عوامل موثر بر ارائه مراقبت ایمن واحدهای امدادی اورژانس پیش بیمارستانی استان مازندران
محورهای موضوعی : -مدیریت خدمات بهداشتی و درمانیمصطفی گل چوبی 1 , لیلا کیکاوسی آرانی 2
1 - دانش‌آموخته کارشناسی ارشد، گروه مدیریت خدمات بهداشتی و درمانی، واحد الکترونیکی، دانشگاه آزاد اسلامی، تهران، ایران
2 - استادیار، گروه مدیریت خدمات بهداشتی و درمانی، دانشکده بهداشت و مرکز تحقیقات بهداشت، ایمنی و محیط، دانشگاه علوم پزشکی البرز، کرج، ایران
کلید واژه: اورژانس پیش بیمارستانی, واحد امدادی, مراقبت ایمن,
چکیده مقاله :
مقدمه: ارائه مراقبت ایمن توسط واحدهای امدادی اورژانس پیش بیمارستانی در حوادث و بحران ها نقش موثری در کاهش بار جراحات و آسیب ها دارد. این مطالعه با هدف بررسی عوامل موثر بر ارائه مراقبت ایمن توسط واحدهای امدادی اورژانس پیش بیمارستانی در استان مازندران انجام شد.روش پژوهش: این پژوهش از نوع توصیفی- تحلیلی (مقطعی) بود. جامعه آماری پژوهش پرسنل عملیاتی واحدهای امدادی پایگاه‌های منتخب اورژانس پیش بیمارستانی استان مازندران بودند(165=N). نمونه‌گیری به روش سرشماری انجام شد. ابزار گردآوری داده ها، پرسشنامه محقق ساخته بود که در بررسی روایی محتوای کمی از شاخص روایی محتوا و نسبت روایی محتوا استفاده شد. سپس پایایی پرسشنامه با روش آلفای کرونباخ 82/0برآورد شد. تحلیل داده‌ها با استفاده از نرم‌افزار20 SPSS انجام شد. رتبه‌بندی و اولویت‌بندی عوامل موثر بر ارائه مراقبت ایمن واحدهای امدادی اورژانس پیش بیمارستانی با آزمون فریدمن انجام شد.یافته‌ها: از دیدگاه پرسنل عملیاتی واحدهای امدادی اورژانس پیش بیمارستانی استان مازندران، پنج عامل در ارائه مراقبت ایمن این واحدها موثر بود که عامل انگیزه به عنوان اثرگذارترین عامل در رتبه اول (با میانگین رتبه3/49) و تجهیزات پزشکی به عنوان کم اثرترین عامل در رتبه پنجم (با میانگین رتبه 5/49) بود.نتیجه‌گیری: سیاست‌گذاری در زمینه ارتقای انگیزه پرسنل واحدهای امدادی و آموزش آنها، تامین نیروی انسانی لازم، مدیریت واحدهای امدادی و ارتقای تجهیزات پزشکی موجب ارتقای ارائه مراقبت ایمن واحدهای امدادی اورژانس پیش بیمارستانی می‌شود.
Introduction: Providing safe care in accidents and crises by pre-hospital emergency aid units plays an effective role in reducing the burden of injuries and damages. This study was conducted with the aim of investigating the factors affecting the provision of safe care by pre-hospital emergency units in Mazandaran province.Methods: This research was descriptive-analytical (cross-sectional). The statistical population of the research was operational personnel of emergency units of selected pre-hospital emergency bases in Mazandaran province (N=165) and sampling was done by census method. The data collection tool was a researcher-made questionnaire, which was used to check the quantitative content validity using the content validity index and the content validity ratio. Then the reliability of the questionnaire was estimated by Cronbach's alpha method of 0.82. Data analysis was done using SPSS 20 software. The ranking and prioritization of factors affecting the provision of safe care in pre-hospital emergency units was done with Friedman's test.Results: From the point of view of operational personnel of pre-hospital emergency aid units of Mazandaran province, 5 factors were effective in providing safe care in pre-hospital emergency aid units, which is the motivation factor in the first place (with an average rating of 3.49) as the most effective factor and medical equipment in the fifth place (with an average rating of 5.49), was the least effective factor.Conclusion: Policy-making in the field of improving the motivation of the personnel of relief units and their training, providing the necessary manpower, managing relief units and improving medical equipment will improve the provision of safe care in pre-hospital emergency relief units.
1- Sriram VM, Naseer R, Hyder AA. Provision of prehospital emergency medical services in Punjab, Pakistan: Case study of a public sector provider. Surgery, 2017; 162(6): S12-S23.
2- Senol V, Argun M, Celebi I. Evaluation of Risk Perception and Management in Emergency Medical Services Providers Working in Pre-hospital Areas in Kayseri, Turkey. Ethno-Medicine, 2018; 12(1): 40-8.
3- Kazamneghad E, Pourshaikhian M, Vatankhah S. Quality Survey of Pre-hospital Emergency Services in Guilan Province. Journal of Guilan University of Medical Sciences, 2015; 23(92): 50-8.
4- Walk CT, Ross A, Kranker L, Whitmill M, Ballester M, Parikh PP, Semon G, Ekeh AP. The Oregon district shooting: Reviewing the pre-hospital protocols and the role of the resident during a multiple casualty event. The American Surgeon; 2022 Jul 8:00031348221114044.
5- Olave-Rojas D, Nickel S. Modeling a pre-hospital emergency medical service using hybrid simulation and a machine learning approach. Simulation Modelling Practice and Theory, 2021 May 1; 109: 102302.
6- Panagioti M, Khan K, Keers RN, Abuzour A, Phipps D, Kontopantelis E, Bower P, Campbell S, Haneef R, Avery AJ, Ashcroft DM. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. Bmj, 2019 Jul 17; 366.
7- Kim NK, Rahim NF, Iranmanesh M, Foroughi B. The role of the safety climate in the successful implementation of safety management systems. Safety science, 2019 Oct 1; 118: 48-56.
8- Atesok K, Satava RM, Van Heest A, Hogan MV, Pedowitz RA, Fu FH, Sitnikov I, Marsh JL, Hurwitz SR. Retention of skills after simulation-based training in orthopaedic surgery. Journal of the American Academy of Orthopaedic Surgeons, 2016 Aug 1; 24(8): 505-14.
9- Donaldson LJ, Neelam D. World patient safety day: a call for action on health worker safety. Journal of Patient Safety and Risk Management, 2020 Oct; 25(5): 171-3.
10- Basson T, Montoya A, Neily J, Harmon L, Watts BV. Improving patient safety culture: a report of a multifaceted intervention. J Patient Saf, 2018; 14(2): 107–11.
1- Ajalli A, Khoshknab M, Dibaee M. The survey of patient safety culture in razi psychiatric center in Tehran. Health Promotion Management, 2015; 4: 85-94.
12- Reader TW, Gillespie A. Stakeholders in safety: Patient reports on unsafe clinical behaviors distinguish hospital mortality rates. Journal of Applied Psychology, 2021 Mar; 106(3): 439.
13- Heidari M, Aliakbari F, Heydarpoor S, Nehrir B, Yadollahi S. Pre-hospital Emergency Service Challenges in the Face of the COVID-19 Pandemic in Iran. Disaster Medicine and Public Health Preparedness; 2022 Jun 7: 1-7.
14- Heidari M, Shahbazi S. Assessment of Emergency Medical Services (EMS) Staff’s knowledge and Practice about Principles and Equipment used for Patient Handling in EMS Centres of Isfahan Province . J Res Dev Nurs Midw, 2015; 12(1): 111-117.
15- Olave-Rojas D, Nickel S. Modeling a pre-hospital emergency medical service using hybrid simulation and a machine learning approach. Simul Model Pract Theory, 2021; 109: 102302.
16- Available from: http://ems.mazums.ac.ir/Index.aspx?page_=form&lang=1&sub=54&tempname=N115main&PageID=47479.
17- Eubanks JB. The EMS Deficit: A Study on the Excessive Staffing Shortages of Paramedics and its Impact on EMS Performance in the States of South Carolina and North Carolina and Interventions for Organizational Improvements.(2022). Doctoral Dissertations and Projects. 3596. https://digitalcommons.liberty.edu/doctoral/3596
18- Eri M, Jafari N, Kabir M, Mahmoodishan G, Moghassemi M, Tahanian M, et al. Concept and challenges of delivering preventive and care services in prehospital emergency medical service: A qualitative study. Journal of Mazandaran University of Medical Sciences, 2015; 25(126): 42-57.
19- Sheikhbardsiri H, Khademipour G, Nekoei‐Moghadam M, Aminizadeh M. Motivation of the nurses in pre‐hospital emergency and educational hospitals emergency in the southeast of Iran. The International journal of health planning and management, 2018; 33(1): 255-64.
20- Sabouri E, NADERI MM, Saburie O, Mohammadi Y, Tavakkoli F .The Evaluation of prehospital emergency performance indicators in Birjand, 2015. Iranian Journal of Emergency Care, 2017; 1(1): 61-8.
21- Henriksson O, Björnstig U, Saveman BI, Lundgren P. Protection against cold–a survey of available equipment in Swedish pre‐hospital services. Acta Anaesthesiologica Scandinavica, 2017; 61(10): 1354-60.
22- Mason S, Stone T, Jacques R, Lewis J, Simpson R, Kuczawski M, Franklin M. Creating a real-world linked research platform for analyzing the urgent and emergency care system. Medical Decision Making, 2022 Nov; 42(8): 999-1009.
23- Esmail S, Maryam NM, Omid S, Yahya M, Fatemeh T. The Evaluation of prehospital emergency performance indicators in Birjand, 2015. Iranian Journal of Emergency Care, 2017 ;1(1): 8-61. eng.
24- Cummings D, Mc Morris H. Saskatchewan emergency medical services (EMS) review: inal report. Health ministry; 2009.
25- Herzberg S, Hansen M, Schoonover A, Skarica B, McNulty J, Harrod T, Snowden JM, Lambert W, Guise JM. Association between measured teamwork and medical errors: an observational study of prehospital care in the USA. BMJ ope, 2019 Oct 1; 9(10): e025314.
26- Abate H, Mekonnen C. Knowledge, practice, and associated factors of nurses in pre-hospital emergency care at a Tertiary care teaching hospital. Open Access Emergency Medicine; 2020 Dec 31: 459-69.
27- Plummer V, Boyle M. Knowledge, attitude, and practice of ambulance nurses in prehospital care in Malang, Indonesia. Australasian Emergency Care, 2018; 21(1): 8-12.
28- Asadi P, Noori Roodsari N, Eslami Kenarsari H, Darabi Niya MR, Pourshaikhian M. Knowledge Level of Pre-Hospital Emergency Medical Services Personnel about Ambulance Equipment in Rasht, Iran. Journal of Guilan University of Medical Sciences, 2022; 31(1): 40-49.
29- Rowland M, Adefuye AO. An Evaluation of Pre-Hospital Emergency Care Personnel Knowledge About Crisis Resource Management and Perspectives of Educators About Inclusion of Crisis Resource Management in the Pre-Hospital Emergency Care Curriculum. Advances in Medical Education and Practice; 2022 Dec 31: 849-64.
30- Butler MW, Adefuye AO. Assessing the knowledge of emergency medical care personnel in the Free State, South Africa, on aspects of paediatric pre-hospital emergency care. Pan African Medical Journal, 2019 Mar 1; 32(1).
31- Hosseini SH, Arab M, Keikavoosi‐Arani L. Evaluation of safety managem and clinical setting in selected hospitals of Tehrn Medical Sciences. EBNESINA, 2022; 24(2): 60-69.
32- Keikavoosi Arani L, Ramezani M, AbedinSalimAbadi P. Codification of national accreditation standards for management and leadership in hospitals of Iran. Journal of Mazandaran University of Medical Sciences, 2014 Dec 10; 24(119): 194-8.
_||_1- Sriram VM, Naseer R, Hyder AA. Provision of prehospital emergency medical services in Punjab, Pakistan: Case study of a public sector provider. Surgery, 2017; 162(6): S12-S23.
2- Senol V, Argun M, Celebi I. Evaluation of Risk Perception and Management in Emergency Medical Services Providers Working in Pre-hospital Areas in Kayseri, Turkey. Ethno-Medicine, 2018; 12(1): 40-8.
3- Kazamneghad E, Pourshaikhian M, Vatankhah S. Quality Survey of Pre-hospital Emergency Services in Guilan Province. Journal of Guilan University of Medical Sciences, 2015; 23(92): 50-8.
4- Walk CT, Ross A, Kranker L, Whitmill M, Ballester M, Parikh PP, Semon G, Ekeh AP. The Oregon district shooting: Reviewing the pre-hospital protocols and the role of the resident during a multiple casualty event. The American Surgeon; 2022 Jul 8:00031348221114044.
5- Olave-Rojas D, Nickel S. Modeling a pre-hospital emergency medical service using hybrid simulation and a machine learning approach. Simulation Modelling Practice and Theory, 2021 May 1; 109: 102302.
6- Panagioti M, Khan K, Keers RN, Abuzour A, Phipps D, Kontopantelis E, Bower P, Campbell S, Haneef R, Avery AJ, Ashcroft DM. Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. Bmj, 2019 Jul 17; 366.
7- Kim NK, Rahim NF, Iranmanesh M, Foroughi B. The role of the safety climate in the successful implementation of safety management systems. Safety science, 2019 Oct 1; 118: 48-56.
8- Atesok K, Satava RM, Van Heest A, Hogan MV, Pedowitz RA, Fu FH, Sitnikov I, Marsh JL, Hurwitz SR. Retention of skills after simulation-based training in orthopaedic surgery. Journal of the American Academy of Orthopaedic Surgeons, 2016 Aug 1; 24(8): 505-14.
9- Donaldson LJ, Neelam D. World patient safety day: a call for action on health worker safety. Journal of Patient Safety and Risk Management, 2020 Oct; 25(5): 171-3.
10- Basson T, Montoya A, Neily J, Harmon L, Watts BV. Improving patient safety culture: a report of a multifaceted intervention. J Patient Saf, 2018; 14(2): 107–11.
1- Ajalli A, Khoshknab M, Dibaee M. The survey of patient safety culture in razi psychiatric center in Tehran. Health Promotion Management, 2015; 4: 85-94.
12- Reader TW, Gillespie A. Stakeholders in safety: Patient reports on unsafe clinical behaviors distinguish hospital mortality rates. Journal of Applied Psychology, 2021 Mar; 106(3): 439.
13- Heidari M, Aliakbari F, Heydarpoor S, Nehrir B, Yadollahi S. Pre-hospital Emergency Service Challenges in the Face of the COVID-19 Pandemic in Iran. Disaster Medicine and Public Health Preparedness; 2022 Jun 7: 1-7.
14- Heidari M, Shahbazi S. Assessment of Emergency Medical Services (EMS) Staff’s knowledge and Practice about Principles and Equipment used for Patient Handling in EMS Centres of Isfahan Province . J Res Dev Nurs Midw, 2015; 12(1): 111-117.
15- Olave-Rojas D, Nickel S. Modeling a pre-hospital emergency medical service using hybrid simulation and a machine learning approach. Simul Model Pract Theory, 2021; 109: 102302.
16- Available from: http://ems.mazums.ac.ir/Index.aspx?page_=form&lang=1&sub=54&tempname=N115main&PageID=47479.
17- Eubanks JB. The EMS Deficit: A Study on the Excessive Staffing Shortages of Paramedics and its Impact on EMS Performance in the States of South Carolina and North Carolina and Interventions for Organizational Improvements.(2022). Doctoral Dissertations and Projects. 3596. https://digitalcommons.liberty.edu/doctoral/3596
18- Eri M, Jafari N, Kabir M, Mahmoodishan G, Moghassemi M, Tahanian M, et al. Concept and challenges of delivering preventive and care services in prehospital emergency medical service: A qualitative study. Journal of Mazandaran University of Medical Sciences, 2015; 25(126): 42-57.
19- Sheikhbardsiri H, Khademipour G, Nekoei‐Moghadam M, Aminizadeh M. Motivation of the nurses in pre‐hospital emergency and educational hospitals emergency in the southeast of Iran. The International journal of health planning and management, 2018; 33(1): 255-64.
20- Sabouri E, NADERI MM, Saburie O, Mohammadi Y, Tavakkoli F .The Evaluation of prehospital emergency performance indicators in Birjand, 2015. Iranian Journal of Emergency Care, 2017; 1(1): 61-8.
21- Henriksson O, Björnstig U, Saveman BI, Lundgren P. Protection against cold–a survey of available equipment in Swedish pre‐hospital services. Acta Anaesthesiologica Scandinavica, 2017; 61(10): 1354-60.
22- Mason S, Stone T, Jacques R, Lewis J, Simpson R, Kuczawski M, Franklin M. Creating a real-world linked research platform for analyzing the urgent and emergency care system. Medical Decision Making, 2022 Nov; 42(8): 999-1009.
23- Esmail S, Maryam NM, Omid S, Yahya M, Fatemeh T. The Evaluation of prehospital emergency performance indicators in Birjand, 2015. Iranian Journal of Emergency Care, 2017 ;1(1): 8-61. eng.
24- Cummings D, Mc Morris H. Saskatchewan emergency medical services (EMS) review: inal report. Health ministry; 2009.
25- Herzberg S, Hansen M, Schoonover A, Skarica B, McNulty J, Harrod T, Snowden JM, Lambert W, Guise JM. Association between measured teamwork and medical errors: an observational study of prehospital care in the USA. BMJ ope, 2019 Oct 1; 9(10): e025314.
26- Abate H, Mekonnen C. Knowledge, practice, and associated factors of nurses in pre-hospital emergency care at a Tertiary care teaching hospital. Open Access Emergency Medicine; 2020 Dec 31: 459-69.
27- Plummer V, Boyle M. Knowledge, attitude, and practice of ambulance nurses in prehospital care in Malang, Indonesia. Australasian Emergency Care, 2018; 21(1): 8-12.
28- Asadi P, Noori Roodsari N, Eslami Kenarsari H, Darabi Niya MR, Pourshaikhian M. Knowledge Level of Pre-Hospital Emergency Medical Services Personnel about Ambulance Equipment in Rasht, Iran. Journal of Guilan University of Medical Sciences, 2022; 31(1): 40-49.
29- Rowland M, Adefuye AO. An Evaluation of Pre-Hospital Emergency Care Personnel Knowledge About Crisis Resource Management and Perspectives of Educators About Inclusion of Crisis Resource Management in the Pre-Hospital Emergency Care Curriculum. Advances in Medical Education and Practice; 2022 Dec 31: 849-64.
30- Butler MW, Adefuye AO. Assessing the knowledge of emergency medical care personnel in the Free State, South Africa, on aspects of paediatric pre-hospital emergency care. Pan African Medical Journal, 2019 Mar 1; 32(1).
31- Hosseini SH, Arab M, Keikavoosi‐Arani L. Evaluation of safety managem and clinical setting in selected hospitals of Tehrn Medical Sciences. EBNESINA, 2022; 24(2): 60-69.
32- Keikavoosi Arani L, Ramezani M, AbedinSalimAbadi P. Codification of national accreditation standards for management and leadership in hospitals of Iran. Journal of Mazandaran University of Medical Sciences, 2014 Dec 10; 24(119): 194-8.