护士对高警示药物给药安全的认知：一项定性描述性研究。
Nurses' perceptions of high-alert medication administration safety: A qualitative descriptive study.
机构信息
College of Health Professions, Towson University, Towson, Maryland.
College of Nursing, Medical University of South Carolina, Charleston, South Carolina.
出版信息
J Adv Nurs. 2019 Dec;75(12):3654-3667. doi: 10.1111/jan.14173. Epub 2019 Sep 5.
AIMS
The aim of this study was to determine nurses' perceptions of supports and barriers to high-alert medication (HAM) administration safety.
DESIGN
A qualitative descriptive design was used.
METHODS
Eighteen acute care nurses were interviewed about HAM administration practices. Registered nurses (RNs) working with acutely ill adults in two hospitals participated in one-on-one interviews from July-September, 2017. Content analysis was conducted for data analysis.
RESULTS
Three themes contributed to HAM administration safety: Organizational Culture of Safety, Collaboration, and RN Competence and Engagement. Error factors included distractions, workload and acuity. Work arounds bypassing bar code scanning and independent double check procedures were common. Findings highlighted the importance of intra- and interprofessional collaboration, nurse engagement and incorporating the patient in HAM safety.
CONCLUSIONS
Current HAM safety strategies are not consistently used. An organizational culture that supports collaboration, education on safe HAM practices, pragmatic HAM policies and enhanced technology are recommended to prevent HAM errors.
IMPACT
Hospitals incorporating these findings could reduce HAM errors. Research on nurse engagement, intra- and interprofessional collaboration and inclusion of patients in HAM safety strategies is needed.
目的
本研究旨在确定护士对高警示药物（HAM）给药安全的支持和障碍的看法。
设计
采用定性描述性设计。
方法
对 18 名从事急症护理的护士进行了 HAM 给药实践的访谈。2017 年 7 月至 9 月，在两家医院参与急性重症成人护理的注册护士（RN）接受了一对一的访谈。对数据进行了内容分析。
结果
三个主题有助于 HAM 给药安全：安全组织文化、协作以及 RN 的能力和参与度。错误因素包括分心、工作量和疾病严重程度。绕过条码扫描和独立双检查程序的工作规避行为很常见。研究结果强调了跨专业协作、护士参与以及将患者纳入 HAM 安全的重要性。
结论
目前的 HAM 安全策略并未得到一致应用。建议建立支持协作、安全使用 HAM 实践教育、实用的 HAM 政策和增强技术的组织文化，以预防 HAM 错误。
影响
采用这些发现的医院可以减少 HAM 错误。需要开展关于护士参与度、跨专业和多专业协作以及将患者纳入 HAM 安全策略的研究。
Zotero 插件