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Development of a New Tool to Combine the Promotion of Patient Mobility With Safe Patient Handling Equipment: The Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide. 开发新工具,将促进病人移动与安全的病人搬运设备相结合:约翰霍普金斯安全搬运病人指南》(JH-SPHM)。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1177/21650799241268745
Sowmya Kumble, Kevin H McLaughlin, Karli Funk, Steven Dekany, Daniel Ludwig, Holley Farley, Anita M Stone, Nozomi Tahara, Erica Newkirk, Erik Hoyer, Daniel L Young

Background: Promoting safe patient mobility for providers and patients is a safety priority in the hospital setting. Safe patient handling equipment aids safe mobility but can also deter active movement by the patient if used inappropriately. Nurses need guidance to choose equipment that ensures their safety and that of the patients while promoting active mobility and preventing workplace-related injury.

Methods: Using a modified Delphi approach with a diverse group of experts, we created the Johns Hopkins Safe Patient Handling Mobility (JH-SPHM) Guide. This diverse group of 10 experts consisted of nurses, nurse leaders, physical and occupational therapists, safe patient handling committee representatives, and a fall prevention committee leader. The application of the tool was then tested in the hospital environment by two physical therapists.

Findings: Consensus was reached for safe patient handling (SPH) equipment recommendations at each level of the Johns Hopkins Mobility Goal Calculator (JH-Mobility Goal Calculator). Expert SPH equipment recommendations were then added to JH-Mobility Goal Calculator levels to create the JH-Safe Patient Handling Mobility Guide. JH-Safe Patient Handling Mobility Guide equipment suggestions were compared with equipment recommendations from physical therapists revealing strong agreement (n = 125, 88%).

Conclusion: The newly created JH-Safe Patient Handling Mobility Guide provides appropriate safe patient-handling equipment recommendations to help accomplish patients' daily mobility goals.

Applications to practice: The Johns Hopkins Safe Patient Handling Mobility Guide simultaneously facilitates patient mobility and optimizes safety for nursing staff through recommendations for safe patient handling equipment for use with hospitalized patients.

背景:促进医护人员和患者的安全移动是医院环境中的安全重点。安全的病人搬运设备有助于安全地移动病人,但如果使用不当,也会阻碍病人的主动移动。护士在选择设备时需要得到指导,以确保自己和患者的安全,同时促进主动移动并预防与工作场所相关的伤害:方法:我们采用改良的德尔菲法,与不同的专家小组合作,制定了《约翰霍普金斯安全患者搬运移动指南》(JH-SPHM)。这个由 10 位专家组成的多元化小组包括护士、护士长、理疗师和职业治疗师、安全搬运病人委员会代表以及跌倒预防委员会负责人。随后,两名理疗师在医院环境中对该工具的应用进行了测试:研究结果:在约翰-霍普金斯大学移动能力目标计算器(JH-Mobility Goal Calculator)的各个级别上,就安全搬运病人(SPH)设备建议达成了共识。然后,将专家建议的 SPH 设备添加到 JH 移动能力目标计算器的各个级别中,形成了《JH-病人安全搬运移动指南》。将《JH-患者安全移位指南》的设备建议与物理治疗师的设备建议进行比较,结果显示两者的建议非常一致(n = 125,88%):结论:新制定的《约翰霍普金斯安全患者移位指南》提供了适当的安全患者移位设备建议,有助于实现患者的日常移位目标:约翰霍普金斯大学的《安全患者搬运移动指南》通过为住院患者提供安全的患者搬运设备建议,同时促进了患者的移动,并优化了护理人员的安全性。
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引用次数: 0
Simulation Integration With Total Worker Health. 模拟与工人全面健康的结合。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-11-01 Epub Date: 2024-08-28 DOI: 10.1177/21650799241271099
Benjamin McManus, Katherine B Redden, Marjorie L White
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引用次数: 0
Online Mindfulness-Based Interventions for Healthcare Professionals: A Scoping Review. 针对医疗保健专业人员的在线正念干预:范围审查。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-11-01 Epub Date: 2024-08-31 DOI: 10.1177/21650799241254554
Gumhee Baek, Chiyoung Cha, Miran Lee, Aram Cho

Background: Healthcare professionals work in challenging environments with extended working hours and excessive workloads to provide high-quality care. However, they hardly get the time to care for themselves. Online mindfulness-based interventions-which are not restricted by time or location-can be a powerful strategy to help healthcare professionals.

Objectives: This scoping review aims to explore the current evidence about online mindfulness-based interventions for healthcare professionals.

Design: A scoping review was conducted.

Methods: A literature search was conducted to retrieve articles published between October 2016 and March 2023 in seven databases, including backward and forward citation tracking from the included articles. Among 1,278 articles retrieved, 33 met the criteria for review.

Results: Two-thirds of the studies utilized commercialized mindfulness programs (n = 22). Duration of the mindfulness interventions varied from 1 week to 4 months, and half of the studies used audio-guided programs. Online mindfulness-based intervention studies were targeted to reduce burnout (n = 26), and the majority reported reduction in burnout (n = 18).

Conclusion: Most studies used individual audio-guided programs that warrant the use of diverse delivery methods such as video media, simulation, and virtual reality for interactions in the future. Although the literature has accumulated evidence for commercialized online mindfulness-based interventions, further studies are needed to develop and test tailored interventions for healthcare professionals.

背景:医护人员的工作环境充满挑战,工作时间长,工作量大,要提供高质量的护理服务。然而,他们几乎没有时间照顾自己。基于正念的在线干预--不受时间或地点的限制--可以成为帮助医护人员的有力策略:本范围综述旨在探索目前针对医护人员的在线正念干预的相关证据:方法:进行文献检索:方法:进行文献检索,检索七个数据库中2016年10月至2023年3月期间发表的文章,包括对收录文章的前后引文追踪。在检索到的1278篇文章中,有33篇符合审查标准:三分之二的研究使用了商业化的正念计划(n = 22)。正念干预的持续时间从 1 周到 4 个月不等,半数研究使用音频指导程序。基于正念的在线干预研究以减少职业倦怠为目标(n = 26),大多数研究报告称职业倦怠有所减轻(n = 18):结论:大多数研究都使用了个人音频指导程序,因此未来有必要使用视频媒体、模拟和虚拟现实等多种方法进行互动。虽然文献已为商业化的在线正念干预积累了证据,但仍需进一步研究,为医护人员开发和测试量身定制的干预措施。
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引用次数: 0
Psychosocial Work Factors, Job Stress, and Self-Rated Health Among Hotel Housekeepers. 酒店管家的社会心理工作因素、工作压力和自我健康评价。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-30 DOI: 10.1177/21650799241282787
M Esther García-Buades, Maribel Montañez-Juan, Joanna Blahopoulou, Silvia Ortiz-Bonnin, Xènia Chela-Alvarez, Oana Bulilete, Joan Llobera

Background: Hotel housekeeping is widely recognized as a poor-quality job due to its high demands and limited resources. Hotel housekeepers (HHs) face both hard physical work and mentally demanding conditions, yet psychosocial factors in this feminized and precarious occupation remain under-researched. To address this gap, this study examines HHs' exposure to psychosocial factors at work and their impact on job stress and self-rated health.

Methods: A cross-sectional survey of a random sample of 926 HHs in the Balearic Islands (Spain) assessed job stress, self-rated health, psychosocial factors (job demands and resources), and sociodemographic variables using the Copenhagen Psychosocial Questionnaire II (COPSOQ-II) and the National Health Survey. Descriptive analysis and hierarchical linear regression models were applied.

Results: The prevalence of job stress was 61.1% (95% confidence interval [CI] = [57.8%, 64.1%]), while the prevalence of poor self-rated health was 59.9% (95% CI = [56.6%, 62.9%]). Hotel housekeepers were highly exposed to job demands such as intense work pace, job-specific stressors, work-life conflict, and emotional demands; highly available job resources were role clarity, task meaning, and social support. Regression models revealed work pace, work-life conflict, nationality, and weak leader support as key predictors of job stress; and work-life conflict and leadership quality as key predictors of self-rated health.

Conclusion/application to practice: Although considered an eminently physical job, psychosocial work factors play a key role in explaining HHs' job stress and self-rated health. Occupational health professionals should design workplace interventions to reduce work pace, mitigate work-life conflict, and enhance resources such as leader support, sense of community, and leadership quality.

背景:由于要求高且资源有限,酒店管家被公认为是一份质量不高的工作。酒店管家(HHs)既要面对艰苦的体力劳动,又要面对苛刻的精神条件,但对这一女性化和不稳定职业中的社会心理因素的研究仍然不足。为了填补这一空白,本研究探讨了酒店管家在工作中接触的社会心理因素及其对工作压力和自我健康评价的影响:对巴利阿里群岛(西班牙)的 926 户家庭进行了随机抽样横断面调查,使用哥本哈根社会心理问卷 II (COPSOQ-II) 和全国健康调查评估了工作压力、自我健康评价、社会心理因素(工作要求和资源)以及社会人口变量。研究采用了描述性分析和分层线性回归模型:工作压力的发生率为 61.1%(95% 置信区间 [CI] = [57.8%, 64.1%]),而自评健康状况不良的发生率为 59.9%(95% 置信区间 [CI] = [56.6%, 62.9%])。酒店管家面临的工作要求较高,如紧张的工作节奏、特定的工作压力、工作与生活的冲突和情感要求;可用性较高的工作资源是角色清晰度、任务意义和社会支持。回归模型显示,工作节奏、工作与生活的冲突、国籍和薄弱的领导支持是工作压力的主要预测因素;工作与生活的冲突和领导质量是自我健康评价的主要预测因素:尽管家政服务被认为是一项体力劳动,但社会心理学工作因素在解释家政服务人员的工作压力和自我健康评价方面起着关键作用。职业健康专业人员应设计工作场所干预措施,以降低工作节奏,缓解工作与生活的冲突,并增强领导支持、社区感和领导素质等资源。
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引用次数: 0
Circumstantial Factors Among Kentucky Nurse Suicide Decedents, 2005 to 2019. 2005 年至 2019 年肯塔基州护士自杀死者的间接因素。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-26 DOI: 10.1177/21650799241289139
Paul E Norrod, Julie Marfell, Lee Anne Walmsley, Sabrina Brown

Background: Nurse suicide, a complex occupational health concern, is urgently in need of research due to the personal and occupational suicide risk factors experienced by nurses, namely mental health problems (e.g., depression), job problems, and substance misuse. Therefore, the study aims were to determine the contextual characteristics and circumstantial factors associated with nurse suicide in Kentucky. Methods: Secondary suicide data were obtained from the Kentucky Violent Death Reporting System (KYVDRS) from 2005 to 2019. Nurse suicide cases were identified using the Bureau of Labor Statistics Standard Occupational Classification. A mixed-methods analysis using descriptive statistics and qualitative evaluation was conducted to determine the distributions of demographic, injury, and weapon characteristics, followed by a qualitative analysis of the KYVDRS incident narrative text of nurse suicide decedents. Results: There were 88 decedents identified with a nursing occupation. The predominant means of death for male (59%) and female (45%) nurses involved firearms. Thematic analysis showed nurse decedents experienced a mental health problem (51%) and premeditated (50%) suicide preceding death. Incidentally, 51% of all cases experienced multiple circumstantial factors (e.g., relationship problems and premeditation) preceding their death by suicide. Discussion/Application to Practice: Nurse suicide decedents experienced multifactorial risk factors preceding their death by suicide, namely depression, premeditated suicide, and relationship problems. Occupational health practitioners and health care organizations can implement individual and organizational prevention efforts to help prevent nurse suicide.

背景:护士自杀是一个复杂的职业健康问题,由于护士经历的个人和职业自杀风险因素,即心理健康问题(如抑郁症)、工作问题和药物滥用,护士自杀亟需研究。因此,本研究旨在确定与肯塔基州护士自杀相关的背景特征和环境因素。研究方法从肯塔基州暴力死亡报告系统(KYVDRS)中获取了 2005 年至 2019 年的二次自杀数据。使用美国劳工统计局的标准职业分类确定了护士自杀案例。使用描述性统计和定性评估进行了混合方法分析,以确定人口统计学、伤害和武器特征的分布情况,随后对 KYVDRS 事件中护士自杀死者的叙述文本进行了定性分析。结果:共有 88 名死者被确认从事护理职业。男护士(59%)和女护士(45%)的主要死亡方式都涉及枪支。专题分析表明,护士死者在死前有精神健康问题(51%)和预谋自杀(50%)。顺便提一下,在所有案例中,51%的人在自杀死亡前经历了多种环境因素(如人际关系问题和预谋)。讨论/实践应用:护士自杀死者在自杀死亡前经历了多种风险因素,即抑郁、预谋自杀和人际关系问题。职业健康从业者和医疗机构可以通过个人和组织预防措施来帮助防止护士自杀。
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引用次数: 0
Noise Exposure and Hearing Loss Among Landscape and Groundskeepers. 园林和园艺工人的噪声暴露与听力损失。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-24 DOI: 10.1177/21650799241288910
Joshua Lyon

Excessive noise exposure within the working population is a health concern that has received increased attention in recent years. Levels have been established by national organizations that reflect safe exposure, but many kinds of equipment used in the landscaping and groundskeeper industries still exceed them. While noise risks are often long-term in nature and occur with cumulative exposure, prevention and exposure methods can still be used by employers to protect their workers' long-term health. Recalling the hierarchy of controls established by the National Institute for Occupational Health and Safety (NIOSH), various strategies can be implemented without creating excessive supervisory burden and with minimal costs. Occupational health nurses can further help reduce excessive noise exposure by encouraging the use of an easy-to-use noise-level assessment app created by NIOSH.

工作人群接触过量噪音是一个健康问题,近年来受到越来越多的关注。国家组织已经制定了反映安全接触水平的标准,但园林绿化和地面维护行业使用的许多设备仍然超过了这些标准。虽然噪声风险往往是长期性的,而且是在累积暴露的情况下发生的,但雇主仍然可以使用预防和暴露方法来保护工人的长期健康。回顾美国国家职业健康与安全研究所(NIOSH)制定的分级控制措施,可以在不造成过重监管负担和最低成本的情况下实施各种策略。职业健康护士可以通过鼓励使用 NIOSH 开发的易于使用的噪声级评估应用程序,进一步帮助减少过度的噪声暴露。
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引用次数: 0
A Qualitative Assessment of Changes in Occupational Exposures Among Healthcare Facility Workers. 对医疗机构工作人员职业暴露变化的定性评估。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-23 DOI: 10.1177/21650799241284085
David Gimeno Ruiz de Porras, Jenil Patel, Sadie Conway, Lisa Pompeii, Laura E Mitchell, Arch Carson, Lawrence W Whitehead, Inkyu Han, Jan-Paul Zock, Paul K Henneberger, Riddhi Patel, Joy De Los Reyes, George L Delclos

Adult-onset asthma, notably prevalent among healthcare professionals, especially nurses, is often attributed to occupational factors such as exposure to cleaning agents. Studies consistently underscore the substantial role of such exposure in work-related asthma among hospital staff. We aimed to (a) identify and characterize current practices in cleaning and aerosolized medication administration; (b) assess changes in practices since a similar 2003 study of Texas healthcare workers; and (c) identify factors contributing to diverse exposures within healthcare job categories. We conducted focus groups with 38 participants in 6 healthcare settings, analyzing current practices, changes since 2003, and factors contributing to exposure diversity. We used a three-step approach for data analysis, including sociodemographic characterization, a scissor-and-sort technique for exposure description, and qualitative content analysis. Participants were primarily healthcare providers (76%) and housekeepers/cleaners (11%) who reported exposure to aerosolized medications, cleaning products, adhesives, and solvents. Participants reported transitioning from cleaning practices to new formulas with reduced odors and shifting from spray cleansers to wipes. Personal protective equipment (PPE) used during cleaning tasks varied, with training differing among job categories. Aerosolized medication administration varied among facilities, with reported medication types and protocol changes over time. The results emphasized the significance of maintaining uniform protection, disseminating knowledge, and consistently adhering to PPE protocols in the healthcare environment. Addressing the identified gaps in comprehension and potential sources of exposure variability requires additional focus on occupational health and safety initiatives.

成人哮喘在医护人员(尤其是护士)中尤为常见,其发病原因通常与职业因素有关,如接触清洁剂。研究一致强调,在医院工作人员中,接触清洁剂在与工作相关的哮喘中起着重要作用。我们的目标是:(a) 识别和描述目前在清洁和喷雾给药方面的做法;(b) 评估自 2003 年对得克萨斯州医护人员进行类似研究以来的做法变化;(c) 识别导致医护工作类别中不同暴露的因素。我们与 6 个医疗机构的 38 名参与者进行了焦点小组讨论,分析了当前的做法、自 2003 年以来的变化以及导致暴露多样性的因素。我们采用三步法进行数据分析,包括社会人口特征描述、暴露描述的剪刀排序技术和定性内容分析。参与者主要是医疗保健提供者(76%)和管家/清洁工(11%),他们报告说接触过气溶胶药物、清洁产品、粘合剂和溶剂。参与者报告说,他们正在从清洁方法过渡到气味更少的新配方,并从喷雾清洁剂转向湿巾。清洁任务中使用的个人防护设备 (PPE) 各不相同,不同工种的培训也不尽相同。不同机构的气溶胶给药方法各不相同,报告的药物类型和方案也随着时间的推移而发生变化。研究结果强调了在医疗环境中保持统一保护、传播知识和始终如一地遵守个人防护设备规程的重要性。要解决已发现的理解差距和潜在的暴露变异源,就需要进一步关注职业健康和安全措施。
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引用次数: 0
Summarizing Recommendations for the Prevention of Occupational Heat-Related Illness in Outdoor Workers A Scoping Review. 关于预防户外工作者职业热相关疾病的建议摘要范围审查。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-21 DOI: 10.1177/21650799241281998
Ashley Edgerly, Gordon Lee Gillespie, Amit Bhattacharya, Beverly M Hittle

Background: Outdoor workers face unique challenges in preventing heat-related illnesses (HRI). Although preventable, HRI and death from heat exposure continue. A review of the most recent recommendation for HRI prevention in outdoor workers in the United States was warranted. A scoping review using PRISMA guidelines was conducted to compile policy statements and recommendations on the prevention of HRI and synthesize them into a three-step plan for prevention using the Haddon Matrix.

Method: PubMed, CINAHL, Medline, and websites from organizations and regulating bodies were searched for sources. Key terms such as occupational OR workers OR employers OR policymakers, HRI OR heat stress OR heat, prevention, recommendations OR position statements were used. Inclusion criteria were articles published within the last 5 years written in English and containing recommendations for preventing HRI in outdoor workers. Research not based on U.S. workers was excluded from the review.

Results: Twenty sources comprised the review. Several themes emerged, indicating deficient recommendations for secondary and tertiary prevention.

Conclusion/application to practice: This review's findings can be used by occupational health nurses (OHNs) in developing comprehensive interventions for preventing HRI and injury, using clear language, and following evidenced-based practices to increase workplace health and safety and promote equity.

背景:户外工作者在预防热相关疾病(HRI)方面面临着独特的挑战。尽管热相关疾病是可以预防的,但热暴露导致的热相关疾病和死亡仍在继续。有必要对美国户外工作者预防热相关疾病的最新建议进行回顾。我们采用 PRISMA 准则进行了一次范围界定审查,汇编了有关预防 HRI 的政策声明和建议,并使用 Haddon 矩阵将其归纳为预防 HRI 的三步计划:方法:检索了 PubMed、CINAHL、Medline 以及各组织和监管机构的网站。关键词包括职业或工人或雇主或决策者、HRI 或热应激或热量、预防、建议或立场声明。纳入标准为过去 5 年内发表的英文文章,其中包含对户外工作者预防 HRI 的建议。非基于美国工人的研究不在审查范围之内:综述包括 20 篇资料。出现了几个主题,表明二级和三级预防建议存在不足:职业健康护士(OHNs)可利用本综述的研究结果制定预防 HRI 和伤害的综合干预措施,使用清晰的语言并遵循循证实践,以提高工作场所的健康和安全并促进公平。
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引用次数: 0
Protecting America's Farmers From the Bird Flu, H5N1. 保护美国农民免受禽流感 H5N1 的侵袭。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-17 DOI: 10.1177/21650799241282685
Hannah Rumsey
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引用次数: 0
Staff Safety Alert Banner Program Against Workplace Violence at an Urban American Hospital. 一家美国城市医院的员工安全警示标语计划,反对工作场所暴力。
IF 2.3 4区 医学 Q1 NURSING Pub Date : 2024-10-05 DOI: 10.1177/21650799241280667
Crystal Li, Stephanie Bentley, Mangla S Gulati, Kristie Snedeker, Madeline R Marks

Background: Workplace violence (WPV) in healthcare has become an issue worldwide, with increasing prevalence after the COVID-19 pandemic. Notably, WPV in any setting has individual and systemic repercussions. However, despite extensive literature reporting the prevalence of WPV in healthcare worldwide, effective, standardized prevention policies have not been established. We developed and piloted a WPV initiative at an urban hospital in the state of Maryland. Here, we aim to describe our program development methods and implementation.

Methods: The 6-month program utilized a reporting tool developed within patients' electronic medical records (EMRs) to request the display of a Staff Safety Alert (SSA) banner to alert healthcare professionals of patients who engaged in violent behavior and are at increased risk of subsequent behavior. This tool was piloted on 21 patient care units. A review committee either approved or denied case requests filed by frontline workers, with holistic consideration involving patient status, potential biases, and communication flaws.

Results: Twenty-one banner requests were filed during the course of the pilot. Of which, eight were approved, and 13 were denied. The multi-trauma intermediate care floor filed the most case requests for a safety banner.

Conclusions/application to practice: Our pilot program offers a patient-centered intervention program where extensive personnel training and patient-focused considerations were applied prior to the approval or denial of a banner display. The SSA program was the initial step in institutionally combatting WPV in healthcare as staff are encouraged to officially document unsafe events followed by careful action in response.

背景:医疗保健领域的工作场所暴力(WPV)已成为全球范围内的一个问题,在 COVID-19 大流行之后,其发生率越来越高。值得注意的是,任何环境中的 WPV 都会对个人和系统产生影响。然而,尽管有大量文献报道了 WPV 在全球医疗保健领域的流行情况,但有效的标准化预防政策尚未建立。我们在马里兰州的一家城市医院制定并试行了一项 WPV 计划。在此,我们旨在介绍我们的计划制定方法和实施情况:这项为期 6 个月的计划利用在患者电子病历(EMR)中开发的报告工具,要求显示员工安全警示(SSA)横幅,以提醒医护人员注意有暴力行为且后续行为风险增加的患者。该工具在 21 个病人护理单元进行了试点。审查委员会在全面考虑患者状况、潜在偏见和沟通缺陷的情况下,批准或拒绝一线员工提出的案例申请:结果:在试点过程中,共提交了 21 份标语申请。结果:试点期间共提交了 21 份标语申请,其中 8 份获得批准,13 份被拒绝。多创伤中级护理楼层提出的安全标语申请最多:我们的试点计划提供了一项以患者为中心的干预计划,在批准或拒绝悬挂横幅之前,我们对人员进行了广泛的培训,并考虑到了以患者为中心的因素。由于我们鼓励员工正式记录不安全事件,并采取谨慎的应对措施,因此安全标语计划是医疗机构打击 WPV 的第一步。
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引用次数: 0
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Workplace Health & Safety
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