Pazokian M, Zagheri Tafreshi M, Rassouli M
Department of Nursing, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int Nurs Rev. 2014 Jun;61(2):246-54. doi: 10.1111/inr.12086. Epub 2014 Feb 19.
Medical errors are one of the major threats for patient safety in all countries. Medication errors are common medical mistakes that can lead to serious consequences and even death of patients.
The aim of this study was to explore nurses' perspectives of factors influencing medication errors.
This qualitative study based on content analysis included 20 nurses (n = 20) with at least 2 years of clinical experience working in a large teaching hospital. The nurses were selected using purposeful sampling. The data were collected using semi-structured interviews and analysed using deductive content analysis approach based on Reason's human error model. Rigor of the data was confirmed by external and member check.
Two themes were identified by the participants: (1) the individual approach including personal and psychological characteristics of nurses, patient medical history and physicians' orders errors; and (2) the cultural and organizational approach including workplace conditions, learning process, risk management strategies, nurses' pharmacological knowledge, inevitable nursing errors and medication error complications.
Concern about the potential consequences related to reporting of the medication errors was the major limitation of this study. Participants' concerns were handled by keeping their identity confidential and anonymous.
Results show the importance of planning comprehensive educational programmes and providing constructive feedback in a favourable learning climate.
Findings of this study can be beneficial to managers for nurturing a transparent organizational culture, whereby staff members freely discuss their errors in patient care and seek advice for problem solving.
医疗差错是所有国家患者安全面临的主要威胁之一。用药差错是常见的医疗失误,可导致严重后果甚至患者死亡。
本研究旨在探讨护士对影响用药差错因素的看法。
这项基于内容分析的定性研究纳入了20名在一家大型教学医院工作、至少有2年临床经验的护士(n = 20)。采用目的抽样法选取护士。通过半结构式访谈收集数据,并基于瑞森的人为差错模型采用演绎性内容分析法进行分析。通过外部审核和成员审核来确认数据的严谨性。
参与者确定了两个主题:(1)个体因素,包括护士的个人和心理特征、患者病史及医生医嘱错误;(2)文化和组织因素,包括工作场所条件、学习过程、风险管理策略、护士的药理学知识、不可避免的护理差错及用药差错并发症。
本研究的主要局限在于担心用药差错报告可能带来的后果。通过对参与者的身份保密和匿名来处理他们的担忧。
结果表明规划全面的教育项目以及在良好的学习氛围中提供建设性反馈的重要性。
本研究结果有助于管理人员培育透明的组织文化,使工作人员能够自由讨论他们在患者护理中的差错并寻求解决问题的建议。