Health care workers’ experiences of workplace incidents that posed a risk of patient and worker injury: a critical incident technique analysis

BMC Health Services Research

Charlotte Wåhlin¹  Axel Ros²  Susanne Kvarnström³  Emma Nilsing Strid⁴ 

[1] Division of Prevention, Rehabilitation and Community Medicine, Occupational and Environmental Medicine Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;Unit of Intervention and Implementation Research for Worker Health, Institute for Environmental Medicine, Karolinska Institute, Stockholm, Sweden;Region Jönköping County and The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden;Region Östergötland, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden;University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden;

关键词: Patient safety;    Occupational health;    Safety management;    Musculoskeletal pain;    Psychological distress;   

DOI  :  10.1186/s12913-021-06517-x

来源: Springer

【 摘 要 】

BackgroundHealth care workers (HCWs) are at high risk of occupational injuries and approximately 10–15% of patients are affected by an adverse event during their hospital stay. There is scarce scientific literature about how HCWs manage these risks in practice and what support they need. This knowledge is needed to improve safety for patients and HCWs. This study explores HCWs’ experiences of workplace incidents that led to injury or posed a risk of patient and worker injury, with focus on HCWs’ emotions and actions.MethodsThis study employed a qualitative design using the critical incident technique. Semi-structured individual interviews were held with 34 HCWs from three regions in Sweden. Data were analysed using inductive category development.ResultsAltogether 71 workplace incidents were reported. The analysis of two dimensions – the emotions HCWs feel and the actions team members and managers take when a workplace incident occurs – yielded two categories each: Anxiety during the incident, Persistent distress after the incident, Team interplay for safety actions and Support and ratification from managers and colleagues. Health care workers risked their own safety and health to provide patient safety. Teamwork and trustful relationships were critical for patient and worker safety. Support and validation from colleagues and managers were important for closure; unsatisfactory manager response and insufficient opportunities to debrief the incident could lead to persistent negative emotions. Participants described insecurity and fear, sadness over being injured at work, and shame and self-regret when the patient or themselves were injured. When the workplace had not taken the expected action, they felt anger and resignation, often turning into long-term distress.ConclusionsWork situations leading to injury or risk of patient and worker injury are emotionally distressing for HCWs. Team interplay may facilitate safe and dynamic practices and help HCWs overcome negative emotions. Organizational support is imperative for individual closure. For safety in health care, employers need to develop strategies for active management of risks, avoiding injuries and providing support after an injury.

【 授权许可】

CC BY