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提高肿瘤护理的高可靠性:护士的关键作用——系统评价与主题分析

Enhancing High Reliability in Oncology Care: The Critical Role of Nurses-A Systematic Review and Thematic Analysis.

作者信息

Komatsu Hiroko, Hara Akemi, Koyama Fumiko, Komatsu Yasuhiro

机构信息

Division of Faculty Development Nursing, Kindai University, 377-2 Ohnohigashi, Osakasayama 589-8511, Osaka, Japan.

Department of Healthcare Quality and Safety, Graduate School of Medicine, Gunma University, 3-39-22 Showa-machi, Maebashi 371-8511, Gunma, Japan.

出版信息

Healthcare (Basel). 2025 Jan 31;13(3):283. doi: 10.3390/healthcare13030283.

Abstract

The oncology setting is complex and recognized as a high-risk area, with an increased potential for errors due to the complexity of therapeutic modalities and different processes. Nurses are pivotal in fostering a culture of patient safety and high reliability and actively contribute to the enhancement of safety standards in oncology care. This review systematically identified and examined the critical role of nurses in promoting high reliability within oncology organizations to ensure optimal patient outcomes. : A systematic review was performed in the PubMed, CINAHL, and Cochran Library databases in accordance with PRISMA guidelines. Using Tomas and Harden's three stages, 12 studies were deductively and thematically analyzed to discover themes. We identified eight themes concerning nurses' roles in achieving high reliability in healthcare within oncology organizations: establishing standardized and safe administration, enhancing situational awareness, promoting effective communication, advocating for patients, building a culture of safety, leading safety culture improvements, engaging staff, and fostering patient engagement. Nurses play a critical role in identifying, communicating, and correcting safety threats, overcoming various organizational barriers to safety concerns, and maintaining and developing a culture of safety for patients and families. Although this review included a relatively limited body of literature, the findings highlight the need for further research that considers the unique characteristics of health and healthcare systems. Protocol registry; UMIN Clinical Trials Registry (UMIN-CTR) Registry No. UMIN000056140.

摘要

肿瘤学领域情况复杂,被公认为高风险领域,由于治疗方式和不同流程的复杂性,出错的可能性增加。护士在营造患者安全和高可靠性文化方面起着关键作用,并积极为提高肿瘤护理的安全标准做出贡献。本综述系统地确定并研究了护士在肿瘤组织内促进高可靠性以确保患者获得最佳治疗效果方面的关键作用。:根据PRISMA指南,在PubMed、CINAHL和Cochran图书馆数据库中进行了系统综述。使用托马斯和哈登的三个阶段,对12项研究进行了演绎和主题分析以发现主题。我们确定了八个与护士在肿瘤组织内实现医疗保健高可靠性方面的作用相关的主题:建立标准化和安全的给药方式、增强态势感知、促进有效沟通、为患者代言、营造安全文化、引领安全文化改进、让员工参与以及促进患者参与。护士在识别、沟通和纠正安全威胁、克服各种安全问题的组织障碍以及为患者和家属维护和发展安全文化方面发挥着关键作用。尽管本综述纳入的文献数量相对有限,但研究结果凸显了开展进一步研究的必要性,这类研究应考虑健康和医疗系统的独特特征。方案注册;UMIN临床试验注册库(UMIN-CTR)注册号UMIN000056140。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/550d/11817837/91d7ddbbd889/healthcare-13-00283-g001.jpg

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