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护士对术后因抢救失败而死亡患者的护理经历。

Nurses' Experiences With Patients Who Die From Failure to Rescue After Surgery.

作者信息

Bacon Cynthia Thornton

机构信息

Assistant Professor, University of North Carolina at Greensboro, School of Nursing, Greensboro, North Carolina.

出版信息

J Nurs Scholarsh. 2017 May;49(3):303-311. doi: 10.1111/jnu.12294. Epub 2017 Apr 6.

Abstract

PURPOSE

To describe the lived experiences of hospital nurses caring for surgical patients who died from failure to rescue (FTR).

DESIGN

A qualitative phenomenologic approach was used. Methods to ensure rigor and trustworthiness were incorporated into the design.

METHODS

The investigator conducted one-on-one semistructured interviews with 14 nurses, and data were analyzed using Colaizzi's methods.

FINDINGS

Six themes were identified: (a) the environment surrounding the FTR was unexpected; (b) FTR was unexpected but not preventable; (c) nurses were emotionally ill-prepared for the FTR; (d) nurse outcomes are different in unexpected versus expected death; (e) nurses' roles as protectors are important; and (f) FTR effects future nursing practice.

CONCLUSIONS

Nurses' reactions after an FTR surgical death may be different when there is no identified nursing error contributing to the event. There may be key differences between deaths that are simply unexpected and those that involve FTR. The importance of mentoring junior nurses in protective surveillance skills is vital.

CLINICAL RELEVANCE

Developing an understanding of nurses' experiences with FTR can assist nurse leaders to better support nurses who experience FTR deaths. Insight into the environment surrounding FTR deaths provides a foundation for future research aimed at improving patient safety and quality through an improved working environment for nurses.

摘要

目的

描述医院护士护理因抢救失败(FTR)而死亡的手术患者的真实经历。

设计

采用质性现象学方法。确保严谨性和可信度的方法已纳入设计之中。

方法

研究者对14名护士进行了一对一的半结构化访谈,并使用科莱齐的方法对数据进行了分析。

结果

确定了六个主题:(a)FTR周围的环境出乎意料;(b)FTR出乎意料但不可预防;(c)护士对FTR在情绪上准备不足;(d)意外死亡与预期死亡时护士的结果不同;(e)护士作为保护者的角色很重要;(f)FTR影响未来的护理实践。

结论

当未发现护理失误导致FTR手术死亡时,护士的反应可能会有所不同。单纯意外死亡与涉及FTR的死亡之间可能存在关键差异。指导初级护士掌握保护性监测技能至关重要。

临床意义

了解护士在FTR方面的经历有助于护士长更好地支持经历FTR死亡的护士。深入了解FTR死亡周围的环境为未来旨在通过改善护士工作环境提高患者安全和质量的研究奠定了基础。

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