Bondurant Patricia G, Nielsen-Farrell Jill, Armstrong Lori
Department of Nursing, Texas Children's Hospital, Houston, Texas (Dr Bondurant and Ms Armstrong); and MoonPenny Consulting (Ms Nielsen-Farrell).
J Perinat Neonatal Nurs. 2015 Apr-Jun;29(2):170-8. doi: 10.1097/JPN.0000000000000101.
Neonatal intensive care units (NICUs) are at high risk for medical errors due to the population, setting, and complexity of care. Furthermore, "near misses" often precede actual errors yet are mostly underreported and unrecognized as safety concerns. There is a growing recognition that a systems approach to quality and safety is foundational to improving care at the bedside and patient outcomes. The High Reliability Organization model is one such approach. It recognizes the challenges of a highly complex system and combines this recognition with a continual emphasis on reducing errors. Although the principles of the High Reliability Organization hold promise in accelerating quality and safety in the NICU, it is imperative that nurses at the bedside as well as nurse leaders actually learn how to operationalize high reliability principles and strategies that lead to better outcomes. This article outlines the necessary principles, culture, strategies, and behaviors that NICU nurses and nurse leaders must adopt to achieve high reliability in their units.
由于新生儿重症监护病房（NICU）的患者群体、环境以及护理的复杂性，其医疗差错风险很高。此外，“险些失误”往往先于实际差错发生，但大多未得到充分报告，也未被视为安全问题。人们越来越认识到，采用系统方法来提高质量和安全性是改善床边护理和患者预后的基础。高可靠性组织模型就是这样一种方法。它认识到高度复杂系统所面临的挑战，并将这种认识与持续强调减少差错相结合。尽管高可靠性组织的原则有望加速NICU的质量和安全提升，但至关重要的是，床边护士以及护士长必须切实学会如何实施能带来更好结果的高可靠性原则和策略。本文概述了NICU护士和护士长为在其科室实现高可靠性而必须采用的必要原则、文化、策略和行为。
