Defining the Role and Occupational Health Issues of Patient Sitters

摘要 病人保姆是负责“不断观察”有风险的病人的保健工作者， 伤害自己和他人（例如，有自杀倾向、有跌倒危险、情绪激动、暴力、退缩 药物/酒精）。这通常需要他们管理困难的病人和情况， 8到12小时轮班尽管医疗机构严重依赖患者 保姆，在临床文献中有一个共识，即这项工作定义不清， 担任这一角色的工人缺乏培训，无法满足其工作要求。此外，本发明还 许多研究已经检验了病人看护者对病人结果的有效性（例如， 患者跌倒预防）;然而，最近的一项系统综述仅确定了过去的一项研究 十年来，与病人保姆中的工人健康和安全问题有关。虽然医疗保健 已知工人处于许多职业暴露和结果的高风险中（例如， 肌肉骨骼损伤、暴露于飞沫/空气传播病原体、血液传播病原体），无 研究已经检查了患者看护者中的这些类型的暴露/结果。病人保姆服务 在病人护理中起着关键作用，然而，在临床文献中，它们的定义很差， 在职业健康文献中基本上没有。为了解决这些差距，我们的目标是定义 在急性护理儿科和成人医院环境中，患者保姆的作用，描述 类型的培训和继续教育，病人保姆接受和需要，并检查 护理人员遇到的职业健康和安全问题。我们建议进行一项 对病人看护者和医院领导者的横断面混合方法研究。协同 德克萨斯州医院管理局（THA），我们将邀请领导人监督他们的病人保姆 计划/工作人员（n=430家德克萨斯州医院）参加了一项匿名在线调查， 病人保姆在医院的作用，以及医院的程序和政策， 这些工人。在那些回应的人中，我们将要求进行匿名访问 在他们的病人保姆中进行在线调查，目标是招募1,000名保姆， 儿科和成人急症护理医院。病人保姆调查的发展将是 根据医院领导人调查结果，以及 一个来自参与医院的病人保姆的子集。保姆调查将确定细节 关于工作职责、培训、职业安全和健康问题以及组织 支持.这项工作的结果将把保姆纳入职业文献， 可以在职业健康和安全的背景下对其进行适当的定义和考虑 预防工作。

Abstract Patient sitters are healthcare workers responsible for “constant observation” of patients at risk for harming themselves and others (e.g., suicidal, at risk for falling, agitated, violent, withdrawing from drugs/alcohol). This often requires them to manage difficult patients and situations on their own in isolation for 8- to 12-hour shifts. Although healthcare organizations rely heavily on patient sitters, there is consensus in the clinical-based literature that this job is poorly defined, and that workers in this role are poorly trained and prepared to meet the requirements of their job. Further, numerous studies have examined the effectiveness of patient sitters on patient outcomes (e.g., patient fall prevention); however, a recent systematic review identified only one study in the past decade that pertained to worker health and safety issues among patient sitters. While healthcare workers are known to be at high risk for numerous occupational exposures and outcomes (e.g., musculoskeletal injury, exposure to droplet/airborne pathogens, bloodborne pathogens), no studies have examined these types of exposures/outcomes in patient sitters. Patient sitters serve a critical role in patient care, yet, they are poorly defined in the clinical-based literature, and are essentially absent in the occupation health literature. To address these gaps, we aim to define the role of the patient sitter in the acute care pediatric and adult hospital settings, describe the types of training and continuing education that patient sitters receive and need, and examine the occupational health and safety issues that patient sitters encounter. We propose to conduct a cross-sectional, mixed methods study of patient sitters and hospital leaders. In collaboration with the Texas Hospital Administration (THA), we will invite leaders that oversee their Patient Sitter program/workers (n=430 Texas hospitals) to participate in an anonymous online survey about the role of the patient sitter in their hospitals, as well as hospital procedures and policies that pertain to these workers. Among those that respond, we will request access to conduct an anonymous online survey among their patient sitters with the goal of recruiting 1,000 sitters, with a mix from pediatric and adult acute care hospitals. The development of the patient sitter survey will be informed by the hospital leader survey findings, as well as focus group discussion findings among a subset of patient sitters from the participating hospitals. The sitter survey will ascertain details about job responsibilities, training, occupational safety and health issues, and organizational support. Findings from this proposed work will place sitters into the occupational literature where they can be appropriately defined and considered in the context of occupational health and safety prevention efforts.