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重症监护病房护士的差错管理:一项定性研究。

Nurses' Error Management in Critical Care Units: A Qualitative Study.

作者信息

Nasrabadi Alireza Nikbakht, Peyrovi Hamid, Valiee Sina

机构信息

School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran (Dr Nasrabadi); Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Dr Peyrovi); and Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran (Dr Valiee).

出版信息

Crit Care Nurs Q. 2017 Apr/Jun;40(2):89-98. doi: 10.1097/CNQ.0000000000000145.

Abstract

Nursing errors are common in critical care units, and nurses are in the first line of confrontation. The purpose of this study was to explore the processes of managing nursing errors in critical care units in Iran and to develop a theoretical explanation of the phenomenon. This was a grounded theory study. We recruited a sample of 18 critical care nurses for the study. The sampling method was purposive and then changed to theoretical. The data were collected through in-depth interviews. For data analysis, we employed the constant comparative analysis technique. The core category of the study was "continuous situational analysis." The main categories were situational analysis and error removal. When nurses confronted an error, they opted for analyzing the error situation in terms of the nature of error, probable consequences, monitoring, and life threat. Accordingly, they employed error removal strategies such as self-action, cooperation, notifying, and censoring. These steps happened concurrently, successively, or cyclically. To manage their committed errors, nurses usually go through an informal process. Nurse-managers need to design effective error management strategies and require the practicing nurses to adhere to them. A practical model for effective prevention and management of nursing errors in critical care units is necessary.

摘要

护理差错在重症监护病房很常见,护士处于应对的第一线。本研究的目的是探讨伊朗重症监护病房护理差错的管理过程,并对这一现象进行理论解释。这是一项扎根理论研究。我们招募了18名重症监护护士作为研究样本。抽样方法先是目的抽样,然后改为理论抽样。数据通过深入访谈收集。对于数据分析,我们采用了持续比较分析技术。该研究的核心类别是“持续情境分析”。主要类别是情境分析和差错消除。当护士遇到差错时,他们会根据差错的性质、可能的后果、监测情况和生命威胁来选择分析差错情境。相应地,他们采用自我行动、合作、通知和审查等差错消除策略。这些步骤同时、相继或循环发生。为了管理自己所犯的差错,护士通常要经历一个非正式的过程。护士长需要设计有效的差错管理策略,并要求执业护士遵守这些策略。有必要建立一个有效的预防和管理重症监护病房护理差错的实用模型。

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