急诊护理人员工作场所暴力应对策略的研究
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摘要
目的针对本院急诊室工作场所暴力发生的原因进行改进,减少急诊护理人员工作场所暴力的发生率,提高护理人员的职业满意度。
方法运用自身对照方法进行量性研究,采用护理管理2007年12月颁布的工作场所暴力调查表2008版量表,明确护理人员工作场所暴力发生的现状,回顾大量的文献及采用头脑风暴法和鱼骨图分析工作场所暴力发生的原因,针对原因采取了改造环境、改进流程、加强护理人员培训和管理、加强医院辅助支持系统、加强患者和家属的教育和管理等一系列措施。对44名急诊护理人员在干预前后发放问卷调查进行比较。
结果暴力发生频率中的从未发生和>2次/年干预前后两者的差异具有统计学意义(P<0.01),暴力发生方式中的肢体暴力、肢体暴力威胁、骚扰、故意损害财产干预前后两者的差异具有统计学意义(P<0.01)；恐吓、具有威胁性及破坏性行为、欺凌、携带或使用武器干预前后两者的差异无统计学意义(>0.05)
结论只要管理者高度重视,结合医院工作场所暴力发生的原因采取合理有效的改进措施,可以有效预防和减少工作场所暴力的发生。
Aims To summarize the reasons of workplace violence happened in nursing of emergency department and find out solutions, in order to decrease the incidence of workplace violence and increase the job satisfaction of nursing professions.
Methods Workplace Violence Investigation Questionnaire, published by nursing administration on Dec,2007, was used to investigate 44 ED nursing personnel by quantitive and comparison study. Aimed at the causes of workplace violence by the moethod of brainstorming and fishbone diagrams. Several measures, such as change of environment, improvement of procedures, training and management of nursing personnel, reinforcement of hospital support system and patient/relatives'education, were used to as intervene means to the study objects. The result of investigation after intervene was compared with one before intervene.
Results As far as frequency of violence is concerned, the increase of NEVER and decrease of OCCASIONAL has statistical meaning. The incidence of physical violence, threaten of physical violence, harassment, intentional damage to property has decreased significantly after intervene. A certain behaviors, such as Intimidation, threatening and disruptive behaviors, bullying, bear arms have not statistical meanings after intervene.
Conclusion As long as hospital administrators pay much attention, workplace violence can be prevented effectively by appropriate solutions based on reasons.
方法运用自身对照方法进行量性研究,采用护理管理2007年12月颁布的工作场所暴力调查表2008版量表,明确护理人员工作场所暴力发生的现状,回顾大量的文献及采用头脑风暴法和鱼骨图分析工作场所暴力发生的原因,针对原因采取了改造环境、改进流程、加强护理人员培训和管理、加强医院辅助支持系统、加强患者和家属的教育和管理等一系列措施。对44名急诊护理人员在干预前后发放问卷调查进行比较。
结果暴力发生频率中的从未发生和>2次/年干预前后两者的差异具有统计学意义(P<0.01),暴力发生方式中的肢体暴力、肢体暴力威胁、骚扰、故意损害财产干预前后两者的差异具有统计学意义(P<0.01)；恐吓、具有威胁性及破坏性行为、欺凌、携带或使用武器干预前后两者的差异无统计学意义(>0.05)
结论只要管理者高度重视,结合医院工作场所暴力发生的原因采取合理有效的改进措施,可以有效预防和减少工作场所暴力的发生。
Aims To summarize the reasons of workplace violence happened in nursing of emergency department and find out solutions, in order to decrease the incidence of workplace violence and increase the job satisfaction of nursing professions.
Methods Workplace Violence Investigation Questionnaire, published by nursing administration on Dec,2007, was used to investigate 44 ED nursing personnel by quantitive and comparison study. Aimed at the causes of workplace violence by the moethod of brainstorming and fishbone diagrams. Several measures, such as change of environment, improvement of procedures, training and management of nursing personnel, reinforcement of hospital support system and patient/relatives'education, were used to as intervene means to the study objects. The result of investigation after intervene was compared with one before intervene.
Results As far as frequency of violence is concerned, the increase of NEVER and decrease of OCCASIONAL has statistical meaning. The incidence of physical violence, threaten of physical violence, harassment, intentional damage to property has decreased significantly after intervene. A certain behaviors, such as Intimidation, threatening and disruptive behaviors, bullying, bear arms have not statistical meanings after intervene.
Conclusion As long as hospital administrators pay much attention, workplace violence can be prevented effectively by appropriate solutions based on reasons.
引文
1.世界卫生组织.新的研究表明工作场所暴力威胁卫生服务[R].世界卫生组织简报,2002,(14)：6-9.
2. 郑亚华.输液室护士受暴力行为侵袭的原因及对策[J].护理与康复,2005,4(3)：228-229.
3. 韩江红.关注并防范卫生保健领域中的暴力[J].中华护理杂志,2002,37(9)：718-719.
4. Keely BR. Recognition and prevention of hospital violence [J]. Dimens Crit Care Nurs.2002,21 (6):236-241.
5. Greg Warchol. Workplace violence,1992-1996. Bureau of Justice Statistics Special Report:National Crime Victimization Survey[R]. U.S. Department of Justice,1998.
6.李霜.暴力-医院中的职业危害[J].国外医学·卫生学分册,2003.30(3)：163.
7. 陈祖辉,王声湧,卢业成等.医院工作场所暴力的流行病学特征及危险因素分析[J].中华流行病学杂志,2004,25(1)：3-5.
8. 樊静,姜湖.医疗纠纷的现状及对医院和医务人员的影响[J].中国医院管理,2003,23(1)：29-31.
9. Lyneham J. Violence in New South Wales emergency departments [J]. Aust J Adv Nurs,2001,18(2):8-17.
10.陈祖辉,王声湧.急诊科护士工作场所心理暴力问题调查研究[J].护理学杂志,2004,19(15)：3-6.
11.王培席,陈传波,白琴,等.急诊护士遭受工作场所暴力后的体验.中华护理杂志,2007,42(5)：437-439.
12. CoreyGGenes.fears, phobias, and phobic disorders [J]. Journal of Counseling &Development,1990,6:628-632.
13. Gates DM, Ross CS, McQueen L. Violence against emergency department workers [J]. J Emerg Med,2006,31(3):331-337.
14. Ryan D, Maguire J. Aggression and violence - a problem in Irish Accident and Emergency departments [J]. J Nurs Manag,2006,14(2):106-115.
15.荆春霞,王声湧,陈祖辉等.医护人员对医院暴力的认知状况调查[J].中国公共卫生,2004,20(3)：338-339.
16. McPhaul KM, Lipscomb JA.Workplace violence in health care:recognized but not regulated [J]. Online J Issues Nurs.2004,9(3):7.
17. Fernandes CM, Bouthillette F, Raboud JM, et al. Violence in the emergency department:a survey of health care workers [J]. CMAJ,1999,161(10):1245-1248.
18.金静芬,许杰,沈国丽.急诊分诊管理程序的软件开发与应用研究[J].护理与康复,2007,6(4)：219-220,223.
19.叶国芳,叶敏,粱红燕。护理文化建设对监护室护士压力的影响[J].护理与康复,2007,2(6)：130-131.
20.叶志弘,姜安丽.护士群体中同事支持系统的研究进展[J].中华护理杂志,2007,42(10)：938-939.
21.陈荣凤,沈洁,尹自芳.对护理本科生实施导师制的构想与思考[J].解放军护理杂志,2005,22(7)；82-84.
22.谢魏,张大伟,谢晋宇.工作场所暴力问题的产生和预防[J].华东经济管理,2005,19(8)：123-126.
23.潘红英,苏伟.急诊护理人员遭受医院工作场所暴力的现状分析及应对[J].护理与康复,2008,7(5)：334-336.
[1]荆春霞,王声湧,陈祖辉,等.医护人员对医院暴力的认知状况调查[J].中国公共卫生,2004,20(3)：338-339.
[2]Saines JC. Violence and aggression in A & E: recommendations for action [J]. Accid Emerg Nurs,1999,7:8-12.
[3]郑亚华.输液室护士受暴力行为侵袭的原因及对策[J].护理与康复,2005, 4(3)：228-229.
[4]韩江红.关注并防范卫生保健领域中的暴力[J].中华护理杂志,2002,37(9)：718-719.
[5]Keely BR. Recognition and prevention of hospital violence[J]. Dimens Crit Care Nurs,2002,21(6):236-241.
[6]李霜.暴力—医院中的职业危害[J].国外医学卫生学分册,2003,30(3)：163.
[7]Victoria C. Workplace violence[J]. American Journal Nursing,1999,3:60.
[8]Carol A. Protecting yourself from violence in the workplace[J]Nursing,2002.6: 58-63.
[9]李波,宁宇,寇长贵,等.护士在医疗场所遭受暴力侵害的现况分析[J].中国医院管理,2005,25(12)：23-25.
[10]Lyneham J. Violence in New South Wales emergency departments [J]. Aust J Adv Nurs,2001,18(2):8-17.
[11]Fernandes CM, Bouthillette F, Raboud JM, at al. Violence in the emergency department:a survey of health care workers [J]. CMAJ,1999,161(10): 1245-1248.
[12]陈祖辉,王声湧,卢业成,等.医院工作场所暴力的流行病学特征及危险因素分析[J].中华流行病学杂志,2004,25(1)：3-5.
[13]杨巧红,肖丹.护理人员遭受工作场所暴力的现况调查与分析[J].护理研究,2005,19(2)：203-204.
[14]樊静,姜湖.医疗纠纷的现状及对医院和医务人员的影响[J]中国医院管理,2003,23(1)：29-31.
[15]Rew K, Yk L, Ke L, et al. Prevalence of workplace violence a—gainst nu in Hong Kong[J]. Hong Kong Med J,2006,12(1):6-9.
[16]陈祖辉,王声湧.急诊科护士工作场所心理暴力问题调查研究[J].护理学杂志,2004,19(15)：3-6.
[17]McPhaul KM, Lipscomb JA. Workplace violence in health care: recognized but not regulated[J]. Online J Issues Nurs,2004,9(3):7.
[18]GatesDM, RossCS, McQueen L. Violence against emergency department workers[J]. J Emerg Med,2006,31(3):331-337.
[19]Ryan D, Maguire J. Aggression and violenc—a problem in Irish Accident and Emergency departments [J]. J Nurs Manag,2006,14(2):106-115.
[20]吕秋玲.在护理管理中坚持以人为本[J].护理管理杂志,2002,2(5)：37-38.
[21]马伟光,李继平.医院场所暴力原因分析及对策[J].护理管理杂志,2005,5(5)：23-24.
[22]丁雪梅.护理人员法律知识认知水平的调查及对策[J].护理与康复,2007,6(2)：86-87.
[23]王声滇.伤害流行病学[M].北京：人民卫生出版社,2003
[24]罗红,吴小珊.美国医院对工作场所暴力的防范[J].中国实用护理杂志,2003,19(12)：65-66.
[25]金静芬,许杰,沈国丽.急诊分诊管理程序的软件开发与应用研究[J].护理与康复,2007,6(4)：219-220,223.
[26]叶国芳,叶敏,粱红燕.护理文化建设对监护室护士压力的影响[J].护理与康复,2007,6(2)：130-131.
2. 郑亚华.输液室护士受暴力行为侵袭的原因及对策[J].护理与康复,2005,4(3)：228-229.
3. 韩江红.关注并防范卫生保健领域中的暴力[J].中华护理杂志,2002,37(9)：718-719.
4. Keely BR. Recognition and prevention of hospital violence [J]. Dimens Crit Care Nurs.2002,21 (6):236-241.
5. Greg Warchol. Workplace violence,1992-1996. Bureau of Justice Statistics Special Report:National Crime Victimization Survey[R]. U.S. Department of Justice,1998.
6.李霜.暴力-医院中的职业危害[J].国外医学·卫生学分册,2003.30(3)：163.
7. 陈祖辉,王声湧,卢业成等.医院工作场所暴力的流行病学特征及危险因素分析[J].中华流行病学杂志,2004,25(1)：3-5.
8. 樊静,姜湖.医疗纠纷的现状及对医院和医务人员的影响[J].中国医院管理,2003,23(1)：29-31.
9. Lyneham J. Violence in New South Wales emergency departments [J]. Aust J Adv Nurs,2001,18(2):8-17.
10.陈祖辉,王声湧.急诊科护士工作场所心理暴力问题调查研究[J].护理学杂志,2004,19(15)：3-6.
11.王培席,陈传波,白琴,等.急诊护士遭受工作场所暴力后的体验.中华护理杂志,2007,42(5)：437-439.
12. CoreyGGenes.fears, phobias, and phobic disorders [J]. Journal of Counseling &Development,1990,6:628-632.
13. Gates DM, Ross CS, McQueen L. Violence against emergency department workers [J]. J Emerg Med,2006,31(3):331-337.
14. Ryan D, Maguire J. Aggression and violence - a problem in Irish Accident and Emergency departments [J]. J Nurs Manag,2006,14(2):106-115.
15.荆春霞,王声湧,陈祖辉等.医护人员对医院暴力的认知状况调查[J].中国公共卫生,2004,20(3)：338-339.
16. McPhaul KM, Lipscomb JA.Workplace violence in health care:recognized but not regulated [J]. Online J Issues Nurs.2004,9(3):7.
17. Fernandes CM, Bouthillette F, Raboud JM, et al. Violence in the emergency department:a survey of health care workers [J]. CMAJ,1999,161(10):1245-1248.
18.金静芬,许杰,沈国丽.急诊分诊管理程序的软件开发与应用研究[J].护理与康复,2007,6(4)：219-220,223.
19.叶国芳,叶敏,粱红燕。护理文化建设对监护室护士压力的影响[J].护理与康复,2007,2(6)：130-131.
20.叶志弘,姜安丽.护士群体中同事支持系统的研究进展[J].中华护理杂志,2007,42(10)：938-939.
21.陈荣凤,沈洁,尹自芳.对护理本科生实施导师制的构想与思考[J].解放军护理杂志,2005,22(7)；82-84.
22.谢魏,张大伟,谢晋宇.工作场所暴力问题的产生和预防[J].华东经济管理,2005,19(8)：123-126.
23.潘红英,苏伟.急诊护理人员遭受医院工作场所暴力的现状分析及应对[J].护理与康复,2008,7(5)：334-336.
[1]荆春霞,王声湧,陈祖辉,等.医护人员对医院暴力的认知状况调查[J].中国公共卫生,2004,20(3)：338-339.
[2]Saines JC. Violence and aggression in A & E: recommendations for action [J]. Accid Emerg Nurs,1999,7:8-12.
[3]郑亚华.输液室护士受暴力行为侵袭的原因及对策[J].护理与康复,2005, 4(3)：228-229.
[4]韩江红.关注并防范卫生保健领域中的暴力[J].中华护理杂志,2002,37(9)：718-719.
[5]Keely BR. Recognition and prevention of hospital violence[J]. Dimens Crit Care Nurs,2002,21(6):236-241.
[6]李霜.暴力—医院中的职业危害[J].国外医学卫生学分册,2003,30(3)：163.
[7]Victoria C. Workplace violence[J]. American Journal Nursing,1999,3:60.
[8]Carol A. Protecting yourself from violence in the workplace[J]Nursing,2002.6: 58-63.
[9]李波,宁宇,寇长贵,等.护士在医疗场所遭受暴力侵害的现况分析[J].中国医院管理,2005,25(12)：23-25.
[10]Lyneham J. Violence in New South Wales emergency departments [J]. Aust J Adv Nurs,2001,18(2):8-17.
[11]Fernandes CM, Bouthillette F, Raboud JM, at al. Violence in the emergency department:a survey of health care workers [J]. CMAJ,1999,161(10): 1245-1248.
[12]陈祖辉,王声湧,卢业成,等.医院工作场所暴力的流行病学特征及危险因素分析[J].中华流行病学杂志,2004,25(1)：3-5.
[13]杨巧红,肖丹.护理人员遭受工作场所暴力的现况调查与分析[J].护理研究,2005,19(2)：203-204.
[14]樊静,姜湖.医疗纠纷的现状及对医院和医务人员的影响[J]中国医院管理,2003,23(1)：29-31.
[15]Rew K, Yk L, Ke L, et al. Prevalence of workplace violence a—gainst nu in Hong Kong[J]. Hong Kong Med J,2006,12(1):6-9.
[16]陈祖辉,王声湧.急诊科护士工作场所心理暴力问题调查研究[J].护理学杂志,2004,19(15)：3-6.
[17]McPhaul KM, Lipscomb JA. Workplace violence in health care: recognized but not regulated[J]. Online J Issues Nurs,2004,9(3):7.
[18]GatesDM, RossCS, McQueen L. Violence against emergency department workers[J]. J Emerg Med,2006,31(3):331-337.
[19]Ryan D, Maguire J. Aggression and violenc—a problem in Irish Accident and Emergency departments [J]. J Nurs Manag,2006,14(2):106-115.
[20]吕秋玲.在护理管理中坚持以人为本[J].护理管理杂志,2002,2(5)：37-38.
[21]马伟光,李继平.医院场所暴力原因分析及对策[J].护理管理杂志,2005,5(5)：23-24.
[22]丁雪梅.护理人员法律知识认知水平的调查及对策[J].护理与康复,2007,6(2)：86-87.
[23]王声滇.伤害流行病学[M].北京：人民卫生出版社,2003
[24]罗红,吴小珊.美国医院对工作场所暴力的防范[J].中国实用护理杂志,2003,19(12)：65-66.
[25]金静芬,许杰,沈国丽.急诊分诊管理程序的软件开发与应用研究[J].护理与康复,2007,6(4)：219-220,223.
[26]叶国芳,叶敏,粱红燕.护理文化建设对监护室护士压力的影响[J].护理与康复,2007,6(2)：130-131.