are decreasing assaults and injuries. The SAVER Model Policies have the potential to inform national standards and regulations on workplace violence in EMS.
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Affiliation(s)
- Jennifer A. Taylor
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Regan M. Murray
- Health, Human Performance and Recreation, University of Arkansas College of Education and Health Professions, Fayetteville, AR, USA
| | - Andrea L. Davis
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Sherry Brandt-Rauf
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | | | | | | | - David Picone
- San Diego Fire-Rescue Department, San Diego, CA, USA
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Nowrouzi-Kia B, Nixon J, Ritchie S, Wenghofer E, VanderBurgh D, Sherman J. Examining the quality of work-life of paramedics in northern Ontario, Canada: A cross-sectional study. Work 2022; 72:135-147. [DOI: 10.3233/wor-205025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Paramedics are exposed to multiple stressors in the workplace. They are more likely to develop occupational-related stress conditions compared to other occupations. This study focused on understanding the factors affecting QoWL of paramedics in northern Ontario, Canada; a particular focus was on understanding the personal and organizational factors, such as practicing community paramedicine (CP), which may be associated with Quality of Work Life (QoWL). METHODS: Paramedic QoWL was assessed using an online survey that was distributed to approximately 879 paramedics across northern Ontario. The survey included the 23-Item Work- Related Quality of Work Life Scale. Data analysis involved linear regressions with nine predictor variables deemed to be related to QoWL for paramedics with QoWL and its six subscales as dependent variables. Multiple linear regressions were used to assess the personal and organizational factors, such as practicing of CP, which predicted QoWL. RESULTS: One hundred and ninety-seven paramedics completed the questionnaire. Overall, the mean QoWL score of all paramedic participants was 73.99, and this average compared to relevant published norms for other occupations. Factors that were most associated with higher QoWL were, experience practicing CP (p < 0.05), number of sick days/year (p < 0.01), and higher self- rated mental health (p < 0.001). CONCLUSIONS: Higher paramedic QoWL appears to be associated with many factors such as number of sick days per year, self-rated mental health, and participation in CP. EMS organizations should consider establishing necessary workplace health promotion strategies that are targeted at improving QoWL for paramedics.
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Affiliation(s)
- B. Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada
- School of Kinesiology and Health Sciences, Faculty of Education and Health, Laurentian University, Sudbury, ON, Canada
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | | | - S.D. Ritchie
- School of Kinesiology and Health Sciences, Faculty of Education and Health, Laurentian University, Sudbury, ON, Canada
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | - E.F. Wenghofer
- School of Kinesiology and Health Sciences, Faculty of Education and Health, Laurentian University, Sudbury, ON, Canada
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, ON, Canada
| | - D. VanderBurgh
- Department of Family Medicine, McMaster University, Hamilton, Ontario, ON, Canada
| | - J.E. Sherman
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, ON, Canada
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Cooper BH. Exploring the factors that influence trauma team activation in emergency department staff. Emerg Nurse 2022; 30:e2133. [PMID: 35502574 DOI: 10.7748/en.2022.e2133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/09/2022]
Abstract
Regional trauma networks enable the rapid and safe management and transfer of patients with traumatic injury between designated trauma units and one of 27 major trauma centres throughout the UK. Multispecialty trauma teams are available 24 hours a day, seven days a week, and are activated immediately upon receipt of a patient presenting with major trauma. With most serious trauma patients going direct to major trauma centres rather than a less specialised hospital-based trauma unit, it can be challenging for hospital-based trauma unit staff to gain experience and skill in this area, leading to potential inconsistencies in the process of activating the trauma team. The aim of this service evaluation was to identify factors influencing the decision to activate the trauma team in emergency department (ED) staff working within a 700-bed trauma unit. A questionnaire was sent to 107 staff and 70 completed it, a response rate of 65%. Results indicated that shortfalls in trauma-specific training, lack of clinical experience, undefined roles and responsibilities, department culture, ambulance handover, knowledge of clinical guidelines and previous experience of trauma team activation all affected the decision to activate the trauma team. Trauma-specific training and the support of senior staff could enhance confidence and appropriate trauma team activation rates.
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González-Recio S, Boada-Cuerva M, Serrano-Fernández MJ, Assens-Serra J, Araya-Castillo L, Boada-Grau J. Personality and impulsivity as antecedents of occupational health in the construction industry. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:2403-2410. [PMID: 34704546 DOI: 10.1080/10803548.2021.1992946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives. In health and safety at work, two main groups of causes of occupational accidents have been identified: unsafe conditions or technical factors; and the causes related to safe behavior or the human factor. The objective of this study is to analyze the predictive variables (emotional intelligence, personality, impulsivity and safety of the work environment) for three factors of the CONS-32 scale (criterion variables: use of protections, personal risk behavior and personal physical workload) in the construction sector. Methods. Using a sample of 256 Spanish workers from this sector, we analyzed the significant correlations between the three criterion variables and a set of variables extracted from various instruments, as well as the regression models that explain most of the variance. Results. The results show that the main predictive variables that explain the three factors are those related to responsibility as a personality trait, impulsivity and safety of the work environment. Conclusions. Based on the empirical evidence found, the most explanatory factor in all cases is safety climate in the work environment.
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Affiliation(s)
- Sonia González-Recio
- Faculty of Education Sciences and Psychology, Universitat Rovira i Virgili (URV), Spain.,Faculty of Education Sciences and Psychology, Universitat Oberta de Catalunya (UOC), Spain
| | | | - María-José Serrano-Fernández
- Faculty of Education Sciences and Psychology, Universitat Rovira i Virgili (URV), Spain.,Faculty of Education Sciences and Psychology, Universitat Oberta de Catalunya (UOC), Spain
| | - Jordi Assens-Serra
- Department of Strategy, Leadership & People, EADA Business School, Spain
| | | | - Joan Boada-Grau
- Faculty of Education Sciences and Psychology, Universitat Rovira i Virgili (URV), Spain.,Faculty of Education Sciences and Psychology, Universitat Oberta de Catalunya (UOC), Spain
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11
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Exploring safety culture in the Finnish ambulance service with Emergency Medical Services Safety Attitudes Questionnaire. Scand J Trauma Resusc Emerg Med 2021; 29:148. [PMID: 34641925 PMCID: PMC8507218 DOI: 10.1186/s13049-021-00960-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
Background Emergency Medical Services (EMS) is, by its nature, a challenging context that may create risks for both patients and employees. It is also known that an organisation’s safety culture has an influence on both patient and employee safety. Finnish EMS organisations lack knowledge of how their safety culture is perceived by their employees. Aim This study aims to test the psychometric properties of the Emergency Medical Services Safety Attitudes Questionnaire (EMS-SAQ) in a Finnish EMS setting. We also explore the connections between individual- and organisation-based characteristics and safety attitudes in the Finnish EMS. Methods A cross-sectional survey study design was used. The EMS-SAQ was used to collect data via social media. The instrument measures six domains of workplace safety culture: safety climate, teamwork climate, perceptions of management, job satisfaction, working conditions and stress recognition. The 5-point Likert scale was converted to a 100-point scale and mean ≥ 75 was dichotomized as a positive. Confirmatory factor analysis (CFA) was carried out to validate the EMS-SAQ in a Finnish setting. Other results were analysed by using non-parametric tests. Results 327 responses were included in the analysis. CFA showed that the total EMS-SAQ model had acceptable goodness-of-fit values in the Finnish EMS setting. Total mean scores for each safety culture domain were identified non-positively (mean score < 75); safety climate 60.12, teamwork climate 60.92, perceptions of management 56.31, stress recognition 64.55, working conditions 53.43 and job satisfaction 70.36. Higher education was connected to lower job satisfaction and the teamwork climate within the individual characteristics. All organisation-based characteristics caused at least one significant variation in the safety culture domain scores. Working area significantly affected (p < 0.05) five out of the six safety culture domain scores. Conclusions The EMS-SAQ is a valid tool to evaluate safety culture among the Finnish EMS organisations; it offers a novel method to evaluate safety and patient safety within the Finnish EMS organisations. According to the findings, the organisation-based characteristics more likely had an impact on safety attitudes than did the individual-based characteristics. Therefore, it is suggested that the Finnish EMS organisations undertake safety culture development at the organisational level. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00960-9.
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12
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Conti SM, Kroening LR, Molles JJ, Davenport ML, Kinsler RE, Lloyd AL. Optimal Physical Space for En Route Care: Medic Posture and Injury Survey. Mil Med 2021; 186:305-310. [PMID: 32968770 DOI: 10.1093/milmed/usaa223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION An anonymous online survey was presented to active duty U.S. Army, Reserve, and National Guard Soldiers with experience as en route care medical providers with the intent of identifying factors which contribute to musculoskeletal disorders in U.S. Army en route care medical providers. The survey looked at transport vehicle design, equipment, and awkward postures that could play a role in causing injuries. MATERIALS AND METHODS Survey responses were received from 60 en route care providers regarding postures assumed during administration of en route critical care tasks, routine medical transport scenarios, and patient loading. Care providers reported gender, height, weight, experience, tasks, and awkward postures experienced. They also reported occupational injuries that occurred as a result of performing job duties, such as back, neck, and joint pain, injuries, and discomfort. RESULTS The survey was answered by 56 (93.3%) males and 4 females (6.7%) with an average of 7.34 years of experience as en route care personnel. Lower back injuries were suffered by 87% of respondents. The most common causes were awkward positions and lifting patients. There are statistically significant relationships between shoulder injuries and overextending, lower back injuries and overextending, and lower back injuries and reaching backwards, ankle injuries and care provider height, and knee injuries and the frequency at which care providers utilized the postures of kneeling, squatting, reaching behind themselves, and straining to lift a heavy weight. Loading and unloading patients from evacuation platforms was among the top causes of all awkward postures among respondents. CONCLUSION Results of this survey emphasize the need for injury mitigation and prevention strategies to reduce impacts on soldier health and readiness.
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Affiliation(s)
- Sandra M Conti
- U.S. Army Aeromedical Research Laboratory, 6901 Farrell Rd,, Fort Rucker, AL 36362.,Goldbelt Frontier, LLC, 5500 Cherokee Ave Suite 100 Alexandria, VA 22302
| | - Laura R Kroening
- U.S. Army Aeromedical Research Laboratory, 6901 Farrell Rd,, Fort Rucker, AL 36362.,Oak Ridge Institute for Science and Education, 130 Badger Rd, Oak Ridge, TN 37830
| | - Jeffrey J Molles
- U.S. Army Aeromedical Research Laboratory, 6901 Farrell Rd,, Fort Rucker, AL 36362.,Goldbelt Frontier, LLC, 5500 Cherokee Ave Suite 100 Alexandria, VA 22302
| | - Matthew L Davenport
- U.S. Army Aeromedical Research Laboratory, 6901 Farrell Rd,, Fort Rucker, AL 36362
| | - Rachel E Kinsler
- U.S. Army Aeromedical Research Laboratory, 6901 Farrell Rd,, Fort Rucker, AL 36362
| | - Amy L Lloyd
- U.S. Army Aeromedical Research Laboratory, 6901 Farrell Rd,, Fort Rucker, AL 36362.,Goldbelt Frontier, LLC, 5500 Cherokee Ave Suite 100 Alexandria, VA 22302
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O’connor P, O’malley R, Oglesby AM, Lambe K, Lydon S. Measurement and monitoring patient safety in prehospital care: a systematic review. Int J Qual Health Care 2021; 33:mzab013. [PMID: 33459774 PMCID: PMC10517741 DOI: 10.1093/intqhc/mzab013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 01/05/2021] [Accepted: 01/18/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Prehospital care is potentially hazardous with the possibility for patients to experience an adverse event. However, as compared to secondary care, little is known about how patient safety is managed in prehospital care settings. OBJECTIVES The objectives of this systematic review were to identify and classify the methods of measuring and monitoring patient safety that have been used in prehospital care using the five dimensions of the Measuring and Monitoring Safety (MMS) framework and use this classification to identify where there are safety 'blind spots' and make recommendations for how these deficits could be addressed. METHODS Searches were conducted in January 2020, with no limit on publication year, using Medline, PsycInfo, CINAHL, Web of Science and Academic Search. Reference lists of included studies and existing related reviews were also screened. English-language, peer-reviewed studies concerned with measuring and monitoring safety in prehospital care were included. Two researchers independently extracted data from studies and applied a quality appraisal tool (the Quality Assessment Tool for Studies with Diverse Designs). RESULTS A total of 5301 studies were screened, with 52 included in the review. A total of 73% (38/52) of the studies assessed past harm, 25% (13/52) the reliability of safety critical processes, 1.9% (1/52) sensitivity to operations, 38.5% (20/52) anticipation and preparedness and 5.8% (3/52) integration and learning. A total of 67 methods for measuring and monitoring safety were used across the included studies. Of these methods, 38.8% (26/67) were surveys, 29.9% (20/67) were patient records reviews, 14.9% (10/67) were incident reporting systems, 11.9% (8/67) were interviews or focus groups and 4.5% (3/67) were checklists. CONCLUSIONS There is no single method of measuring and monitoring safety in prehospital care. Arguably, most safety monitoring systems have evolved, rather than been designed. This leads to safety blind spots in which information is lacking, as well as to redundancy and duplication of effort. It is suggested that the findings from this systematic review, informed by the MMS framework, can provide a structure for critically thinking about how safety is being measured and monitored in prehospital care. This will support the design of a safety surveillance system that provides a comprehensive understanding of what is being done well, where improvements should be made and whether safety interventions have had the desired effect.
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Affiliation(s)
- Paul O’connor
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
| | - Roisin O’malley
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
| | - Anne-Marie Oglesby
- Health Protection and Surveillance Centre, 25-27 Middle Gardiner St, Dublin 1, Ireland
| | - Kathryn Lambe
- Discipline of General Practice, School of Medicine, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
| | - Sinéad Lydon
- Irish Centre for Applied Patient Safety and Simulation, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
- School of Medicine, National University of Ireland Galway, Galway H91 TK33, County Galway, Ireland
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Roth K, Baier N, Felgner S, Busse R, Henschke C. [Association between Safety Culture and Risk of Burnout: A Survey of Non-Medical Rescue Workers]. DAS GESUNDHEITSWESEN 2020; 84:199-207. [PMID: 33302321 DOI: 10.1055/a-1276-0817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Stressors such as safety culture in organizations that increase the risk of burnout have been studied in nursing and inpatient care settings. However, investigations in the setting of preclinical emergency medical services (EMS) are still limited. The study aims at (1) investigating burnout in health care workers in preclinical EMS and their perceived safety culture, and (2) analyzing the association between the two. METHODS Using the Maslach Burnout Inventory (MBI) and the Emergency Medical Services - Safety Attitudes Questionnaire (EMS-SAQ), an online survey was conducted with non-medical health care workers in preclinical EMS. Descriptive analyses were performed using frequencies, mean values, percentages and the Pearson correlation coefficient. A logistic regression model was used to determine the relationship between safety culture and the risk of burnout. RESULTS A total of 1,101 questionnaires was considered for analysis. Most of the participants were male (86.2%) and younger than 40 years (73.2%). A high risk of burnout for participants was found for the dimensions of emotional exhaustion and depersonalization (EE 26.3% and DP 40.2%). In the context of measuring safety culture, especially management, working conditions, and safety climate were negatively perceived by the participants. Furthermore, high stress recognition (EE: OR=3.317, p<0.01; DP: OR=1.910, p<0.01), negative job satisfaction (EE: OR=0.297, p<0.01; DP: OR=0.576, p<0.01) and negatively perceived working conditions (EE: OR 0.598, p<0.05; DP: 0.937, p<0.05) were significantly associated with a high risk of burnout. CONCLUSION This is the first large scale study investigating burnout among non-medical health care workers in preclinical EMS and their perceived safety culture in Germany as well as the association between the two. The results show the necessity to focus on perceived dimensions of safety culture in organizations, to develop measures reducing stress and improve job satisfaction and working conditions. In the context of increasing skills shortage, this is especially relevant with regard to the challenges of patient safety and quality of outcomes in care.
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Affiliation(s)
- Karsten Roth
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin.,Projektmanagement, Hans Peter Esser GmbH, Kürten
| | - Natalie Baier
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin.,Kiel Institut für Weltwirtschaft, Kiel
| | - Susanne Felgner
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin
| | - Reinhard Busse
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin
| | - Cornelia Henschke
- Fachgebiet Management im Gesundheitswesen, Technische Universität Berlin, Berlin.,Fakultät für Gesundheitswissenschaften Brandenburg, Brandenburgische Technische Universität Cottbus - Senftenberg
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Donnelly EA, Bradford P, Davis M, Hedges C, Socha D, Morassutti P, Pichika SC. What influences safety in paramedicine? Understanding the impact of stress and fatigue on safety outcomes. J Am Coll Emerg Physicians Open 2020; 1:460-473. [PMID: 33000071 PMCID: PMC7493488 DOI: 10.1002/emp2.12123] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The purpose of this study was to build on extant research linking fatigue to safety outcomes in paramedicine by assessing the influence of a multiplicity of workplace stressors, including chronic and critical incident stresses on safety outcomes. METHODS A cross-sectional survey was deployed to 10 paramedic services in Ontario. Validated survey instruments measured operational and organizational chronic stress, critical incident stress, post-traumatic stress symptomatology (PTSS), fatigue, safety outcomes, and demographics. Analysis of covariance assessed associations of workplace stresses with safety outcomes and corroborated findings using hierarchical linear model and generalized estimating equations (GEE) by taking into account paramedic service when assessing the proposed associations. A non-responder survey was conducted to asses for demographic differences in those who did and did not complete the survey. RESULTS This survey had a response rate of 40.5% (n = 717/1767); 80% of paramedics reported an injury or exposure to pathogen, 95% reported safety compromising behaviors, and 76% reported medical errors. In the GEE analyses, paramedic injury was significantly related to fatigue (0.13, SE = 0.06, P = 0.020), critical incident stress (0.03, SE = 0.01, P < 0.01), and PTSS (0.03, SE = 0.01, P < 0.01). Safety compromising behaviors were significantly associated with fatigue (0.37, SE = 0.06, P < 0.01), organizational stress (0.06, SE = 0.01, P < 0.01), and critical incident stress (0.01. SE = 0.01, P = 0.017). Medication errors were significantly related to fatigue (0.12, SE = 0.05, P < 0.01). Finally, the bivariate analysis showed increased stress factors and fatigue was associated with increased safety outcomes. CONCLUSION These findings illustrate that a host of different stressors may influence safety-related behaviors. For those interested in safety, these findings point to the need for a holistic focus on fatigue and stress in paramedicine.
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Affiliation(s)
| | - Paul Bradford
- Department of Emergency Medicine Windsor Regional Hospital Southwest Ontario Regional Base Hospital Program University of Western Ontario London Ontario Canada
| | - Matthew Davis
- Division of Emergency Medicine Southwest Ontario Regional Base Hospital Program University of Western Ontario London Ontario Canada
| | | | - Doug Socha
- Hastings-Quinte Paramedic Services Belleville Ontario Canada
| | - Peter Morassutti
- Southwest Ontario Regional Base Hospital Program-Windsor Site Windsor Ontario Canada
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Compassion Fatigue and Vicarious Trauma in Everyday Hospital Social Work: A Personal Narrative of Practitioner–Researcher Identity Transition. SOCIAL SCIENCES-BASEL 2019. [DOI: 10.3390/socsci8110313] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The story of my evolution as a practice-based collaborative researcher is a story that comes full circle. Through exploring my own experiences of compassion fatigue and vicarious trauma as a hospital-based social worker, I am able to investigate the phenomenon across the profession and provide a critique of the needs of practitioners working in the complex environment of hospitals and health care. Parallel to this is an investigation into the need for practice research in this complex environment and in the profession overall as seen through the lens of a collaborative research partnership with social work hospital colleagues that transformed my approach to research. I have drawn on personal narrative, autoethnography and reflexive processing to investigate my own impact on and from this research. I conclude with an understanding of the power of storytelling in participatory action research and in the potential in collaborative research methodologies for authentic reciprocity and relationship to traverse the practice–research divide.
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Taylor JA, Murray RM, Davis AL, Shepler LJ, Harrison CK, Novinger NA, Allen JA. Creation of a Systems-Level Checklist to Address Stress and Violence in Fire-Based Emergency Medical Services Responders. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s41542-019-00047-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taylor JA, Murray RM, Davis AL, Shepler LJ, Harrison CK, Novinger NA, Allen JA. Creation of a Systems-Level Checklist to Address Stress and Violence in Fire-Based Emergency Medical Services Responders. OCCUPATIONAL HEALTH SCIENCE 2019; 3:265-295. [PMID: 34796263 PMCID: PMC8596461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Between 57 and 93% of Emergency Medical Services (EMS) responders reported having experienced verbal or physical violence at least once in their career. Therefore, the primary goal of this study was to develop a systems-level checklist for violence against fire-based EMS responders using findings from a systematic literature review and outcomes from a national stakeholder meeting. First, a literature review of violence against EMS responders resulted in an extensive list of 162 academic and industrial publications. Second, from these sources, 318 potential candidate items were developed. Third, Q-methodology was employed to categorize, refine, and de-duplicate the items. Fourth, ThinkLet systems facilitated consensus-building, collaboration, and evaluation of the checklist with diverse subject matter experts representing 27 different EMS organizations, government, academia, labor unions, and fire departments during a two-day consensus conference. The final SAVER checklist contains 174 items organized by six phases of EMS response: pre-event, traveling to the scene, scene arrival, patient care, assessing readiness to return to service, and post-event. So called pause points for the individual EMS responder were incorporated at the end of each of phase. Overall, 47.5% of votes across all phases rated items as most feasible, 33.7% as less feasible, and 11.6% as extremely difficult. The SAVER systems-level Checklist is an innovative application of traditional checklists, designed to shift the onus of safety and health from that of the individual first responder to the organization by focusing on actions that leadership can institute through training, policy, and environmental modifications.
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Affiliation(s)
- Jennifer A. Taylor
- Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA
| | - Regan M. Murray
- Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA
| | - Andrea L. Davis
- Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA
| | - Lauren J. Shepler
- Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA
| | - Cecelia K. Harrison
- Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA
| | - Neva A. Novinger
- Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, 3215 Market Street, Nesbitt Hall, Room 655, Philadelphia, PA 19104, USA
| | - Joseph A. Allen
- Rocky Mountain Center for Occupational & Environmental Health, University of Utah Health, Salt Lake City, UT, USA
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Castro GLTD, Tourinho FSV, Martins MDFDSV, Medeiros KSD, Ilha P, Santos VEP. PROPOSTA DE PASSOS PARA A SEGURANÇA DO PACIENTE NO ATENDIMENTO PRÉ-HOSPITALAR MÓVEL. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-070720180003810016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo: propor passos para a segurança do paciente a partir da análise dos riscos no atendimento pré-hospitalar móvel sob a ótica dos enfermeiros. Método: estudo quantitativo, e descritivo. Amostra intencional, composta por 23 enfermeiros. Utilizou-se o método de pesquisa fotográfica para identificar os riscos à segurança do paciente em um Serviço de Atendimento Móvel de Urgência de uma cidade do Rio Grande do Norte. A coleta foi realizada de março a junho de 2012 e organizada em cinco etapas: obtenção das fotos de situações de segurança e não segurança; seleção de fotos pela qualidade de imagem; seleção de fotos pelos experts da temática; seleção de dez imagens de modo aleatório; e aplicação do instrumento de análise das fotos pelos profissionais. Foi utilizada a análise de conteúdo e análise descritiva. Resultados: os riscos apontados no estudo foram: dificuldades no acondicionamento de equipamentos e materiais; especificidades do trabalho no atendimento pré-hospitalar móvel; risco de infecção; risco de traumas; e dificuldades na administração de medicamentos. A partir dessas informações e confrontos com a literatura, foram sugeridos dez passos para a segurança do paciente no atendimento pré-hospitalar, voltados às necessidades de redução dos riscos apresentados. Conclusão: a análise de riscos e proposta de intervenções para a segurança do paciente favorecem a qualidade do atendimento em saúde, com benefícios na esfera: paciente, equipe, profissional e ambiente. Sugere-se que sejam desenvolvidas de acordo com as necessidades de cada serviço.
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Patterson PD, Higgins JS, Van Dongen HPA, Buysse DJ, Thackery RW, Kupas DF, Becker DS, Dean BE, Lindbeck GH, Guyette FX, Penner JH, Violanti JM, Lang ES, Martin-Gill C. Evidence-Based Guidelines for Fatigue Risk Management in Emergency Medical Services. PREHOSP EMERG CARE 2018; 22:89-101. [DOI: 10.1080/10903127.2017.1376137] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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21
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Studnek JR, Infinger AE, Renn ML, Weiss PM, Condle JP, Flickinger KL, Kroemer AJ, Curtis BR, Xun X, Divecha AA, Coppler PJ, Bizhanova Z, Sequeira DJ, Lang E, Higgins JS, Patterson PD. Effect of Task Load Interventions on Fatigue in Emergency Medical Services Personnel and Other Shift Workers: A Systematic Review. PREHOSP EMERG CARE 2018; 22:81-88. [DOI: 10.1080/10903127.2017.1384874] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Klemenc-Ketiš Z, Deilkås ET, Hofoss D, Bondevik GT. Patient Safety Culture in Slovenian out-of-hours Primary Care Clinics. Zdr Varst 2017; 56:203-210. [PMID: 29062394 PMCID: PMC5639809 DOI: 10.1515/sjph-2017-0028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/23/2017] [Indexed: 11/19/2022] Open
Abstract
Introduction Patient safety culture is a concept which describes how leader and staff interaction, attitudes, routines and practices protect patients from adverse events in healthcare. We aimed to investigate patient safety culture in Slovenian out-of-hours health care (OOHC) clinics, and determine the possible factors that might be associated with it. Methods This was a cross-sectional study, which took place in Slovenian OOHC, as part of the international study entitled Patient Safety Culture in European Out-of-Hours Services (SAFE-EUR-OOH). All the OOHC clinics in Slovenia (N=60) were invited to participate, and 37 agreed to do so; 438 employees from these clinics were invited to participate. We used the Slovenian version of the Safety Attitudes Questionnaire – an ambulatory version (SAQAV) to measure the climate of safety. Results Out of 438 invited participants, 250 answered the questionnaire (57.1% response rate). The mean overall score ± standard deviation of the SAQ was 56.6±16.0 points, of Perceptions of Management 53.6±19.6 points, of Job Satisfaction 48.5±18.3 points, of Safety Climate 59.1±22.1 points, of Teamwork Climate 72.7±16.6, and of Communication 51.5±23.4 points. Employees working in the Ravne na Koroškem region, employees with variable work shifts, and those with full-time jobs scored significantly higher on the SAQ-AV. Conclusion The safety culture in Slovenian OOHC clinics needs improvement. The variations in the safety culture factor scores in Slovenian OOHC clinics point to the need to eliminate variations and improve working conditions in Slovenian OOHC clinics.
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Affiliation(s)
- Zalika Klemenc-Ketiš
- University of Maribor, Faculty of Medicine, Department of Family Medicine, Taborska 8, 2000, Maribor, Slovenia
| | | | - Dag Hofoss
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Gunnar Tschudi Bondevik
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,National Centre for Emergency Primary Health Care, Uni Research Health, Bergen, Norway
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Hughes AM, Patterson PD, Weaver MD, Gregory ME, Sonesh SC, Landsittel DP, Krackhardt D, Hostler D, Lazzara EH, Wang X, Vena JE, Salas E, Yealy DM. Teammate Familiarity, Teamwork, and Risk of Workplace Injury in Emergency Medical Services Teams. J Emerg Nurs 2017; 43:339-346. [DOI: 10.1016/j.jen.2016.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 10/31/2016] [Accepted: 11/22/2016] [Indexed: 10/19/2022]
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Hesselink G, Berben S, Beune T, Schoonhoven L. Improving the governance of patient safety in emergency care: a systematic review of interventions. BMJ Open 2016; 6:e009837. [PMID: 26826151 PMCID: PMC4735318 DOI: 10.1136/bmjopen-2015-009837] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To systematically review interventions that aim to improve the governance of patient safety within emergency care on effectiveness, reliability, validity and feasibility. DESIGN A systematic review of the literature. METHODS PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, the Cochrane Database of Systematic Reviews and PsychInfo were searched for studies published between January 1990 and July 2014. We included studies evaluating interventions relevant for higher management to oversee and manage patient safety, in prehospital emergency medical service (EMS) organisations and hospital-based emergency departments (EDs). Two reviewers independently selected candidate studies, extracted data and assessed study quality. Studies were categorised according to study quality, setting, sample, intervention characteristics and findings. RESULTS Of the 18 included studies, 13 (72%) were non-experimental. Nine studies (50%) reported data on the reliability and/or validity of the intervention. Eight studies (44%) reported on the feasibility of the intervention. Only 4 studies (22%) reported statistically significant effects. The use of a simulation-based training programme and well-designed incident reporting systems led to a statistically significant improvement of safety knowledge and attitudes by ED staff and an increase of incident reports within EDs, respectively. CONCLUSIONS Characteristics of the interventions included in this review (eg, anonymous incident reporting and validation of incident reports by an independent party) could provide useful input for the design of an effective tool to govern patient safety in EMS organisations and EDs. However, executives cannot rely on a robust set of evidence-based and feasible tools to govern patient safety within their emergency care organisation and in the chain of emergency care. Established strategies from other high-risk sectors need to be evaluated in emergency care settings, using an experimental design with valid outcome measures to strengthen the evidence base.
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Affiliation(s)
- Gijs Hesselink
- Regional Emergency Healthcare Network, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
| | - Sivera Berben
- Regional Emergency Healthcare Network, Radboud University Medical Center, Nijmegen, The Netherlands
- Faculty of Health and Social Studies, Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Thimpe Beune
- Regional Emergency Healthcare Network, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lisette Schoonhoven
- Regional Emergency Healthcare Network, Radboud University Medical Center, Nijmegen, The Netherlands
- Radboud University Medical Center, Scientific Institute for Quality of Healthcare (IQ healthcare), Nijmegen, The Netherlands
- Faculty of Health Science, NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
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Weaver MD, Patterson PD, Fabio A, Moore CG, Freiberg MS, Songer TJ. The association between weekly work hours, crew familiarity, and occupational injury and illness in emergency medical services workers. Am J Ind Med 2015; 58:1270-7. [PMID: 26391202 DOI: 10.1002/ajim.22510] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Emergency Medical Services (EMS) workers are shift workers in a high-risk, uncontrolled occupational environment. EMS-worker fatigue has been associated with self-reported injury, but the influence of extended weekly work hours is unknown. METHODS A retrospective cohort study was designed using historical shift schedules and occupational injury and illness reports. Using multilevel models, we examined the association between weekly work hours, crew familiarity, and injury or illness. RESULTS In total, 966,082 shifts and 950 reports across 14 EMS agencies were obtained over a 1-3 year period. Weekly work hours were not associated with occupational injury or illness. Schedule characteristics that yield decreased exposure to occupational hazards, such as part-time work and night work, conferred reduced risk of injury or illness. CONCLUSIONS Extended weekly work hours were not associated with occupational injury or illness. Future work should focus on transient exposures and agency-level characteristics that may contribute to adverse work events.
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Affiliation(s)
- Matthew D. Weaver
- Division of Sleep Medicine; Harvard Medical School; Boston Massachusetts
- Departments of Medicine and Neurology; Brigham and Women's Hospital; Boston Massachusetts
| | - P. Daniel Patterson
- Department of Emergency Medicine; Carolinas HealthCare System Medical Center; Charlotte North Carolina
| | - Anthony Fabio
- Department of Epidemiology, University of Pittsburgh; Graduate School of Public Health; Pittsburgh Pennsylvania
| | - Charity G. Moore
- Carolinas HealthCare System; Dickson Advance Analytics Group; Charlotte North Carolina
| | - Matthew S. Freiberg
- Department of Medicine, Vanderbilt University; School of Medicine; Nashville Tennessee
| | - Thomas J. Songer
- Department of Epidemiology, University of Pittsburgh; Graduate School of Public Health; Pittsburgh Pennsylvania
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Carvalho PA, Göttems LBD, Pires MRGM, de Oliveira MLC. Safety culture in the operating room of a public hospital in the perception of healthcare professionals. Rev Lat Am Enfermagem 2015; 23:1041-8. [PMID: 26625994 PMCID: PMC4664003 DOI: 10.1590/0104-1169.0669.2647] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 06/07/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the perception of healthcare professionals about the safety culture in the operating room of a public hospital, large-sized, according to the domains of the Safety Attitudes Questionnaire (SAQ). METHOD Descriptive, cross-sectional and quantitative research, with the application of the SAQ to 226 professionals. Descriptive data analysis, instrument consistency and exploratory factor analysis. RESULTS Participants were distributed homogeneously between females (49.6%) and males (50.4%); mean age of 39.6 (SD±9.9) years and length of professional experience of 9.9 (SD ± 9.2) years. And Cronbach's α of 0.84. It was identified six domains proposed in the questionnaire: stress perception (74.5) and job satisfaction (70.7) showed satisfactory results; teamwork environment (59.1) and climate of security (48.9) presented scores below the minimum recommended (75); unit's management perceptions (44.5), hospital management perceptions (34.9) and working conditions (41.9) presented the lowest averages. CONCLUSIONS The results showed that, from the perspective of the professionals, there is weakness in the values, attitudes, skills and behaviors that determine the safety culture in a healthcare organization.
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Affiliation(s)
| | - Leila Bernarda Donato Göttems
- PhD, Adjunct Professor, Escola Superior de Ciências da Saúde, Fundação
de Ensino e Pesquisa em Ciências da Saúde, Secretaria de Estado de Saúde, Brasília, DF,
Brazil
| | | | - Maria Liz Cunha de Oliveira
- PhD, Adjunct Professor, Fundação de Ensino e Pesquisa em Ciências da
Saúde, Secretaria de Estado de Saúde, Brasília, DF, Brazil
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Patterson PD, Buysse DJ, Weaver MD, Doman JM, Moore CG, Suffoletto BP, McManigle KL, Callaway CW, Yealy DM. Real-time fatigue reduction in emergency care clinicians: The SleepTrackTXT randomized trial. Am J Ind Med 2015; 58:1098-113. [PMID: 26305869 DOI: 10.1002/ajim.22503] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND We assessed performance characteristics and impact of a mobile phone text-message intervention for reducing intra-shift fatigue among emergency clinician shift workers. METHODS We used a randomized controlled trial of 100 participants. All participants received text-message assessments at the start, every 4 hr during, and at end of scheduled shifts over a 90-day period. Text-message queries measured self-rated sleepiness, fatigue, and difficulty with concentration. Additional text-messages were sent to intervention participants to promote alertness. A performance measure of interest was compliance with answering text-messages. RESULTS Ninety-nine participants documented 2,621 shifts and responded to 36,073 of 40,947 text-messages (88% compliance rate). Intervention participants reported lower mean fatigue and sleepiness at 4 hr, 8 hr, and at the end of 12 hr shifts compared to controls (P < 0.05). Intervention participants reported better sleep quality at 90-days compared to baseline (P = 0.01). CONCLUSIONS We showed feasibility and short-term efficacy of a text-message based assessment and intervention tool.
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Affiliation(s)
- P. Daniel Patterson
- Department of Emergency Medicine; Carolinas HealthCare System Medical Center; Charlotte North Carolina
| | - Daniel J. Buysse
- Department of Psychiatry; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Matthew D. Weaver
- Harvard Medical School, Department of Medicine; Division of Sleep Medicine
| | - Jack M. Doman
- Department of Psychiatry; University of Pittsburgh School of Medicine; Pittsburgh Pennsylvania
| | - Charity G. Moore
- Dickson Advance Analytics Group; Carolinas HealthCare System Medical Center; Charlotte North Carolina
| | - Brian P. Suffoletto
- Department of Emergency Medicine; University of Pittsburgh School of Medicines; Pittsburgh Pennsylvania
| | - Kyle L. McManigle
- Department of Emergency Medicine; University of Pittsburgh School of Medicines; Pittsburgh Pennsylvania
| | - Clifton W. Callaway
- Department of Emergency Medicine; University of Pittsburgh School of Medicines; Pittsburgh Pennsylvania
| | - Donald M. Yealy
- Department of Emergency Medicine; University of Pittsburgh School of Medicines; Pittsburgh Pennsylvania
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Hoyle JD, Sleight D, Henry R, Chassee T, Fales B, Mavis B. Pediatric Prehospital Medication Dosing Errors: A Mixed-Methods Study. PREHOSP EMERG CARE 2015; 20:117-24. [DOI: 10.3109/10903127.2015.1061625] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Patterson PD, Klapec SE, Weaver MD, Guyette FX, Platt TE, Buysse DJ. Differences in Paramedic Fatigue before and after Changing from a 24-hour to an 8-hour Shift Schedule: A Case Report. PREHOSP EMERG CARE 2015; 20:132-6. [PMID: 25978152 DOI: 10.3109/10903127.2015.1025158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Emergency medical services (EMS) clinicians often work 24-hour shifts. There is a growing body of literature, with an elevated level of concern among EMS leaders that longer shifts contribute to fatigued workers and negative safety outcomes. However, many questions remain about shift length, fatigue, and outcomes. We describe a case of a 26-year-old male paramedic who switched shift schedules during the midpoint of a randomized trial that addressed fatigue in EMS workers (clinicaltrials.gov identifier: NCT02063737). The participant (case) began the study working full-time with a critical care, advanced life support EMS system that utilized 24-hour shifts. He then transitioned to an EMS system that deploys workers on 8-hour shifts. Per protocol for the randomized trial, the participant completed a battery of sleep health and fatigue surveys at baseline and at the end of 90 days of study. He also reported perceived fatigue, sleepiness, and difficulty with concentration at the beginning, every 4 hours during, and at the end of scheduled shifts, for a total of ten 24-hour shifts and twenty-four 8-hour shifts. We discuss differences in measures taken before and after switching shift schedules, and highlight differences in fatigue, sleepiness, and difficulty with concentration taken at the end of all 34 scheduled shifts stratified by shift duration (24 hours versus 8 hours). Findings from this case report present a unique opportunity to 1) observe and analyze a phenomenon that has not been investigated in great detail in the EMS setting; and 2) address an issue of significance to employers and EMS clinicians alike.
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Fisher JD, Freeman K, Clarke A, Spurgeon P, Smyth M, Perkins GD, Sujan MA, Cooke MW. Patient safety in ambulance services: a scoping review. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03210] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BackgroundThe role of ambulance services has changed dramatically over the last few decades with the introduction of paramedics able to provide life-saving interventions, thanks to sophisticated equipment and treatments available. The number of 999 calls continues to increase, with adverse events theoretically possible with each one. Most patient safety research is based on hospital data, but little is known concerning patient safety when using ambulance services, when things can be very different. There is an urgent need to characterise the evidence base for patient safety in NHS ambulance services.ObjectiveTo identify and map available evidence relating to patient safety when using ambulance services.DesignMixed-methods design including systematic review and review of ambulance service documentation, with areas for future research prioritised using a Delphi process.Setting and participantsAmbulance services, their staff and service users in UK.Data sourcesA wide range of data sources were explored. Multiple databases, reference lists from key papers and citations, Google and the NHS Confederation website were searched, and experts contacted to ensure that new data were included in the review. The databases MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, Science Direct, Emerald, Education Resources Information Center (ERIC), Applied Social Sciences Index and Abstracts, Social Services Abstracts, Sociological Abstracts, International Bibliography of the Social Sciences (IBSS), PsycINFO, PsycARTICLES, Health Management Information Consortium (HMIC), NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED),Health Technology Assessment, the FADE library, Current Awareness Service for Health (CASH), OpenDOAR (Directory of Open Access Repositories) and Open System for Information on Grey Literature in Europe (OpenSIGLE) and Zetoc (The British Library's Electronic Table of Contents) were searched from 1 January 1980 to 12 October 2011. Publicly available documents and issues identified by National Patient Safety Agency (NPSA), NHS Litigation Authority (NHSLA) and coroners’ reports were considered. Opinions and perceptions of senior managers, ambulance staff and service users were solicited.Review methodsData were extracted from annual reports using two-stage thematic analysis, data from quality accounts were collated with safety priorities tabulated and considered using thematic analysis, NPSA incident report data were collated and displayed comparatively using descriptive statistics, claims reported to NHSLA were analysed to identify number and cost of claims from mistakes and/or poor service, and summaries of coroners’ reports were assessed using thematic analysis to identify underlying safety issues. The depth of analysis is limited by the remit of a scoping exercise and availability of data.ResultsWe identified studies exploring different aspects of safety, which were of variable quality and with little evidence to support activities currently undertaken by ambulance services. Adequately powered studies are required to address issues of patient safety in this service, and it appeared that national priorities were what determined safety activities, rather than patient need. There was inconsistency of information on attitudes and approaches to patient safety, exacerbated by a lack of common terminology.ConclusionPatient safety needs to become a more prominent consideration for ambulance services, rather than operational pressures, including targets and driving the service. Development of new models of working must include adequate training and monitoring of clinical risks. Providers and commissioners need a full understanding of the safety implications of introducing new models of care, particularly to a mobile workforce often isolated from colleagues, which requires a body of supportive evidence and an inherent critical evaluation culture. It is difficult to extrapolate findings of clinical studies undertaken in secondary care to ambulance service practice and current national guidelines often rely on consensus opinion regarding applicability to the pre-hospital environment. Areas requiring further work include the safety surrounding discharging patients, patient accidents, equipment and treatment, delays in transfer/admission to hospital, and treatment and diagnosis, with a clear need for increased reliability and training for improving handover to hospital.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Joanne D Fisher
- Department of Health Sciences, Warwick Medical School, Coventry, UK
| | - Karoline Freeman
- Department of Health Sciences, Warwick Medical School, Coventry, UK
| | - Aileen Clarke
- Department of Health Sciences, Warwick Medical School, Coventry, UK
| | - Peter Spurgeon
- Department of Health Sciences, Warwick Medical School, Coventry, UK
| | - Mike Smyth
- West Midlands Ambulance Service, Millennium Point, Waterfront Business Park, Brierley Hill, West Midlands, UK
| | - Gavin D Perkins
- Department of Health Sciences, Warwick Medical School, Coventry, UK
| | | | - Matthew W Cooke
- Department of Health Sciences, Warwick Medical School, Coventry, UK
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The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system. CAN J EMERG MED 2015; 17:411-9. [DOI: 10.1017/cem.2014.74] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractIntroductionThe role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives.MethodsAn ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010.ResultsDuring the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population.ConclusionsDespite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a “learning organization” and improve both efficacy and safety of first aid care.
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Patterson PD, Buysse DJ, Weaver MD, Callaway CW, Yealy DM. Recovery between Work Shifts among Emergency Medical Services Clinicians. PREHOSP EMERG CARE 2015; 19:365-75. [DOI: 10.3109/10903127.2014.995847] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Patterson PD, Buysse DJ, Weaver MD, Suffoletto BP, McManigle KL, Callaway CW, Yealy DM. Emergency healthcare worker sleep, fatigue, and alertness behavior survey (SFAB): development and content validation of a survey tool. ACCIDENT; ANALYSIS AND PREVENTION 2014; 73:399-411. [PMID: 25449415 PMCID: PMC4254576 DOI: 10.1016/j.aap.2014.09.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 08/11/2014] [Accepted: 09/30/2014] [Indexed: 05/08/2023]
Abstract
BACKGROUND Workplace safety is a recognized concern in emergency medical services (EMS). Ambulance crashes are common and injury rates exceed that of the general working public. Fatigue and sleepiness during shift work pose a safety risk for patients and EMS workers. Changing EMS worker behaviors and improving alertness during shift work is hampered by a lack of instruments that reliably and accurately measure multidimensional beliefs and habits that predict alertness behavior. OBJECTIVES We sought to test the reliability and validity of a survey tool (the sleep, fatigue, and alertness behavior survey [SFAB]) designed to identify the cognitions of EMS workers concerning sleep, fatigue, and alertness behaviors during shift work. METHODS We operationalized the integrative model of behavioral prediction (IMBP) and developed a pool of 97 candidate items and sub-items to measure eight domains of the IMBP. Five sleep scientists judged the content validity of each item and a convenience sample of EMS workers completed a paper-based version of the SFAB. We retained items judged content valid by five sleep scientists and performed exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and tests of reliability and internal consistency. We identified a simple factor structure for each scale and calculated means and standard deviations for each item and scale. RESULTS We received 360 completed SFAB surveys from a convenience sample of 800 EMS workers attending two regional continuing education conferences (45% participation rate). Forty-seven candidate items and sub-items/options were removed following content validation, EFA, and CFA testing. Analyses revealed a simple factor structure for seven of eight domains and a final pool of 50 items and sub-items/options. Domains include: attitudes, normative beliefs, knowledge, salience, habits, environmental constraints, and intent. EFA tests of self-efficacy items failed to identify a simple factor structure. We retained two self-efficacy items based on Spearman-Brown correlation of 0.23 (p<0.0001). CONCLUSIONS Measurement of sleep, fatigue, and alertness behavior among EMS workers is challenging. We describe the development and psychometric testing of a survey tool that may be useful in a variety of applications addressing sleep, fatigue, and alertness behavior among EMS workers.
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Affiliation(s)
- P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
| | - Daniel J Buysse
- Department of Psychiatry and Clinical Translational Science, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Matthew D Weaver
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brian P Suffoletto
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kyle L McManigle
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Clifton W Callaway
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Donald M Yealy
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Understanding Multiteam Systems in Emergency Care: One Case at a Time. ACTA ACUST UNITED AC 2014. [DOI: 10.1108/s1534-085620140000016007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Andersson Hagiwara M, Suserud BO, Andersson-Gäre B, Sjöqvist BA, Henricson M, Jonsson A. The effect of a Computerised Decision Support System (CDSS) on compliance with the prehospital assessment process: results of an interrupted time-series study. BMC Med Inform Decis Mak 2014; 14:70. [PMID: 25106732 PMCID: PMC4136405 DOI: 10.1186/1472-6947-14-70] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 08/06/2014] [Indexed: 11/29/2022] Open
Abstract
Background Errors in the decision-making process are probably the main threat to patient safety in the prehospital setting. The reason can be the change of focus in prehospital care from the traditional “scoop and run” practice to a more complex assessment and this new focus imposes real demands on clinical judgment. The use of Clinical Guidelines (CG) is a common strategy for cognitively supporting the prehospital providers. However, there are studies that suggest that the compliance with CG in some cases is low in the prehospital setting. One possible way to increase compliance with guidelines could be to introduce guidelines in a Computerized Decision Support System (CDSS). There is limited evidence relating to the effect of CDSS in a prehospital setting. The present study aimed to evaluate the effect of CDSS on compliance with the basic assessment process described in the prehospital CG and the effect of On Scene Time (OST). Methods In this time-series study, data from prehospital medical records were collected on a weekly basis during the study period. Medical records were rated with the guidance of a rating protocol and data on OST were collected. The difference between baseline and the intervention period was assessed by a segmented regression. Results In this study, 371 patients were included. Compliance with the assessment process described in the prehospital CG was stable during the baseline period. Following the introduction of the CDSS, compliance rose significantly. The post-intervention slope was stable. The CDSS had no significant effect on OST. Conclusions The use of CDSS in prehospital care has the ability to increase compliance with the assessment process of patients with a medical emergency. This study was unable to demonstrate any effects of OST.
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Patterson PD, Moore CG, Weaver MD, Buysse DJ, Suffoletto BP, Callaway CW, Yealy DM. Mobile phone text messaging intervention to improve alertness and reduce sleepiness and fatigue during shiftwork among emergency medicine clinicians: study protocol for the SleepTrackTXT pilot randomized controlled trial. Trials 2014; 15:244. [PMID: 24952387 PMCID: PMC4080698 DOI: 10.1186/1745-6215-15-244] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/11/2014] [Indexed: 11/06/2022] Open
Abstract
Background Mental and physical fatigue while at work is common among emergency medical services (EMS) shift workers. Extended shifts (for example 24 hours) and excessive amounts of overtime work increase the likelihood of negative safety outcomes and pose a challenge for EMS fatigue-risk management. Text message-based interventions are a potentially high-impact, low-cost platform for sleep and fatigue assessment and distributing information to workers at risk of negative safety outcomes related to sleep behaviors and fatigue. Methods/Design We will conduct a pilot randomized trial with a convenience sample of adult EMS workers recruited from across the United States using a single study website. Participants will be allocated to one of two possible arms for a 90-day study period. The intervention arm will involve text message assessments of sleepiness, fatigue, and difficulty with concentration at the beginning, during, and end of scheduled shifts. Intervention subjects reporting high levels of sleepiness or fatigue will receive one of four randomly selected intervention messages promoting behavior change during shiftwork. Control subjects will receive assessment only text messages. We aim to determine the performance characteristics of a text messaging tool for the delivery of a sleep and fatigue intervention. We seek to determine if a text messaging program with tailored intervention messages is effective at reducing perceived sleepiness and/or fatigue among emergency medicine clinician shift workers. Additional aims include testing whether a theory-based behavioral intervention, delivered by text message, changes ‘alertness behaviors’. Discussion The SleepTrackTXT pilot trial could provide evidence of compliance and effectiveness that would support rapid widespread expansion in one of two forms: 1) a stand-alone program in the form of a tailored/individualized sleep monitoring and fatigue reduction support service for EMS workers; or 2) an add-on to a multi-component fatigue risk management program led and maintained by employers or by safety and risk management services. Trial Registration Clinicaltrials.gov NCT02063737, Registered on 10 January 2014
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Affiliation(s)
- Paul Daniel Patterson
- Department of Emergency Medicine, School of Medicine, University of Pittsburgh, 3600 Forbes Avenue, Iroquois Bldg, Suite 400A, Pittsburgh, PA, USA.
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Patterson PD, Lave JR, Martin-Gill C, Weaver MD, Wadas RJ, Arnold RM, Roth RN, Mosesso VN, Guyette FX, Rittenberger JC, Yealy DM. Measuring adverse events in helicopter emergency medical services: establishing content validity. PREHOSP EMERG CARE 2013; 18:35-45. [PMID: 24003951 DOI: 10.3109/10903127.2013.818179] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION We sought to create a valid framework for detecting adverse events (AEs) in the high-risk setting of helicopter emergency medical services (HEMS). METHODS We assembled a panel of 10 expert clinicians (n = 6 emergency medicine physicians and n = 4 prehospital nurses and flight paramedics) affiliated with a large multistate HEMS organization in the Northeast US. We used a modified Delphi technique to develop a framework for detecting AEs associated with the treatment of critically ill or injured patients. We used a widely applied measure, the content validity index (CVI), to quantify the validity of the framework's content. RESULTS The expert panel of 10 clinicians reached consensus on a common AE definition and four-step protocol/process for AE detection in HEMS. The consensus-based framework is composed of three main components: (1) a trigger tool, (2) a method for rating proximal cause, and (3) a method for rating AE severity. The CVI findings isolate components of the framework considered content valid. CONCLUSIONS We demonstrate a standardized process for the development of a content-valid framework for AE detection. The framework is a model for the development of a method for AE identification in other settings, including ground-based EMS.
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Affiliation(s)
- P Daniel Patterson
- From the Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Patterson PD, Anderson MS, Zionts ND, Paris PM. The emergency medical services safety champions. Am J Med Qual 2012; 28:286-91. [PMID: 23150883 DOI: 10.1177/1062860612463727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The overarching mission of prehospital emergency medical services (EMS) is to deliver lifesaving care for people when their needs are greatest. Fulfilling this mission is challenged by threats to patient and provider safety. The EMS setting is a high-risk one because care is delivered rapidly in the out-of-hospital setting where resources of benefit to patients are limited. There is growing evidence that safety culture varies widely across EMS agencies. A poor safety culture may manifest as error in medication, back injuries, and other poor outcomes for patient and provider. Recently, federal and national leaders of EMS (ie, the National Highway Traffic Safety Administration) have made improving EMS safety culture a national priority. Unfortunately, few initiatives can help local EMS leaders achieve that priority. The authors describe the successful EMS Champs Fellowship program, supported by the Jewish Healthcare Foundation, designed to train EMS leaders to improve safety for patients and providers.
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Affiliation(s)
- P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh School of Medicine, 3600 Forbes Avenue, Iroquois Bldg, Pittsburgh, PA 15261, USA
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The Impact of Stress on Paramedic Performance During Simulated Critical Events. Prehosp Disaster Med 2012; 27:369-74. [DOI: 10.1017/s1049023x12001021] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesSubstantial research demonstrates that the stressors accompanying the profession of paramedicine can lead to mental health concerns. In contrast, little is known about the effects of stress on paramedics’ ability to care for patients during stressful events. In this study, we examined paramedics’ acute stress responses and performance during simulated high-stress scenarios.MethodsTwenty-two advanced care paramedics participated in simulated low-stress and high-stress clinical scenarios. The paramedics provided salivary cortisol samples and completed an anxiety questionnaire at baseline and following each scenario. Clinical performance was videotaped and scored on a checklist of specific actions and a global rating of performance. The paramedics also completed patient care documentation following each scenario.ResultsThe paramedics demonstrated greater increases in anxiety (P < .05) and salivary cortisol levels (P < .05) in response to the high-stress scenario compared to the low-stress scenario. Global rating scores were significantly lower in the high-stress scenario than in the low-stress scenario (P < .05). Checklist scores were not significantly different between the two scenarios (P = .12). There were more errors of commission (reporting information not present in the scenario) in the patient care documentation following the high-stress scenario than following the low-stress scenario (P < .05). In contrast, there were no differences in omission errors (failing to recall information present in the scenario) between the two scenarios (P = .34).ConclusionClinical performance and documentation appear vulnerable to the impact of acute stress. This highlights the importance of developing systems and training interventions aimed at supporting and preparing emergency workers who face acute stressors as part of their every day work responsibilities.LeBlanc VR, Regehr C, Tavares W, Scott AK, MacDonald R, King K. The impact of stress on paramedic performance during simulated critical events. Prehosp Disaster Med. 2012;27(4):1-6.
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Hansen CD, Rasmussen K, Kyed M, Nielsen KJ, Andersen JH. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - a cross-sectional study. BMC Public Health 2012; 12:534. [PMID: 22824415 PMCID: PMC3439275 DOI: 10.1186/1471-2458-12-534] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/28/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. METHODS Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. RESULTS Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. CONCLUSIONS Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands.
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Affiliation(s)
- Claus D Hansen
- Department of Sociology and Social Work, Aalborg University, Aalborg University, Kroghstræde 5, DK 9220, Aalborg Ø, Denmark.
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Adverse Events in EMS: Symptom of a Larger Problem. PREHOSP EMERG CARE 2012. [DOI: 10.3109/10903127.2012.670694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Eliseo LJ, Murray KA, White LF, Dyer S, Mitchell PA, Fernandez WG. EMS providers' perceptions of safety climate and adherence to safe work practices. PREHOSP EMERG CARE 2012; 16:53-8. [PMID: 22128907 DOI: 10.3109/10903127.2011.621043] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Occupational injuries are an important source of morbidity for emergency medical services (EMS) providers. Previous work has shown that employee perceptions of an organization's commitment to safety (i.e., safety climate) correlate with adherence to safe practices. OBJECTIVE To assess the association between perceived safety climate and compliance with safety procedures in an urban EMS system with >100,000 calls/year. METHODS EMS providers were issued a self-administered survey that included questions on demographics, years of experience, perceived safety climate, and adherence to safety procedures. Safety climate was assessed with a 20-item validated instrument. Adherence to safety procedures was assessed with a nine-item list of safety behaviors. Strict adherence to safety procedures was defined as endorsing "agree" or "strongly agree" on 80% of items. The effect of safety climate on compliance with safe practices was estimated using multiple logistic regression. RESULTS One hundred ninety-six of 221 providers (89%) completed surveys; 74% were male; the median age was 36-40 years; and the median amount of experience was 8 years. One hundred twenty-seven of 196 respondents (65%) reported strict adherence to safe work practice. Factor analysis confirmed the original six-factor grouping of questions; frequent safety-related feedback/training was significantly associated with safe practices (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01-4.51). CONCLUSION EMS workers perceiving a high degree of perceived safety climate was associated with twofold greater odds of self-reported level of strict adherence to safe work practices. Frequent safety-related feedback/training was the one dimension of safety climate that had the strongest association with adherence to safe workplace behaviors.
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Affiliation(s)
- Laura J Eliseo
- Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts 02118, USA
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Patterson PD, Weaver MD, Weaver SJ, Rosen MA, Todorova G, Weingart LR, Krackhardt D, Lave JR, Arnold RM, Yealy DM, Salas E. Measuring teamwork and conflict among emergency medical technician personnel. PREHOSP EMERG CARE 2012; 16:98-108. [PMID: 22128909 DOI: 10.3109/10903127.2011.616260] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE We sought to develop a reliable and valid tool for measuring teamwork among emergency medical technician (EMT) partnerships. METHODS We adapted existing scales and developed new items to measure components of teamwork. After recruiting a convenience sample of 39 agencies, we tested a 122-item draft survey tool (EMT-TEAMWORK). We performed a series of exploratory factor analyses (EFAs) and confirmatory factor analysis (CFA) to test reliability and construct validity, describing variation in domain and global scores using descriptive statistics. RESULTS We received 687 completed surveys. The EFAs identified a nine-factor solution. We labeled these factors 1) Team Orientation, 2) Team Structure & Leadership, 3) Partner Communication, Team Support, & Monitoring, 4) Partner Trust and Shared Mental Models, 5) Partner Adaptability & Back-Up Behavior, 6) Process Conflict, 7) Strong Task Conflict, 8) Mild Task Conflict, and 9) Interpersonal Conflict. We tested a short-form (30-item SF) and long-form (45-item LF) version. The CFAs determined that both the SF and the LF possess positive psychometric properties of reliability and construct validity. The EMT-TEAMWORK-SF has positive internal consistency properties, with a mean Cronbach's alpha coefficient ≥0.70 across all nine factors (mean = 0.84; minimum = 0.78, maximum = 0.94). The mean Cronbach's alpha coefficient for the EMT-TEAMWORK-LF was 0.87 (minimum = 0.79, maximum = 0.94). There was wide variation in weighted scores across all nine factors and the global score for the SF and LF. Mean scores were lowest for the Team Orientation factor (48.1, standard deviation [SD] 21.5, SF; 49.3, SD 19.8, LF) and highest (more positive) for the Interpersonal Conflict factor (87.7, SD 18.1, for both SF and LF). CONCLUSIONS We developed a reliable and valid survey to evaluate teamwork between EMT partners.
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Affiliation(s)
- P Daniel Patterson
- Department of Emergency Medicine and Center for Emergency Medicine of Western Pennsylvania, Inc., Pennsylvania, USA.
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Brice JH, Studnek JR, Bigham BL, Martin-Gill C, Custalow CB, Hawkins E, Morrison LJ. EMS Provider and Patient Safety during Response and Transport: Proceedings of an Ambulance Safety Conference. PREHOSP EMERG CARE 2012; 16:3-19. [DOI: 10.3109/10903127.2011.626106] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Patterson PD, Weaver MD, Frank RC, Warner CW, Martin-Gill C, Guyette FX, Fairbanks RJ, Hubble MW, Songer TJ, Callaway CW, Kelsey SF, Hostler D. Association between poor sleep, fatigue, and safety outcomes in emergency medical services providers. PREHOSP EMERG CARE 2011; 16:86-97. [PMID: 22023164 DOI: 10.3109/10903127.2011.616261] [Citation(s) in RCA: 139] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among emergency medical services (EMS) workers. METHODS We used convenience sampling of EMS agencies and a cross-sectional survey design. We administered the 19-item Pittsburgh Sleep Quality Index (PSQI), 11-item Chalder Fatigue Questionnaire (CFQ), and 44-item EMS Safety Inventory (EMS-SI) to measure sleep quality, fatigue, and safety outcomes, respectively. We used a consensus process to develop the EMS-SI, which was designed to capture three composite measurements of EMS worker injury, medical errors and adverse events (AEs), and safety-compromising behaviors. We used hierarchical logistic regression to test the association between poor sleep quality, fatigue, and three composite measures of EMS worker safety outcomes. RESULTS We received 547 surveys from 30 EMS agencies (a 35.6% mean agency response rate). The mean PSQI score exceeded the benchmark for poor sleep (6.9, 95% confidence interval [CI] 6.6, 7.2). More than half of the respondents were classified as fatigued (55%, 95% CI 50.7, 59.3). Eighteen percent of the respondents reported an injury (17.8%, 95% CI 13.5, 22.1), 41% reported a medical error or AE (41.1%, 95% CI 36.8, 45.4), and 90% reported a safety-compromising behavior (89.6%, 95% CI 87, 92). After controlling for confounding, we identified 1.9 greater odds of injury (95% CI 1.1, 3.3), 2.2 greater odds of medical error or AE (95% CI 1.4, 3.3), and 3.6 greater odds of safety-compromising behavior (95% CI 1.5, 8.3) among fatigued respondents versus nonfatigued respondents. CONCLUSIONS In this sample of EMS workers, poor sleep quality and fatigue are common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes.
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Affiliation(s)
- P Daniel Patterson
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
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Weaver MD, Wang HE, Fairbanks RJ, Patterson D. The association between EMS workplace safety culture and safety outcomes. PREHOSP EMERG CARE 2011; 16:43-52. [PMID: 21950463 DOI: 10.3109/10903127.2011.614048] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Prior studies have highlighted wide variation in emergency medical services (EMS) workplace safety culture across agencies. OBJECTIVE To determine the association between EMS workplace safety culture scores and patient or provider safety outcomes. METHODS We administered a cross-sectional survey to EMS workers affiliated with a convenience sample of agencies. We recruited these agencies from a national EMS management organization. We used the EMS Safety Attitudes Questionnaire (EMS-SAQ) to measure workplace safety culture and the EMS Safety Inventory (EMS-SI), a tool developed to capture self-reported safety outcomes from EMS workers. The EMS-SAQ provides reliable and valid measures of six domains: safety climate, teamwork climate, perceptions of management, working conditions, stress recognition, and job satisfaction. A panel of medical directors, emergency medical technicians and paramedics, and occupational epidemiologists developed the EMS-SI to measure self-reported injury, medical errors and adverse events, and safety-compromising behaviors. We used hierarchical linear models to evaluate the association between EMS-SAQ scores and EMS-SI safety outcome measures. RESULTS Sixteen percent of all respondents reported experiencing an injury in the past three months, four of every 10 respondents reported an error or adverse event (AE), and 89% reported safety-compromising behaviors. Respondents reporting injury scored lower on five of the six domains of safety culture. Respondents reporting an error or AE scored lower for four of the six domains, while respondents reporting safety-compromising behavior had lower safety culture scores for five of the six domains. CONCLUSIONS Individual EMS worker perceptions of workplace safety culture are associated with composite measures of patient and provider safety outcomes. This study is preliminary evidence of the association between safety culture and patient or provider safety outcomes.
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Affiliation(s)
- Matthew D Weaver
- Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA
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Reichard AA, Marsh SM, Moore PH. Fatal and Nonfatal Injuries Among Emergency Medical Technicians and Paramedics. PREHOSP EMERG CARE 2011; 15:511-7. [DOI: 10.3109/10903127.2011.598610] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Patterson PD, Weaver MD, Abebe K, Martin-Gill C, Roth RN, Suyama J, Guyette FX, Rittenberger JC, Krackhardt D, Arnold R, Yealy DM, Lave J. Identification of Adverse Events in Ground Transport Emergency Medical Services. Am J Med Qual 2011; 27:139-46. [DOI: 10.1177/1062860611415515] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Kaleab Abebe
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Ronald N. Roth
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Joseph Suyama
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | | | | | - Robert Arnold
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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Youngquist ST, Gee CA. Non-experimental studies in air medical research. Air Med J 2011; 30:168-172. [PMID: 21798446 DOI: 10.1016/j.amj.2011.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article is the 17th in a multipart series designed to assist readers, particularly novices, in the area of clinical research. This article is focused on the process of developing a new research project. It provides tools to help those involved in beginning their own research projects.
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Catlett CL, Jenkins JL, Millin MG. Role of emergency medical services in disaster response: resource document for the National Association of EMS Physicians position statement. PREHOSP EMERG CARE 2011; 15:420-5. [PMID: 21480774 DOI: 10.3109/10903127.2011.561401] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The National Association of EMS Physicians (NAEMSP) advocates for a strong emergency medical services (EMS) role in all phases of disaster management--preparedness, response, and recovery. Emergency medical services administrators and medical directors should play a leadership role in preparedness activities such as training and education, development of performance metrics, establishment of memoranda of understanding (MOUs), and planning for licensure and liability issues. During both the planning and response phases, EMS leadership should advocate for participation in unified command, modified scope of practice appropriate for providers and the event, and expanded roles in community and federal response efforts. To enhance recovery, EMS leadership should strongly advocate for national recognition for EMS efforts and further research into strategies that foster healthy coping techniques and resiliency in the EMS workforce. This resource document will outline the basis for the corresponding NAEMSP position statement on the role of EMS in disaster management.
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Affiliation(s)
- Christina L Catlett
- Johns Hopkins Office of Critical Event Preparedness and Response and Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21209, USA.
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