RESUMEN
BACKGROUND: The aim is to investigate the appropriateness of hazid for performing risk analyses in supporting systems in hospitals. METHODS: We used a case study approach for evaluating introduction of hazid for the first time in two different university hospital settings. The hazid was performed in a customized way according to the specific needs at the two sites. FINDINGS: In both settings studied, the hazid approach revealed several phenomena that were followed up in the ordinary quality improvement work. The results were widely acknowledged as valid as seen from the managerial level. The participants reported that they felt comfortable in the hazid process and were able to freely present their current concerns and perspectives on risks related to their daily work. CONCLUSION: Hazid is basically a meeting between competent workers who elaborate on their own risk picture. It is giving other types of information not gained through other often-used approaches. Specific risk factors can be described in real time as seen by people directly involved, thus circumventing the hierarchy in the organization. The process in itself can trigger improvement actions. APPLICATION TO PRACTICE: Hazid can be used for presenting a valid risk picture as seen from below in the organization.
RESUMEN
INTRODUCTION: The use of a personal resuscitation manikin with video instruction is reportedly as effective as traditional instructor-led courses in teaching lay people basic life support (BLS). We applied this method to an entire hospital staff to determine its effect on their practical and self-judged BLS skills. METHODS: All 5382 employees at Stavanger University Hospital were asked to learn or refresh their BLS skills with the personal resuscitation manikin and video instruction. Prior to and nine months after training, all employees were asked to rate their BLS skills on a scale from one to five. Additionally, randomly chosen study subjects were tested for BLS skills pre-training and six months post-training during 2min of resuscitation on a manikin. RESULTS: In total, 5118 employees took part in the BLS training program. The number of correct chest compressions increased significantly from 60 (5-102) to 119 (75-150) in the pre- vs. post-training periods, respectively, P<0.01, but the number of correct MTM ventilations did not change. Self-reported BLS skills increased from 3.1 (+/-1.0) pre-training to 3.8 (+/-0.8) post-training, P=0.031. CONCLUSION: After distributing a personal resuscitation manikin with video instruction to an entire hospital staff, the median number of correctly performed chest compressions doubled and self-confidence in BLS skills improved significantly. This is a simple and less time-consuming method than instructor-led courses in preparing hospital employees in the basic handling of cardiac arrest.
