作为道德风险的手术安全检查清单合规过程:一个机构的民族学
Marcia Facey1,2, Nancy Baxter2,3,4,5, Melanie Hammond Mobilio4,5
1Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada.
PloS one
|February 26, 2024
概括
护士预先绘制了手术安全检查清单的合规性,造成了伦理问题,并阻碍了准确的患者安全数据. 这种解决方案掩盖了实际的遵守,并影响了护理自主权.
科学领域:
- 医疗保健管理的管理
- 护理实践 护理实践
- 患者安全 患者安全
背景情况:
- 准确的图表对于手术中的患者安全至关重要,防止错误,如错位手术.
- 文件保护在手术室的专业责任和问责制.
- 在加拿大一家教学医院的手术安全检查清单 (SSC) 绘制实践中观察到的差异促使了这项研究.
研究的目的:
- 从护士的角度描述和解释手术安全合规监测的社会组织.
- 调查与SSC相关的观察到的绘图实践背后的原因.
- 识别当前绘图程序中产生的伦理问题.
主要方法:
- 采用了机构民族学,利用来自更大研究的数据.
- 包括51个手术病例的现场观察和与护士的现场采访.
- 与SSC设计师,实施者和OR团队进行了正式的采访和调查.
主要成果:
- 合规表格,而不是SSC本身,成为报告的基础.
- 参与"预绘图"检查清单合规的护士,以满足医院和法律文件要求.
- 这种解决方案在技术上违反了图表原则,并使护士处于道德上困难的境地.
结论:
- 记录SSC合规性造成了道德风险,限制了护士的自主权和道德主动性.
- 这种做法掩盖了实际遵守检查清单的情况,引发了人们对决策数据有效性的担忧.
- 调查结果有助于讨论护理解决方案以及文本,技术和关系对道德实践的影响.
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