麻醉科熟练同伴支持计划成果：第二受害者的看法

IF 2.3 Q2 HEALTH CARE SCIENCES & SERVICES Joint Commission journal on quality and patient safety Pub Date : 2024-06-01 DOI:10.1016/j.jcjq.2024.03.006

Brenda Bursch PhD (is Professor, Department of Psychiatry and Biobehavioral Sciences, and Department of Pediatrics, David Geffen School of Medicine at UCLA.), Keren Ziv MD (is Clinical Professor, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA.), Shevaughn Marchese (is Faculty Development and Career Advancement Program Manager, Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA.), Hilary Aralis PhD (is Professor, Department of Biostatistics, UCLA Fielding School of Public Health.), Teresa Bufford PhD (formerly Graduate Student Researcher and Biostatistician, Department of Biostatistics, UCLA Fielding School of Public Health, is Principal Statistician GSK, Wynnewood, Pennsylvania.), Patricia Lester MD (is Professor, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA. Please address correspondence to Brenda Bursch)

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引用次数: 0

摘要

背景大多数麻醉服务提供者在其培训或职业生涯中都经历过不良事件。有限的证据表明，熟练的同伴支持计划（SPSP）可以减轻最初的痛苦，并支持适应功能和应对能力。本研究评估了第二受害者对自愿性 SPSP 的看法。方法2017 年 12 月，为三家医院和六家门诊手术中心麻醉科和围术期医学科的所有临床和行政人员制定并实施了 SPSP。该计划结合了斯科特第二受害者支持三层干预模式。在实施 SPSP 之前和实施 18 个月后，分别向科室的临床医生进行了调查。在经历过严重不良患者事件的受访者中，作者使用了多重逻辑回归模型，并对角色和每月夜班次数进行了调整，以考察实施该计划后，受访者在感知资源可用性和事件后所获支持方面的差异。共有 25 人参加了实施前和实施后的调查（19 人填写完整）。实施后，62.5% 的受访者表示，自发生严重不良患者事件以来，机构支持得到了改善。统计模型显示，与实施前相比，实施后临床医生同意 "我认为机构从事件中吸取了教训，并采取了适当措施来降低事件再次发生的几率 "这一说法的几率有了显著提高（调整后的几率比 [aOR] 为 3.9，95% 置信区间 [CI] 为 1.01-15.1。结论在大型麻醉科实施熟练的同伴支持计划可以改善基于机构的情感支持。

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Department of Anesthesiology Skilled Peer Support Program Outcomes: Second Victim Perceptions

Background

Most anesthesia providers experience an adverse event during their training or career. Limited evidence suggests skilled peer support programs (SPSPs) reduce initial distress and support adaptive functioning and coping. This study evaluated second victim perceptions of a voluntary SPSP.

Methods

An SPSP was developed and implemented for all clinical and administrative personnel in the Department of Anesthesiology and Perioperative Medicine in three hospitals and six outpatient surgery centers in December 2017. The program incorporated the Scott Three-Tiered Interventional Model of Second Victim Support. Surveys were offered to clinicians in the department prior to implementation of the SPSP and again 18 months after implementation. Among the subset of respondents who experienced a serious adverse patient event, the authors used multiple logistic regression models that adjusted for role and number of night shifts per month to examine differences in perceived resource availability and post-event support received following implementation of the program.

Results

There were 94 surveys (83 complete; 11 partially complete) collected prior to implementation and 84 surveys (67 complete; 17 partially complete) collected after implementation. A total of 25 individuals took the survey at both pre and post (19 complete). After implementation, 62.5% of respondents indicated that institutional support had improved since the occurrence of their serious adverse patient event. Statistical models identified a significant improvement in the probability that a clinician agreed with the statement “I think that the organization learned from the event and took appropriate steps to reduce the chance of it happening again” at post vs. pre (adjusted odds ratio [aOR] 3.9, 95% confidence interval [CI] 1.01–15.1. A statistically significant increase from pre to post in the perceived availability of formal emotional support was identified (aOR 5.2, 95% CI 1.9–22.5).