Health Care Workers’ Experiences of Workplace Incidents that Posed a Risk of Patient and Worker Injury: A Critical Incident Technique Analysis

Abstract

Background Health 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’ actions and emotions.Methods This 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. Results Altogether 71 workplace incidents were reported. The analysis of two dimensions – actions HCWs take and emotions they feel when a workplace incident occurs – yielded two main areas each: HCWs’ actions, actions by the team and managers, anxiety during the incident, and persistent distress after the incident. 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. Conclusions Work 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.

Evaluation of the implementation and effectiveness of a multifactorial intervention strategy for safe patient handling and movement in the healthcare sector: a study protocol of a cluster randomised controlled trial

“…Kugler et al 10 suggested that patient falls could be prevented with knowledge and skills in assessments of risks for patient and HCW, thereby improving safety in PHM. In addition to strategies for the active management of risks and avoiding injuries, the provision of organisational support is imperative for coping with the consequences when a patient or HCW has been injured 11. Previous research into the relationships between HCW’s working conditions and patient injuries demonstrates that a good safety climate supports safe patient care and ensures HCW safety,12 thereby creating a safe healthcare environment.…”