Faculty of Medicine, Nursing and Health Sciences, Monash Rural Health, Monash University, Moe, Vic., Australia.
J Clin Nurs. 2018 May;27(9-10):2072-2082. doi: 10.1111/jocn.14353.
To identify the issues surrounding medication error reporting in community nursing and improvement strategies related to medication safety.
Medication-related problems have been identified from various sources in the literature. Examples of these include incident reporting by healthcare professionals, medico-legal and patient complaints and systematic identification of organisational structure. Only a few studies report on the clinicians' perceptions of medication safety in community nursing and the challenges they face within their workplace to implement medication safety initiatives.
Qualitative design, using conversation-style interviews with experienced registered nurses in primary care roles.
Using a general iterative approach of semantic analysis, our qualitative research study was guided by an essentialist paradigm. Our method for understanding included semi-structured in-depth interviews with 10 clinicians from a large community care organisation in rural Victoria in Australia. We developed an interview guide, which included open-ended questions on clinicians' experiences, perceived barriers and facilitators, and strategies to improve medication safety.
Several barriers have been identified by healthcare practitioners that hinder medication safety in primary care including culture differences between community and hospital setting, politics within the healthcare system, lack of clarity around the nurses' roles and lack of error reporting. Other sources of errors cited by the participants were the lack of clarity or awareness of the processes and procedures of medication incidents reporting for staff within the organisation experience. Lack of education regarding medication safety, the dilemmas associated with reporting and documentation are also significant barriers.
确定社区护理中药物错误报告的问题，并确定与药物安全相关的改进策略。
药物相关问题已在文献的各种来源中得到识别。这些例子包括医疗保健专业人员的事件报告、医疗法律和患者投诉以及对组织结构的系统识别。只有少数研究报告了社区护理中临床医生对药物安全的看法，以及他们在工作场所中面临的实施药物安全措施的挑战。
定性设计，使用与初级保健角色中的经验丰富的注册护士进行对话式访谈。
使用语义分析的一般迭代方法，我们的定性研究受到本质主义范式的指导。我们的理解方法包括对来自澳大利亚维多利亚州农村地区的一家大型社区护理组织的 10 名临床医生进行半结构化深入访谈。我们制定了一份访谈指南，其中包括关于临床医生经验、感知障碍和促进因素以及改善药物安全策略的开放性问题。
医疗保健从业者确定了一些阻碍初级保健药物安全的障碍，包括社区和医院环境之间的文化差异、医疗系统内的政治问题、护士角色缺乏明确性以及缺乏错误报告。参与者还提到了其他来源的错误，例如组织内工作人员对药物事件报告的流程和程序缺乏清晰性或意识。缺乏药物安全教育、与报告和记录相关的困境也是重大障碍。
