Sitterding Mary Cathryn, Ebright Patricia, Broome Marion, Patterson Emily S, Wuchner Staci
Indiana University Health, Indianapolis, USA
Indiana University School of Nursing, Indianapolis, USA.
West J Nurs Res. 2014 Aug;36(7):891-916. doi: 10.1177/0193945914533426. Epub 2014 May 12.
Medication administration error remains a leading cause of preventable death. A gap exists in understanding attentional dynamics, such as nurse situation awareness (SA) while managing interruptions during medication administration. The aim was to describe SA during medication administration and interruption handling strategies. A cross-sectional, descriptive design was used. Cognitive task analysis (CTA) methods informed analysis of 230 interruptions. Themes were analyzed by SA level. The nature of the stimuli noticed emerged as a Level 1 theme, in contrast to themes of uncertainty, relevance, and expectations (Level 2 themes). Projected or anticipated interventions (Level 3 themes) reflected workload balance between team and patient foregrounds. The prevalence of cognitive time-sharing during the medication administration process was remarkable. Findings substantiated the importance of the concept of SA within nursing as well as the contribution of CTA in understanding the cognitive work of nursing during medication administration.
用药错误仍然是可预防死亡的主要原因。在理解注意力动态方面存在差距，例如护士在给药过程中处理干扰时的情境意识（SA）。目的是描述给药过程中的情境意识和干扰处理策略。采用了横断面描述性设计。认知任务分析（CTA）方法为230次干扰的分析提供了依据。主题按情境意识水平进行分析。与不确定性、相关性和期望主题（第2级主题）形成对比的是，注意到的刺激的性质成为第1级主题。预计或预期的干预措施（第3级主题）反映了团队和患者工作重点之间的工作量平衡。给药过程中认知分时的普遍性很显著。研究结果证实了情境意识概念在护理中的重要性以及认知任务分析在理解给药过程中护理认知工作方面的贡献。
