Schwappach David L B, Hochreutener Marc-Anton, Wernli Martin
Swiss Patient Safety Foundation, Zurich, Switzerland.
Oncol Nurs Forum. 2010 Mar;37(2):E84-91. doi: 10.1188/10.ONF.E84-E91.
PURPOSE/OBJECTIVES: To explore oncology nurses' perceptions and experiences with patient involvement in chemotherapy error prevention.
Qualitative descriptive study.
In- and outpatient oncology units of a community hospital in Switzerland.
11 actively practicing oncology nurses working in an ambulatory infusion unit or on wards.
Oncology nurses participated in two focus groups on two occasions. Participants discussed their personal experiences with patients intervening to intercept errors, attitudes toward patient involvement in error prevention, and changes in relationships with patients. A content-analysis framework was applied to the transcripts and analytical categories were generated.
Perceptions about patient involvement in error prevention.
Participants shared affirmative attitudes and overwhelmingly reported positive experiences with engaging patients in safety behaviors, although engaging patients was described as a challenge. Nurses intuitively chose among a set of strategies and patterns of language to engage patients and switch between participative and authoritative models of education. Patient involvement in error prevention was perceived to be compatible with trustful relationships. Efforts to get patients involved have the potential for frustration if preventable errors reach patients. Considerable differences exist among organizational barriers encountered by nurses.
Nurses acknowledged the diverse needs of patients and deliberately used different strategies to involve patients in safety. Patient participation in safety is perceived as a complex learning process that requires cultural change.
Oncology nurses perceive patient education in safety as a core element of their professional role and are receptive to advancing their expertise in this area.
目的/目标:探讨肿瘤护理人员对于患者参与化疗差错预防的看法和经历。
定性描述性研究。
瑞士一家社区医院的肿瘤门诊和住院部。
11名在门诊输液室或病房工作的在职肿瘤护理人员。
肿瘤护理人员分两次参加了两个焦点小组。参与者讨论了他们在患者干预以拦截差错方面的个人经历、对患者参与差错预防的态度以及与患者关系的变化。对访谈记录应用了内容分析框架并生成了分析类别。
对患者参与差错预防的看法。
参与者持肯定态度,绝大多数人报告在让患者参与安全行为方面有积极经历,尽管让患者参与被描述为一项挑战。护士直观地在一系列策略和语言模式中进行选择以吸引患者,并在参与式和权威式教育模式之间切换。患者参与差错预防被认为与信任关系相契合。如果可预防的差错发生在患者身上,让患者参与的努力可能会令人沮丧。护士遇到的组织障碍存在很大差异。
护士认识到患者的不同需求,并刻意采用不同策略让患者参与安全事务。患者参与安全被视为一个复杂的学习过程,需要文化变革。
肿瘤护理人员将安全方面的患者教育视为其专业角色的核心要素,并愿意提升这方面的专业技能。