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从经验丰富的手术室护士角度看提高手术室患者安全

Enhancing patient safety in the operating theatre: from the perspective of experienced operating theatre nurses.

作者信息

Ingvarsdottir Eydis, Halldorsdottir Sigridur

机构信息

Faculty of Graduate Studies, School of Health Sciences, University of Akureyri, Akureyri, Iceland.

Akureyri Hospital v. Eyrarlandsveg, Akureyri, Iceland.

出版信息

Scand J Caring Sci. 2018 Jun;32(2):951-960. doi: 10.1111/scs.12532. Epub 2017 Sep 22.

Abstract

THE STUDY'S RATIONALE: Surgical care is an extensive component of modern health care, but patient safety issues and complications of surgery have been identified as a major cause of death and disability.

OBJECTIVE

The aim of this study was to identify, from the perspective of experienced operating theatre nurses (OTNs), how patient safety in the operating theatre (OT) can be enhanced.

RESEARCH METHODOLOGY AND METHODS

In this phenomenological study, 14 individual interviews were conducted with a purposive sample of 11 participants: ten women and one man. Work experience as an OTN spanned 10-40 years. Mean experience was 16 years.

RESULTS

The enhancement of patient safety in the OT from the perspective of the experienced OTNs is a constant endeavour of managing risks and preventing patient harm it involves respecting the vulnerability of the patient in the OT by being attentive to the patient at each moment, making contact with the patient and recognising how the patient loses all control by being anaesthetised or sedated and is, therefore totally dependent on OT staff. It also involves the OTN navigating the patient as safely as possible through the perioperative process by careful preparation, the use of protocols and checklists and taking measures to prevent complications and harm. Moreover, it involves contributing to a culture of safety by improving work conditions in the OT. Certain competencies of the OTN are essential for the enhancement of patient safety in the OT. These involve both nontechnical and technical competencies.

CONCLUSIONS

Constantly managing risk and preventing the OT patient from harm is essential according to the experienced OTNs, who are in a key position to identify threats to patient safety and should be empowered to enhance patient safety as a constant endeavour.

摘要

研究原理

外科护理是现代医疗保健的重要组成部分,但患者安全问题和手术并发症已被确认为死亡和残疾的主要原因。

目的

本研究的目的是从经验丰富的手术室护士(OTN)的角度,确定如何提高手术室(OT)中的患者安全。

研究方法

在这项现象学研究中,对11名参与者(10名女性和1名男性)进行了14次个人访谈,这些参与者是有目的地选取的。作为OTN的工作经验跨度为10至40年,平均经验为16年。

结果

从经验丰富的OTN的角度来看,提高OT中的患者安全是一项持续的风险管理和预防患者伤害的努力。这包括在OT中尊重患者的脆弱性,时刻关注患者,与患者接触,并认识到患者在麻醉或镇静状态下如何失去所有控制权,因此完全依赖于OT工作人员。这还包括OTN通过精心准备、使用规程和检查表以及采取措施预防并发症和伤害,尽可能安全地引导患者度过围手术期。此外,这还包括通过改善OT中的工作条件来促进安全文化。OTN的某些能力对于提高OT中的患者安全至关重要,这些能力包括非技术能力和技术能力。

结论

经验丰富的OTN认为,持续管理风险并防止OT患者受到伤害至关重要,他们处于识别患者安全威胁的关键位置,应该被赋予权力,将提高患者安全作为一项持续的努力。

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