Hayes Carolyn, Power Tamara, Davidson Patricia M, Daly John, Jackson Debra
University of Technology Sydney, Faculty of Health, Building 10, 235 Jones Street, Broadway, NSW 2007, Australia.
John Hopkins University School of Nursing, United States.
Nurse Educ Today. 2015 Sep;35(9):981-6. doi: 10.1016/j.nedt.2015.07.002. Epub 2015 Jul 8.
Medication errors are a global phenomenon. Each year Australia-wide there are up to 96,000 preventable medication errors and in the United States there are approximately 450,000 preventable medication errors. One of the leading causes of errors is interruption yet some interruptions are unavoidable. In the interest of patient safety, nurses need to not only understand the impact of interruptions, but also be empowered with the knowledge and skills required to develop effective interruption management strategies. Well-planned simulation experiences have the potential to expose students to authentic clinical cases, otherwise unavailable to them, building critical thinking and clinical reasoning skills and preparing them for practice.
This paper describes a simulated role-play experience that was developed to enable undergraduate nurses to experience, reflect on and analyse their responses to interruptions during medication administration.
The simulation design presented in this paper was underpinned by both nursing and educational theorists, in combination with established simulation frameworks.
Embedded within a clinical subject in 2013, the simulation experience was run over two campuses within a large Australian University. Participants included 528 second year undergraduate nursing students and 8 academic teaching staff.
To stimulate reflective learning debriefing immediately followed the simulation experience. Written reflections were completed and submitted over the following 4weeks to extend the reflective learning process and review the impact of the experience from the student perspective.
Undergraduate student nurses often have limited experiential background from which to draw knowledge and develop sound clinical judgements. Through exposure to clinical experiences in a safe environment, simulation technologies have been shown to create positive learning experiences and improve deductive reasoning and analysis. The heightened awareness of interruptions and their impacts on the medication administration process, along with techniques to manage interruptions more effectively serves to better prepare nurses for practice.
用药错误是一个全球性现象。在澳大利亚，每年有多达96000起可预防的用药错误，而在美国，约有450000起可预防的用药错误。错误的主要原因之一是干扰，然而有些干扰是不可避免的。为了患者安全，护士不仅需要了解干扰的影响，还需要具备制定有效干扰管理策略所需的知识和技能。精心策划的模拟体验有可能让学生接触到真实的临床案例，否则他们无法接触到这些案例，从而培养批判性思维和临床推理技能，并为他们的实践做好准备。
本文描述了一种模拟角色扮演体验，旨在让本科护士体验、反思并分析他们在给药过程中对干扰的反应。
本文介绍的模拟设计以护理和教育理论家的理论为基础，并结合了既定的模拟框架。
2013年，该模拟体验嵌入一门临床课程中，在澳大利亚一所大型大学的两个校区开展。参与者包括528名二年级本科护理学生和8名学术教师。
为了促进反思性学习，模拟体验结束后立即进行了总结汇报。学生们在接下来的4周内完成并提交了书面反思，以扩展反思性学习过程，并从学生的角度审视该体验的影响。
本科护生通常经验有限，难以从中汲取知识并做出合理的临床判断。通过在安全环境中接触临床经验，模拟技术已被证明能创造积极的学习体验，提高演绎推理和分析能力。对干扰及其对给药过程影响的更高认识，以及更有效管理干扰的技巧，有助于更好地让护士为实践做好准备。
