Centre for Applied Nursing Research, School of Nursing & Midwifery, College of Health & Science, University of Western Sydney, Penrith South DC, Australia.
Int Nurs Rev. 2010 Dec;57(4):454-62. doi: 10.1111/j.1466-7657.2010.00846.x.
Although many classification systems relating to patient safety exist, no taxonomy was identified that classified nursing errors in clinical management.
To develop a classification system for nursing errors relating to clinical management (NECM taxonomy) and to describe contributing factors and patient consequences.
We analysed 241 (11%) self-reported incidents relating to clinical management in nursing in a metropolitan hospital. Descriptive analysis of numeric data and content analysis of text data were undertaken to derive the NECM taxonomy, contributing factors and consequences for patients.
Clinical management incidents represented 1.63 incidents per 1000 occupied bed days. The four themes of the NECM taxonomy were nursing care process (67%), communication (22%), administrative process (5%), and knowledge and skill (6%). Half of the incidents did not cause any patient harm. Contributing factors (n=111) included the following: patient clinical, social conditions and behaviours (27%); resources (22%); environment and workload (18%); other health professionals (15%); communication (13%); and nurse's knowledge and experience (5%).
The NECM taxonomy provides direction to clinicians and managers on areas in clinical management that are most vulnerable to error, and therefore, priorities for system change management. Any nurses who wish to classify nursing errors relating to clinical management could use these types of errors. This study informs further research into risk management behaviour, and self-assessment tools for clinicians. Globally, nurses need to continue to monitor and act upon patient safety issues.
尽管存在许多与患者安全相关的分类系统，但没有发现将临床管理中的护理错误分类的分类法。
制定与临床管理相关的护理错误分类系统（NECM 分类法），并描述其促成因素和患者后果。
我们分析了一家大都市医院 241 例（占 11%）与护理临床管理相关的自我报告事件。对数字数据进行描述性分析，对文本数据进行内容分析，得出 NECM 分类法、促成因素和对患者的后果。
临床管理事件占每 1000 个占用床位日的 1.63 例。NECM 分类法的四个主题是护理护理过程（67%）、沟通（22%）、行政流程（5%）和知识与技能（6%）。一半的事件没有造成任何患者伤害。促成因素（n=111）包括以下内容：患者临床、社会状况和行为（27%）；资源（22%）；环境和工作量（18%）；其他卫生专业人员（15%）；沟通（13%）；和护士的知识和经验（5%）。
NECM 分类法为临床医生和管理人员提供了有关临床管理中最容易出错的领域的方向，因此是系统变更管理的优先事项。任何希望对与临床管理相关的护理错误进行分类的护士都可以使用这些类型的错误。本研究为风险管理行为和临床医生的自我评估工具提供了进一步的研究信息。在全球范围内，护士需要继续监测和处理患者安全问题。
