约旦大学医院重症护理护士改善静脉给药及减少用药错误

Mahmoud Sayed Ahmed Shahin
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引用次数: 5

摘要

背景:在医院环境中,用药错误是一个严重的问题,在所有科室的住院患者中,用药错误仍然是一个挑战。药物管理中的错误被认为是一个严重的问题,威胁到患者的安全,并可能增加他们的住院时间,治疗费用和死亡率。护士常犯的用药错误可能包括药物制备或给药错误,这是护理实践中风险最高的领域。方法:采用前测后测、准实验、观察设计。采用方便抽样的方法纳入约旦大学医院3个icu护士的所有静脉用药错误(前测236次错误,后测68次错误)。数据收集使用了设计好的事件报告。在护士准备和给药两个多月的时间里,在3个icu中同时收集测前和测后数据(2018年5月和6月)。采用Phillips的《静脉注射治疗手册:输液治疗的循证实践》为所有注册护士设计了量身定制的循证教育计划,采用结构化的课堂讲座和在职培训;此外,还使用了常用药物教育奖章和插图海报作为额外的提醒。结果与结论:半数以上护士为女性,本科以上学历。半数观察到的用药错误发生在外科ICU。白班的静脉用药差错数量明显高于夜班。在实施一系列干预措施后,用药错误的数量显著减少(即,错误从236个减少到68个)。(1)推用奥美拉唑、(2)迅速加用万古霉素、(3)错误时间加用奥美拉唑是观察最多的3种用药方式
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Improving Intravenous Medication Administration and Reducing Medication Errors Among Critical Care Nurses at Jordan University Hospital
Background: Medication errors represent a serious problem in the hospital setting and remain a challenge to navigate among hospitalized patients in all departments. Mistakes in medication administration are considered a significant issue that threatens a patient’s safety and may increase their hospital stay, treatment costs, and mortality rate. Medication errors commonly committed by nurses may include medication preparation or administration errors, which are associated with the highest risk areas in nursing practice. Methodology: A pretest-posttest, quasi-experimental, the observational design was used. Convenience sampling was employed to include all intravenous medication errors committed by nurses in three ICUs of Jordan University Hospital (pretest: 236 errors and post-test: 68 errors, respectively). A designed incident report was used for data collection. Data collection was carried out simultaneously in the three ICUs during nurses’ preparation and administration of intravenous medications over two months for pretest and posttest data (May and June 2018). A tailored evidencedbased educational program designed using Phillips's Manual of I. V. Therapeutics: Evidence-based Practice for Infusion Therapy was furnished to all registered nurses utilizing structured classroom lectures and on-the-job training; moreover, educational medals of common medications and illustration posters were used as additional reminders.Results and Conclusion: More than half of nurses were females and held bachelor’s degrees. Half of the observed medication errors were identified in the surgical ICU. Intravenous medication errors observed during the day shift were significantly higher in number than those in the night shift. A significant reduction in the number of medication errors was noted after the implementation of a bundle of interventions (i.e., there was a reduction from 236 errors to 68 errors). Giving (1) an omeprazole push and then (2) administering vancomycin rapidly thereafter, followed by (3) administering omeprazole at the wrong time, were the three most observed medication BioBacta Journal of Bioscience and Applied Research
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