Lyndon Audrey, Kennedy Holly Powell
Department of Family Healthcare Nursing, UCSF School of Nursing, San Francisco, California 94143, USA.
J Perinat Neonatal Nurs. 2010 Jan-Mar;24(1):22-31. doi: 10.1097/JPN.0b013e3181cb9351.
Communication and teamwork problems are leading causes of documented preventable adverse outcomes in perinatal care. An essential component of perinatal safety is the organizational culture in which clinicians work. Clinicians' individual and collective authority to question the plan of care and take action to change the direction of a clinical situation in the patient's best interest can be viewed as their "agency for safety." However, collective agency for safety and commitment to support nurses in their role of advocacy is missing in many perinatal care settings. This article draws from Organizational Accident Theory, High Reliability Theory, and Symbolic Interactionism to describe the nurse's role in maintaining safety during labor and birth in acute care settings and suggests actions for supporting the perinatal nurse at individual, group, and systems levels to achieve maximum safety in perinatal care.
沟通和团队协作问题是围产期护理中记录在案的可预防不良后果的主要原因。围产期安全的一个重要组成部分是临床医生工作的组织文化。临床医生质疑护理计划并采取行动以患者最佳利益改变临床状况方向的个人和集体权力，可被视为他们的“安全能动性”。然而，在许多围产期护理环境中，缺乏集体安全能动性以及对支持护士发挥倡导作用的承诺。本文借鉴组织事故理论、高可靠性理论和符号互动主义，描述护士在急症护理环境中分娩期间维护安全的作用，并提出在个人、团队和系统层面支持围产期护士的行动，以实现围产期护理的最大安全性。
