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急诊科护士自愿报告用药错误:探讨与工作环境和社会资本的关联。

Voluntary Medication Error Reporting by ED Nurses: Examining the Association With Work Environment and Social Capital.

作者信息

Farag Amany, Blegen Mary, Gedney-Lose Amalia, Lose Daniel, Perkhounkova Yelena

机构信息

Iowa City, IA; San Francisco, CA.

Iowa City, IA; San Francisco, CA.

出版信息

J Emerg Nurs. 2017 May;43(3):246-254. doi: 10.1016/j.jen.2016.10.015. Epub 2017 Mar 28.

Abstract

INTRODUCTION

Medication errors are one of the most frequently occurring errors in health care settings. The complexity of the ED work environment places patients at risk for medication errors. Most hospitals rely on nurses' voluntary medication error reporting, but these errors are under-reported. The purpose of this study was to examine the relationship among work environment (nurse manager leadership style and safety climate), social capital (warmth and belonging relationships and organizational trust), and nurses' willingness to report medication errors.

METHODS

A cross-sectional descriptive design using a questionnaire with a convenience sample of emergency nurses was used. Data were analyzed using descriptive, correlation, Mann-Whitney U, and Kruskal-Wallis statistics.

RESULTS

A total of 71 emergency nurses were included in the study. Emergency nurses' willingness to report errors decreased as the nurses' years of experience increased (r = -0.25, P = .03). Their willingness to report errors increased when they received more feedback about errors (r = 0.25, P = .03) and when their managers used a transactional leadership style (r = 0.28, P = .01).

DISCUSSION

ED nurse managers can modify their leadership style to encourage error reporting. Timely feedback after an error report is particularly important. Engaging experienced nurses to understand error root causes could increase voluntary error reporting.

摘要

引言

用药错误是医疗环境中最常出现的错误之一。急诊科工作环境的复杂性使患者面临用药错误的风险。大多数医院依赖护士自愿报告用药错误,但这些错误报告不足。本研究的目的是探讨工作环境(护士长领导风格和安全氛围)、社会资本(温暖和归属感关系以及组织信任)与护士报告用药错误意愿之间的关系。

方法

采用横断面描述性设计,使用问卷调查便利抽样的急诊护士。数据分析采用描述性、相关性、曼-惠特尼U检验和克鲁斯卡尔-沃利斯统计。

结果

本研究共纳入71名急诊护士。急诊护士报告错误的意愿随着工作年限的增加而降低(r = -0.25,P = 0.03)。当他们收到更多关于错误的反馈(r = 0.25,P = 0.03)以及护士长采用交易型领导风格时(r = 0.28,P = 0.01),他们报告错误的意愿会增加。

讨论

急诊科护士长可以改变领导风格以鼓励错误报告。错误报告后的及时反馈尤为重要。让经验丰富的护士参与理解错误根源可以增加自愿错误报告。

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