"我知道我不应该这样做,但"...使用规避方法成为一个"好护士"的不可避免的紧张
Deborah Debono1, David Greenfield2, Wendy Lipworth3
1School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Frontiers in health services
|August 13, 2025
概括
由于政策与实践的紧张关系,护士们经常使用电子药物管理系统 (EMMS) 解决问题. 这些规避措施,虽然有时是护理所必需的,但会造成压力,并影响患者安全和护士保留.
科学领域:
- 提供医疗保健服务.
- 护理实践的护理实践
- 患者安全 患者安全
背景情况:
- 医疗保健系统实施规则,政策和技术,如电子药物管理系统 (EMMS),以减少错误和复杂性.
- 医院的护士经常制定解决方案,以规避在药物管理过程中遇到的障碍.
- 了解护士对解决方案的经验对于患者安全和员工保留至关重要.
研究的目的:
- 探索护士在日常药物管理中使用规避方法的经验和看法.
- 调查这些规避措施对护士的情感和专业影响.
- 确定挑战,并提出与EMMS中解决方案使用相关的解决方案.
主要方法:
- 一项在澳大利亚两家医院的六个病房进行的民族学研究.
- 通过91个班次,46次采访和7个重点小组收集的数据,共有113名参与者.
- 分析采用了一般的诱导方法,包括成员检查会议.
主要成果:
- 护士们报告了一系列关于解决方案的感受 (积极,消极,矛盾).
- 在对护理交付和政策的坚持之间存在着感知到解决方案的必要性之间的紧张关系.
- 规避措施被视为专家实践的标志,也是对安全程序的偏离.
结论:
- 对患者安全的挑战源于必要的规避方法和政策遵守之间的冲突,导致护士的压力和焦虑.
- 解决方案是医疗保健标准化的固有组成部分,负面的看法可能会产生反作用.
- 开放的对话和解决方案的建设性管理对于减少护士倦怠和提高患者安全至关重要.
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