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护士进行静脉输液监测以确保患者安全的经验:一项质性描述性研究

Experience of Nurses with Intravenous Fluid Monitoring for Patient Safety: A Qualitative Descriptive Study.

作者信息

Park Jeongok, You Sang Bin, Kim Hyejin, Park Cheolmin, Ryu Gi Wook, Kwon Seongae, Kim Youngkyung, Lee Sejeong, Lee Kayoung

机构信息

Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, South Korea.

Yonsei University College of Nursing, Seoul, South Korea.

出版信息

Risk Manag Healthc Policy. 2022 Sep 22;15:1783-1793. doi: 10.2147/RMHP.S374563. eCollection 2022.

Abstract

PURPOSE

Medication administration is a complex process and constitutes a substantial component of nursing practice that is closely linked to patient safety. Although intravenous fluid administration is one of the most frequently performed nursing tasks, nurses' experiences with intravenous rate control have not been adequately studied. This study aimed to explore nurses' experiences with infusion nursing practice to identify insights that could be used in interventions to promote safe medication administration.

PATIENTS AND METHODS

This qualitative descriptive study used focus group interviews of 20 registered nurses who frequently administered medications in tertiary hospitals in South Korea. Data were collected through five semi-structured focus group interviews, with four nurses participating in each interview. We conducted inductive and deductive content analysis based on the 11 key topics of patient safety identified by the World Health Organization. Reporting followed the consolidated criteria for reporting qualitative research (COREQ) checklist.

RESULTS

Participants administered infusions in emergency rooms, general wards, and intensive care units, including patients ranging from children to older adults. Two central themes were revealed: human factors and systems. Human factors consisted of two sub-themes including individuals and team players, while systems encompassed three sub-themes including institutional policy, culture, and equipment.

CONCLUSION

This study found that nurses experienced high levels of stress when administering infusions in the correct dose and rate for patient safety. Administering and monitoring infusions were complicated because nursing processes interplay with human and system factors. Future research is needed to develop nursing interventions that include human and system factors to promote patient safety by reducing infusion-related errors.

摘要

目的

给药是一个复杂的过程,是护理实践的重要组成部分,与患者安全密切相关。尽管静脉输液是最常执行的护理任务之一,但护士在静脉输液速度控制方面的经验尚未得到充分研究。本研究旨在探索护士在输液护理实践中的经验,以确定可用于促进安全给药干预措施的见解。

患者与方法

本定性描述性研究采用焦点小组访谈法,对韩国三级医院中20名经常给药的注册护士进行访谈。通过五次半结构化焦点小组访谈收集数据,每次访谈有四名护士参与。我们基于世界卫生组织确定的11个患者安全关键主题进行了归纳和演绎内容分析。报告遵循定性研究报告统一标准(COREQ)清单。

结果

参与者在急诊室、普通病房和重症监护病房进行输液操作,涉及从儿童到老年人的各类患者。揭示了两个中心主题:人为因素和系统因素。人为因素包括两个子主题,即个体和团队成员,而系统因素包括三个子主题,即机构政策、文化和设备。

结论

本研究发现,护士在为确保患者安全以正确剂量和速度进行输液时承受着高度压力。由于护理过程与人为和系统因素相互作用,输液的给药和监测变得复杂。未来需要开展研究,以制定包括人为和系统因素的护理干预措施,通过减少与输液相关的错误来促进患者安全。

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