Mehanna Diala, El Gerges Najwa, Chalhoub Marianne, Daou Remy
Medical Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
School of Medicine, Saint Joseph University School of Medical Science, Beirut, Lebanon.
BMJ Open Qual. 2024 Dec 30;13(4):e002994. doi: 10.1136/bmjoq-2024-002994.
The aim of this study is to identify the key barriers that prevent medication administration errors (MAEs) from being reported by nurses in Lebanese hospitals.
A quantitative cross-sectional study was conducted at Hotel-Dieu de France Hospital using a self-administered questionnaire. A total of 275 responses were recorded and analysed using the IBM SPSS software V.23.0.
Our study showed that 'Fear' and 'Administrative response' present the two main types of barriers to MAE reporting with a frequency of 62.9% and 60.7%, respectively, with more than half of our nurses confirming it (52.7%). The significant administrative barriers are: No positive feedback if medications were given correctly, too much emphasis being placed on MAE and the focus by the nursing administration on the individual rather than looking at the systems as a potential cause of the MAE whereas the significant fear barriers are the chances of suing the nurse if MAE is reported, the fear of adverse consequences of MAE reporting, the blame of nurses if something happens to the patient as a result of the MAE. No significant association was found between the barriers and demographic factors such as age, gender, experience and attending the training and orientation programmes.
The findings highlight the need for targeted strategies to address these types of barriers. Anonymous error reporting, fostering a culture of transparency and adopting a non-punitive reporting system are approaches that can be implemented for optimal performance improvement, enhanced safety and healthcare quality and reduced wasting of the hospitals' financial resources.
本研究旨在确定阻碍黎巴嫩医院护士报告用药错误（MAE）的关键障碍。
在法国圣约瑟夫医院进行了一项定量横断面研究，采用自填式问卷。共记录了275份回复，并使用IBM SPSS软件V.23.0进行分析。
我们的研究表明，“恐惧”和“行政反应”是MAE报告的两种主要障碍类型，出现频率分别为62.9%和60.7%，超过一半的护士予以确认（52.7%）。显著的行政障碍包括：正确给药时没有积极反馈、对MAE强调过多以及护理管理层关注个人而非将系统视为MAE的潜在原因；而显著的恐惧障碍包括报告MAE时护士被起诉的可能性、对报告MAE产生不良后果的恐惧、如果因MAE导致患者出现问题护士会受到指责。在这些障碍与年龄、性别、经验以及参加培训和入职培训计划等人口统计学因素之间未发现显著关联。
研究结果凸显了针对这些类型障碍制定针对性策略的必要性。匿名错误报告、营造透明文化以及采用非惩罚性报告系统是可以实施的方法，以实现最佳绩效提升、增强安全性和医疗质量，并减少医院财政资源的浪费。
