Choi Sandy Pin-pin, Cheung Kin, Pang Samantha Mei-che
Division of Nursing and Health Studies, The Open University of Hong Kong, China.
J Adv Nurs. 2014 Jul;70(7):1584-93. doi: 10.1111/jan.12316. Epub 2013 Nov 19.
To explicate nurses' role and the underlying processes involved in advocating for safe practice in hospitals.
Nurses' role as patient advocates in safeguarding patients' interests and well-being is constantly upheld. As previous studies have fallen short in delineating the processes of how and in what conditions the patient advocate role is operationalized, this study was conducted to fill the evidence gap through examining nurses' advocacy role and practices in real clinical contexts.
A field study approach that involved multiple methods of data collection was adopted.
This study was conducted from February 2010-March 2011 in four medical units in two public hospitals in Hong Kong. Empirical data were generated from weekly field observations, review of relevant documents and individual semi-structured interviews with 28 nurses and were then analysed through a comparative analysis process.
Nurses play an integral role in ensuring safe practice in hospitals through mitigating risk arising from sudden changes in patients' health conditions and the hospitalization process and correcting near-misses for co-workers to prevent harm. The modelling of expert nurses and team-based learning emerged as essential factors facilitating the development of nurses' advocacy role and practices. The state of 'limited advocacy', as characterized by the adoption of disempowering and coercive measures to ensure patient safety, clearly indicates a need to re-examine the concept of advocacy in contemporary health care.
The findings contribute to a more complete understanding of nurses' advocacy role and practices, which have a significant bearing on patient safety.
阐明护士在倡导医院安全实践中的角色及潜在过程。
护士作为患者权益倡导者维护患者利益和福祉的角色一直得到支持。由于以往研究未能清晰描述患者权益倡导者角色如何以及在何种情况下得以实施的过程，本研究旨在通过考察护士在实际临床环境中的倡导角色和实践来填补这一证据空白。
采用涉及多种数据收集方法的实地研究方法。
本研究于2010年2月至2011年3月在香港两家公立医院的四个医疗科室进行。通过每周的实地观察、相关文件审查以及对28名护士进行的个人半结构化访谈收集实证数据，然后通过比较分析过程进行分析。
护士在确保医院安全实践中发挥着不可或缺的作用，通过减轻患者健康状况和住院过程突然变化带来的风险，以及纠正同事的险些失误以防止伤害。专家护士的示范和基于团队的学习成为促进护士倡导角色和实践发展的关键因素。以采取剥夺权力和强制手段确保患者安全为特征的“有限倡导”状态，清楚地表明有必要重新审视当代医疗保健中的倡导概念。
这些发现有助于更全面地理解护士的倡导角色和实践，这对患者安全具有重要影响。
