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How to act -: implementing health and safety promotion in organizations

HEALTH POLICY AND PLANNING 2000年第3期15卷 247-254页

作者： Rosén, M Jansson, B Karolinska Inst Dept Publ Hlth Sci Div Social Med S-17176 Stockholm Sweden Umea Univ Dept Publ Hlth & Clin Med S-90187 Umea Sweden Natl Board Hlth & Welf Ctr Epidemiol Stockholm Sweden

This interdisciplinary review focuses on strategies for implementing health and safety promotion activities in organizations. Theories are summarized in a checklist and illustrated by some practical examples from Swed... 详细信息

关键词：事故预防革新推广健康促进/组织和管理组织文化组织改革规划制订公共卫生管理安全管理/组织和管理人类

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Commentary: Traffic safety - An American export

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ANNALS OF EMERGENCY MEDICINE 2001年第6期37卷 729-730页

作者： Todd, KH Rollins School of Public Health Emory University Atlanta GA United States

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Procedures of Data and Safety Monitoring Committees

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AMERICAN HEART JOURNAL 2001年第2期141卷 289-294页

作者： Pocock, S Furberg, CD Wake Forest Univ Sch Med Winston Salem NC 27157 USA Univ London London Sch Hyg & Trop Med London WC1E 7HT England

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Direct feedback program gets to heart of improved order writing

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2001年第8期58卷 655-656页

作者： Harteker, LR

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Planning for a bomb threat.

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Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management 1997年第4期17卷 30-36页

作者： Rozovsky, L.E. Health Risk Management Consultant Richmond VA

A bomb threat must always be taken seriously. It is important to have specific response plans in place, especially in a healthcare facility, where patients may be particularly vulnerable both to danger and to the threat of danger. Also, the facility may be judged in the community by how it responds to a threat. A prudent risk manager will plan in advance, setting up a chain of command and specific procedures, and familiarizing all who take on bomb threat duties not only with their responsibilities, but also with one another. There should be a familiar and easy relationship among those required to work together in stressful situations.

关键词：救灾计划爆震/预防和控制卫生设施/标准组织方针安全管理/组织和管理安全措施美国暴力/预防和控制人类

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Applying research to practice. Practical guidelines for occupational health nurses.

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AAOHN journal : official journal of the American Association of Occupational Health Nurses 2002年第11期50卷 520-525;quiz526-527页

作者： Salazar, Mary K School of Nursing University of Washington Seattle WA United States

Much has been written about the research practice gap--and there is no doubt this gap exists in occupational health nursing. It is an irony that the professionals who would benefit most from occupational health and safety research may be the ones who do not participate in or contribute to research. Closing the gap requires a commitment on the part of both practitioners and researchers. It behooves occupational health nurses to constantly seek ways to make the connection--to forge relationships that can continue to advance the specialty. Researchers must increase their efforts to conduct research in "real world" conditions, because this research is most likely to improve practice. Practitioners must be willing to familiarize themselves with research so they can become active participants in the ongoing effort to find answers to troubling occupational health and safety problems. Rosenheck (2001) presents an interesting perspective on the barriers to eliminating the research practice gap. He purports that, although professionals often are highly respectful of scientific endeavors, in reality, "daily decision making is shaped more by power structures, ingrained routines, and established resource configuration than by current scientific findings." In most organizations, standard operating procedures and behavioral norms are the major influences on workplace practices;scientific evidence plays a minor role (Rosenheck, 2001). Several reasons can be found for this lack of reliance on research as a basis for practice. Studies may demonstrate effectiveness among large groups. However, practitioners may not see the relevance or applicability of such studies to individuals or small groups of clients. Also, practitioners may fear that the implementation of new strategies will require more oversight than they are able to provide. Another logistical barrier is the application of the research may require the collaboration of multiple individuals--dynamic environments with extensive

关键词：革新推广信息传播护士作用护理研究/教育护理研究/组织和管理职业卫生护理/教育职业卫生护理/组织和管理研究设计/标准安全管理/组织和管理人类

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Making medication safety a strategic organizational priority.

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The Joint Commission journal on quality improvement 2000年第6期26卷 341-348,317页

作者： Weingart, S.N. Division of General Medicine and Primary Care Beth Israel Deaconess Medical Center Boston 02215 MA United States

Since January 1998 the Executive Session on Medical Error and Patient Safety at Harvard's John F. Kennedy School of Government has periodically convened a group of 25 to 30 practitioners (and a few academics) to discuss issues and identify strategies and solutions concerning patient safety. This profile is adapted from a case study presented at the Executive Session.

关键词：药物副反应报告系统法定报告马萨诸塞给药错误/预防和控制给药系统医院/组织和管理给药系统医院/标准组织状况研究组织目标规划技术安全管理/组织和管理全面质量管理/组织和管理人类

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Promoting patient safety through preoperative patient verification.

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AORN journal 2001年第5期74卷 690-694页

作者： Brown, B. Riippa, M. Shaneberger, K. Outpatient Services Spectrum Health Grand Rapids Mich. USA.

At Spectrum Health, Grand Rapids, Mich, a process to verify patient identification, procedure, and procedure side and site was developed and implemented to improve the current process. Focusing on risk-reduction strategies, an interdisciplinary task force revised the facility's surgical site identification policy and improved the surgical scheduling form to highlight information for sided procedures. Task force members also designed a verification checklist to require the comparison of any procedure data to the physician's order. This article describes these improvements and other methods that were established to ensure patient safety and reduce risk. Ongoing data collection verifies that the process remains in place and that team members are compliant. The improved process maximizes patient safety because it allows for early intervention when any discrepancies are identified.

关键词：表格和记录管理医院乡村密执安组织方针病人识别系统围手术期护理/组织和管理手术前护理/标准规划制订安全管理/组织和管理安全管理/发展趋势外科手术/护理人类

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Assessing and balancing elder risk, safety and autonomy: Decision-making practices of health care professionals

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Home Health Care Services Quarterly 1997年第3期16卷 3-20页

作者： Clemens, Elizabeth L. Hayes, Harriett E. The Gerontology Institute University of Massachusetts-Boston Boston MA 02125-3393 United States Department of Sociology Bridgewater College Bridgewater VA 22812-1599 United States

Diverse professionals assess and manage risk with frail elderly yet no standard practice guidelines are used across the care continuum This qualitative study provides new understanding of how eldercare workers conceptualize and assess risk with frail elderly clients. Fifteen professionals were interviewed using the Long-Interview Method of McCracken (1988) and Crabtree and Miller (1991). Respondents included home care case managers, visiting nurses and hospital discharge social workers. This paper reports on two key decision-making styles identified through multidisciplinary analysis of transcripts: the "snap decision-makers" and the "agonizers." Labeling strategies are identified that may assist eldercare workers with the dissonance between professional training and the realities of practice. Variable thresholds for risk tolerance among diverse professionals were found. These findings suggest that risk assessment often reflects the values of the individual practitioner's profession and agency culture. Standardized training and ethical practice guidelines are needed to reduce extreme variability in professionals* judgments;and to better assist staff with assessing and balancing elder risk, safety and autonomy. © 1997 Taylor & Francis Group, LLC.

关键词：虚弱老人老年人身心健康评价卫生人员/心理学病人医疗小组职业自主权职业病人关系安全管理/组织和管理美国老年人人类

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Preventing home health nursing assistant back and shoulder injuries.

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The Joint Commission journal on quality improvement 2000年第10期26.0卷 587-600页

作者： Leff, E.W. Hagenbach, G.L. Marn, K.K. Franklin County Home Health Agency St Albans Vermont 05478 United States

BACKGROUND: Franklin County Home Health Agency (St Albans, Vermont) undertook a performance improvement project in 1996 to reduce employee injuries. A review of recent injuries led to the prevention of licensed nursing assistants' (LNAs') back and shoulder injuries as the first priority. Root causes of injuries were agency communication, employee training, patient home environment, nursing assistant body mechanics, and failure to use safety measures. Given that injury causality is complex and multifactorial, a variety of improvement strategies were implemented over the following two to three years. IMPLEMENTATION OF POTENTIAL SOLUTIONS: Short-term (a few months), mid-term (six months), and long-term (one year) potential solutions to the LNA back and shoulder injury problem were charted. Safety and health training was the major focus of the team's short-term plan. Risk management forms were to be used to identify and follow up on hazardous situations. RESULTS: Project plans that were successfully implemented included revision of LNA plans of care, standardization of the return-to-work process after injury, development of guidelines for identifying unsafe patient lifts and transfers, improved follow-up of employee reports of injury-risk situations in patient homes, improved body mechanics screening of new employees, and a stronger injury-prevention training program for current employees. A less successful initiative was aimed at collecting more data about injuries and causal factors. Employee injuries were gradually reduced from 4-10 per quarter to 0-3 per quarter. CONCLUSIONS: Injury prevention requires commitment, persistence, and patience--but not expensive improvements. Multiple interventions increase the chances of success when there are many root causes and lack of evidence regarding the effectiveness of various approaches.

关键词：背损伤/流行病学背损伤/预防和控制家庭医疗保健服务护士助理/教育职业病/流行病学职业病/预防和控制危险因素危险处理/组织和管理安全管理/组织和管理肩/损伤时间因素病人转送美国美国职业安全和卫生署人类

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