医疗场所中的医患激烈冲突:澳洲的情况和对策

Violence in medical facilities-A case in Australia

目的通过分析澳大利亚医疗市场案例激烈冲突的主要类型、归因和应对策略,为制定相应政策提供科学依据。方法文献和报告分析。结果医疗场所激烈冲突,主要直接归因于病人、医务人员、系统三方面,并与宏观系统有间接联系。澳大利亚的医患冲突主要发生在精神、心理和急诊服务场所。医务人员短缺和培训不足,医疗机构缺乏完善的员工和病人保护措施是医患冲突的主要系统因素。结论从导致冲突的直接原因入手,主要通过员工培训、加强保护措施和改善服务质量三方面,保护员工和病人安全。

Objective To explore main categories, attributions and strategies of violence in medical facilities of Australia, and provide evidence to policy process on violence prevention. Methods literature reviews and document analysis. Results violence in medical facilities is rare and objective existence. It could directly attribute to patient, health staff and health system, and indirectly link with macro systems such as health finance and professional moral establishment. Most violence cases happened in departments related with mental/psychiatri and emergency services. Shortage of medical staff and lack of experience and training could be found as main staff＇s reasons; while weakness on protection measures in medical service settings and unsatisfied quality of care could be main system＇s reasons. Strategically, staff training, protection strengthening, and quality improving have been identified as major measures of violence prevention. Conclusion training, protection and quality should be three major considerations of Chinese health services on reduciny violence incidence and ensuriny safety of staff and patients.