Iran Journal of Nursing
نشریه پرستاری ایران
IJN
Medical Sciences
http://ijn.iums.ac.ir
108
journal108
2008-5931
2008-5931
10.52547/ijn
fa
jalali
1399
5
1
gregorian
2020
8
1
33
125
online
1
fulltext
fa
عوامل مرتبط با خطاهای دارویی در پرستاران بخشهای داخلی مراکز آموزشی- درمانی دانشگاه علوم پزشکی ایران در سال 1398
The Influential Factors in the Medication Errors by the Nurses of the Internal Wards of the Teaching Hospitals Affiliated to Iran University of Medical Sciences (2019)
پرستاری
nursing
پژوهشي
Research
<div style="text-align: justify;"><strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">زمینه و هدف</span></span></strong>: <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اشتباهات دارویی جزء شایعترین حوادث موجود در حرفه پرستاری است، نتیجه چنین اشتباهاتی، افزایش مدت بستری بیمار در بیمارستان و افزایش هزینههای مراقبت و درمان خواهد بود که گاهی میتواند منجر به آسیب شدید و یا حتی مرگ بیمار گردد. </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">هدف از انجام این پژوهش تعیین</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">عوامل مرتبط با خطاهای دارویی در پرستاران بخشهای داخلی مراکز آموزشی درمانی دانشگاه علوم پزشکی ایران بود.</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">روش بررسی</span></span></strong> <strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">:</span></span></strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> در این مطالعه توصیفی</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">،241 پرستار شاغل در بخشهای داخلی مراکز آموزشی- درمانی دانشگاه علوم پزشکی ایران، از خرداد 1398 تا شهریور 1398 مورد بررسی قرار گرفتند. ابزار گردآوری اطلاعات دراین مطالعه پرسشنامه اطلاعات جمعیت شناختی، پرسشنامه دیدگاه پرستاران از عوامل مرتبط بر خطاهای دارویی بیژنی و همکاران (1392) بود که جهت جمعآوری دادهها پرسشنامهها توسط پرستاران تکمیل شد. سپس دادهها توسط نرم افزار آماری </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">SPSS</span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> نسخه 16 و با به کارگیری آزمونهای آماری مورد تحلیل قرار گرفتند </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">.</span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">یافتهها:</span></span></strong> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">یافتهها نشان داد که خستگی ناشی از کار با میانگین 85/0 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 11/3 بیشترین علت خطای دارویی در بُعد مربوط به پرستار بوده است. همچنین در بُعد بخش، تراکم زیاد کارها با میانگین 85/0 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 09/3 و در بُعد مدیریت پرستاری، کمبود تعداد پرستار نسبت به تعداد بیمار با میانگین 61/0 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 53/3 بیشترین علت خطای دارویی بودهاند. عامل مدیریت پرستاری با میانگین 51/0 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 77/2 بیشترین و عامل بخش با میانگین 54/0 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> 55/2 کمترین میانگین نمره را در بین عوامل مرتبط با خطاهای دارویی از دیدگاه پرستاران مورد پژوهش داشتهاند.</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتیجهگیری کلی:</span></span></span></strong><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> با توجه به یافتهها، بیشترین عوامل مرتبط با خطاهای دارویی </span></span></span><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">از دیدگاه پرستاران به ترتیب مدیریت پرستاری، پرستار و شرایط بخشهای داخلی مورد مطالعه بود. </span></span></span><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">بنابراین پیشنهاد میشود در جهت کاهش خطاهای دارویی ، نحوه مدیریت پرستاری مورد بازنگری قرار گرفته و </span></span></span><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">همچنان میتوان با برگزاری کارگاههای مرتبط با خطاهای دارویی باعث کاهش بروز خطاهای دارویی پرستاران شد</span></span></span><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">.</span></span></span></div>
<div style="text-align: justify;"><strong>Background & Aims:</strong> Medication errors are common incidences in the nursing profession, which could lead to the increased length of hospital stay and treatment costs and occasionally severe damage to the patients or even mortality. The Many studies have investigated medication errors, with a few considering medication errors as a severe issue in the clinical setting. Other findings have confirmed that the cooperation of medical personnel and medical system could influence the rate of medication errors. Considering the essential role of nurses in all the steps of medication preparation to administration, limited studies have evaluated nurses’ viewpoint regarding the influential factors in the incidences of medical malpractices, and mostly the viewpoints of emergency ward or ICU nurses have been investigated. The present study aimed to determine the influential factors in the medication errors by the nurses of the internal wards of the teaching hospitals affiliated to Iran University of Medical Sciences.<br>
<strong>Materials & Methods:</strong> This descriptive study was conducted on 241 nurses employed in the internal wards of the teaching hospitals affiliated to Iran University of Medical Sciences in Tehran, Iran during June-September 2019. Data were collected using a demographic questionnaire and the questionnaire of nurses’ views on medication errors designed by Bijani et al. (2013), which were completed by the nurses. Demographic data included age, gender, marital status, number of children, education level, interest in the nursing profession, nursing profession work experience (years), occupation status, working shift schedule, economic status, clinical workplace, workplace changes in recent months, and number of the off days in the past month. The questionnaire of nurses’ views on the influential factors in medication errors has been developed by Bijani et al. (2013) with 22 items in three domains of the factors related to nurses in medication errors (11 items), factors related to the ward in medication errors (seven items), and factors related to the nursing management in medication errors (four items). The scoring system for each item is based on the significance of each factor on a four-point Likert scale (Very Low, Low, Moderate, and High), and each option is assigned a score within the range of 1-4, respectively. The mean score of each domain was calculated, with the low mean scores indicating the low significance of the domain in the incidence of medication errors and the high mean scores indicating the high significance of the domain in the viewpoint of the nurses. The questionnaire was completed by the nurses in a self-report manner and delivered to the researcher after one week. Data analysis was performed in SPSS version 16 using statistical tests.<br>
<strong>Results:</strong> According to the results, exhaustion due to heavy workload (mean score: 3.11 ± 0.85) was the most common cause of medication errors in the dimension of medication errors by nurses. In the dimension of hospital ward, heavy workload (mean score: 3.09 ± 0.85) was the most frequent cause of medication errors, and in the dimension of nursing management, the insufficient number of nurses in proportion to the number of patients (mean score: 3.53 ± 0.61) was the most common cause of medication errors. In addition, the factor of nursing management (mean score: 2.77 ± 0.51) had the highest mean value, while the factor of ward (mean score: 2.55 ± 0.54) had the lowest mean value among the influential factors in the incidence of medication errors in the viewpoint of the surveyed nurses. Lack of educational workshops (mean score: 2.3 ± 0.81) was the least significant cause of medication errors. The numerical indices of the influential factors in the incidence of medication errors in the domains of nurses, wards, and nursing management based on the demographic characteristics of the nurses indicated that only the number of children had a significant correlation with the incidence of medication errors (P=0.023), and the achieved mean score by the nurses without children was significantly lower compared to those with children (P=0.017). The incidence of medication errors in the domains of ward and nursing management had no significant correlations with the demographic characteristics of the nurses (P>0.05).<br>
<strong>Conclusion:</strong> According to the results, the most significant influential factors in the incidence of medication errors in the viewpoint of the nurses were respectively nursing management, nurses, and the conditions of the internal wards. Therefore, it is suggested that to reduce the incidence of medication errors, the approaches to nursing management be revised. In addition, the implementation of educational workshops regarding medication errors could effectively decrease the incidence of medication errors by nurses, which should be considered by the authorities of educational centers. The incidence of medication errors could be reduced through academic education and by applying theoretical and practical courses during master’s and bachelor’s degree education. Regarding the related factors to the ward, it is recommended that the workload of nurses be decreased by increasing the nursing staff in proportion to patients, so that the working hours and working shifts of nurses could decrease to change their schedule, which could in turn minimize the incidence of medication errors.</div>
خطا, خطاهای دارویی, پرستاران, بخشهای داخلی
Error, Medication Errors, Nurses, Internal Wards
94
107
http://ijn.iums.ac.ir/browse.php?a_code=A-10-46-4&slc_lang=fa&sid=1
A
Hosseinzadeh
علی
حسین زاده
10800319475328460024840
10800319475328460024840
No
MS in Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
کارشناسی ارشد پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران
D
Masror
دریادخت
مسرور
10800319475328460024841
10800319475328460024841
Yes
Department of Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (Corresponding author) Tel: 09123273135 Email: masror.d@iums.ac.ir
گروه پرستاری داخلی و جراحی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران (نویسنده مسئول) شماره تماس:09123273135 Email: masror.d@iums.ac.ir
H
Haghani
حمید
حقانی
10800319475328460024842
10800319475328460024842
No
Department of Biostatistics, School of Health, Iran University of Medical Sciences, Tehran, Iran
گروه آمار زیستی، دانشکده بهداشت، دانشگاه علوم پزشکی ایران، تهران، ایران