University of the Sunshine Coast, PO Box 1149, Pialba, QLD, 4655, Australia.
Faculty of Health, Federation University, PO Box 663, Ballarat, VIC, 2351, Australia.
Nurse Educ Pract. 2019 May;37:109-114. doi: 10.1016/j.nepr.2019.05.006. Epub 2019 May 21.
This paper discusses the findings from the observation phase of a more extensive, appreciative inquiry qualitative study exploring registered nurses' experiences of administering medications. The observations aimed to explore the participants' application of the five-rights of medication administration in practice. Twenty registered nurses working in inpatient medical/surgical units at a regional Australian hospital were observed administering medications from the commencement to the completion of their shift. A data collection tool based on the five-rights of medication administration was used. The findings indicated that medication administration was not as routine as the rights framework suggests. Indeed, what was observed rarely reflected all the criteria of the rights framework. Notably, in practice, some of the rights were unable to be observed because the critical thinking that underpins the rights are implicit. However, the participants were observed to implement strategies beyond those described by the rights framework that ensured safe and timely medication administration. In brief, medication administration in contemporary healthcare settings is more complicated than the linear process suggested by the rights framework. So more attention is warranted, to the safe practice strategies of nurses who, to deal with complex clinical contexts. Their person-centred strategies respond to patient circumstances and maintain safety.
本文讨论了一项更广泛的、欣赏性探究的定性研究观察阶段的结果，该研究旨在探索注册护士给药的经验。观察的目的是探讨参与者在实践中应用给药的“五正确”原则。20 名在澳大利亚一家地区医院的住院内科/外科病房工作的注册护士，从开始到完成轮班期间给药时被观察。使用了一个基于给药“五正确”原则的的工具来收集数据。结果表明，给药并不像权利框架所建议的那样常规。事实上，观察到的情况很少反映出权利框架的所有标准。值得注意的是，在实践中，由于构成权利的批判性思维是隐含的，因此无法观察到一些权利。然而，观察到参与者实施了超越权利框架所描述的策略，这些策略确保了安全和及时的药物管理。简而言之，在当代医疗保健环境中，药物管理比权利框架所建议的线性过程复杂得多。因此，更需要关注护士的安全实践策略，因为他们需要应对复杂的临床环境。他们以患者为中心的策略应对患者的情况并保持安全。
