Evaluating the effectiveness of the SHEL model in reducing occupational exposure risks among pre-hospital emergency personnel: a retrospective cohort study (2018–2024)
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Pre-hospital emergency personnel face significant occupational exposure risks, yet traditional training approaches often prove inadequate. This study evaluated the effectiveness of SHEL (Software, Hardware, Environment, Liveware) model-based training versus standard operating procedure training (SOPT) in reducing occupational exposure incidents. Methods This retrospective cohort study included pre-hospital emergency personnel from an emergency center between January 2018 and June 2024. Participants were divided into SOPT and SHEL groups based on the training received. Knowledge, Attitude, and Practice (KAP) scores and safety behavior compliance were assessed before and 6 months after training. Occupational exposure incidents and root causes were analyzed throughout the one-year follow-up. Psychological status was evaluated using the Nursing Stress Scale and Maslach Burnout Inventory before and 6 months post-training. Results The analysis included 129 and 114 staff in the SOPT and SHEL groups, respectively. Six months post-training, the SHEL group demonstrated significantly higher KAP scores and safety behavior compliance (86.41 vs. 79.83, p < 0.001). The SHEL group had substantially fewer individuals experiencing occupational exposure (10.53% vs. 27.91%, p < 0.001) and fewer total incidents (12.28% vs. 32.56%, p < 0.001), particularly biological exposures. Root cause analysis attributed a lower proportion of incidents to software factors in the SHEL group (14.29% vs. 47.62%, p = 0.027). The SHEL group also showed significantly lower stress (66.43 vs. 71.36, p = 0.004) and burnout scores (depersonalization: 37.09 vs. 35.61, p = 0.001). Conclusion Training based on the SHEL model is more effective than traditional SOPT in enhancing occupational safety, reducing exposure incidents, and improving the psychological well-being of pre-hospital emergency personnel. These findings support the need for more integrated training approaches in emergency medical services.
Source: Frontiers in Public Health
Authors: Yu Li, Xiaojuan Hou, Mingyi Qin
Institution: Fourth Hospital of Hebei Medical University
Language: English
Subfield: Occupational Therapy
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7143990602