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急诊科护士的用药错误。

Medication errors of nurses in the emergency department.

作者信息

Ehsani Seyyedeh Roghayeh, Cheraghi Mohammad Ali, Nejati Amir, Salari Amir, Esmaeilpoor Ayeshe Haji, Nejad Esmaeil Mohammad

机构信息

Department of Nursing, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran;

Associate Professor, Department of Nursing, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran;

出版信息

J Med Ethics Hist Med. 2013 Nov 24;6:11. eCollection 2013.

Abstract

Patient safety is one of the main concepts in the field of healthcare provision and a major component of health services quality. One of the important stages in promotion of the safety level of patients is identification of medication errors and their causes. Medical errors such as medication errors are the most prevalent errors that threaten health and are a global problem. Execution of medication orders is an important part of the treatment and care process and is regarded as the main part of the nurses' performance. The purpose of this study was to explore the medication error reporting rate, error types and their causes among nurses in the emergency department. In this descriptive study, 94 nurses of the emergency department of Imam Khomeini Hospital Complex were selected based on census in 2010-2011. Data collection tool was a researcher-made questionnaire consisting of two parts: demographic information, and types and causes of medication errors. After confirming content-face validity, reliability of the questionnaire was determined to be 0.91 using Cronbach's alpha test. Data analyses were performed by descriptive statistics and inferential statistics. SPSS-16 software was used in this study and P values less than 0.05 were considered significant. The mean age of the nurses was 27.7 ± 3.4 years, and their working experience was 7.3 ± 3.4 years. Of participants 46.8% had committed medication errors in the past year, and the majority (69.04%) had committed the errors only once. Thirty two nurses (72.7%) had not reported medication errors to head nurses or the nursing office. The most prevalent types of medication errors were related to infusion rates (33.3%) and administering two doses of medicine instead of one (23.8%). The most important causes of medication errors were shortage of nurses (47.6%) and lack of sufficient pharmacological information (30.9%). This study showed that the risk of medication errors among nurses is high and medication errors are a major problem of nursing in the emergency department. We recommend increasing the number of nurses, adjusting the workload of the nursing staff in the emergency department, retraining courses to improve the staff's pharmacological information, modification of the education process, encouraging nurses to report medical errors and encouraging hospital managers to respond to errors in a constructive manner in order to enhance patient safety.

摘要

患者安全是医疗保健领域的主要概念之一,也是卫生服务质量的一个主要组成部分。提高患者安全水平的重要阶段之一是识别用药错误及其原因。诸如用药错误之类的医疗差错是威胁健康的最普遍的差错,是一个全球性问题。执行用药医嘱是治疗和护理过程的一个重要部分,并且被视为护士工作的主要部分。本研究的目的是探讨急诊科护士的用药错误报告率、错误类型及其原因。在这项描述性研究中,根据2010 - 2011年的普查,选取了伊玛目霍梅尼医院综合急诊科的94名护士。数据收集工具是研究者编制的问卷,包括两部分:人口统计学信息以及用药错误的类型和原因。在确认内容效度后,使用克朗巴赫α检验确定问卷的信度为0.91。数据分析采用描述性统计和推断性统计。本研究使用SPSS - 16软件,P值小于0.05被视为具有统计学意义。护士的平均年龄为27.7±3.4岁,工作经验为7.3±3.4年。在参与者中,46.8%在过去一年中发生过用药错误,且大多数(69.04%)仅发生过一次错误。32名护士(72.7%)未向护士长或护理办公室报告用药错误。最常见的用药错误类型与输液速度(33.3%)以及给药剂量应为一剂却给了两剂(23.8%)有关。用药错误的最重要原因是护士短缺(47.6%)和缺乏足够的药理学信息(30.9%)。本研究表明,护士发生用药错误的风险很高,用药错误是急诊科护理工作的一个主要问题。我们建议增加护士数量,调整急诊科护理人员的工作量,开展再培训课程以提高工作人员的药理学信息,改进教育过程,鼓励护士报告医疗差错,并鼓励医院管理人员以建设性的方式应对差错,以提高患者安全。

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