Gaffney Theresa A, Hatcher Barbara J, Milligan Renee
School of Nursing, George Mason University, Fairfax, VA, USA.
J Clin Nurs. 2016 Apr;25(7-8):906-17. doi: 10.1111/jocn.13126. Epub 2016 Feb 11.
The aim of this study was to conduct an integrative review of the literature to fully understand nurses' role in medical error recovery.
Despite focused efforts on error prevention, the prevalence of medical errors occurring in the health care system remains a concern. Patient harm can be reduced or prevented by adequate recovery processes that include identifying, interrupting and correcting medical errors in a timely fashion. Both medical error prevention and recovery are critical components in advancing patient safety, yet little is known about nurses' role in medical error recovery.
An integrative review of the literature, guided by Whittmore and Knafl's (Journal of Advanced Nursing, 5, 2005, 546) five-step process, was conducted for the period between 2000-2015. A comprehensive search yielded twelve articles for this review.
The level and quality of evidence of the included articles was rated using a five-level rating system and the Johns Hopkins Nursing Quality of Evidence Appraisal developed by ©The Johns Hopkins Hospital/The Johns Hopkins University.
The medical error recovery rate varied across specialty nursing populations with nurses recovering, on average, as many as one error per shift to as few as one error per week. Nurses rely on knowing the patient, environment and plan of care to aid in medical error recovery.
Nurses play a unique yet invisible role in identifying, interrupting and recovering medical errors. Individual and organisational factors influencing nurses' ability to recover medical errors remain unclear.
Greater understanding of nurse characteristics and organisational factors that influence error recovery can foster the development of effective strategies to detect and correct medical errors and enable organisations to reduce negative outcomes.
本研究旨在对文献进行综合综述，以全面了解护士在医疗差错补救中的作用。
尽管在预防差错方面已付出了专注的努力，但医疗保健系统中发生医疗差错的普遍情况仍然令人担忧。通过适当的补救流程，包括及时识别、中断和纠正医疗差错，可以减少或预防对患者的伤害。预防和补救医疗差错都是提高患者安全的关键组成部分，但对于护士在医疗差错补救中的作用却知之甚少。
以惠特莫尔和克纳夫（《高级护理杂志》，第5卷，2005年，第546页）的五步流程为指导，对2000年至2015年期间的文献进行了综合综述。全面检索后获得了12篇用于本综述的文章。
使用五级评级系统以及由约翰霍普金斯医院/约翰霍普金斯大学开发的约翰霍普金斯护理证据评估质量对纳入文章的证据水平和质量进行评级。
不同专业护理人群的医疗差错补救率各不相同，护士平均每班补救多达1起差错，少至每周1起差错。护士依靠了解患者、环境和护理计划来协助进行医疗差错补救。
护士在识别、中断和补救医疗差错方面发挥着独特但不为人所见的作用。影响护士补救医疗差错能力的个体和组织因素仍不明确。
对影响差错补救的护士特征和组织因素有更深入的了解，可以促进制定有效的策略来检测和纠正医疗差错，并使各组织能够减少负面结果。
