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Hemşireler ‘’Doğru Yanıt’’ takip ediyor mu? Karma yöntem araştırması

Year 2025, Volume: 30 Issue: 1, 102 - 111, 29.01.2025
https://doi.org/10.21673/anadoluklin.1415506

Abstract

Amaç: İlaç uygulama ve yönetimi, klinik hemşirelik uygulamaları arasında önemli bir prosedür olup, hasta güvenliğini ve bakım kalitesini etkileyen önemli göstergelerden biridir. Hemşirelerin ilaç uygulaması sonrasında ilaç etkilerini takip etme durumlarının belirlenmesi amaçlanmıştır.

Yöntemler: Araştırmada keşfedici ve karma araştırma yöntemlerinden sıralı açıklayıcı tasarım kullanılmıştır. Araştırmanın nicel verileri veri toplama formu, nitel verileri ise yarı yapılandırılmış görüşme formu kullanılarak Temmuz-Eylül 2023 tarihleri arasında derinlemesine ve bireysel görüşme yöntemi ile toplanmıştır. Yapılan görüşmeler ses kayıt cihazı ile kayıt edilmiştir.

Bulgular: Hemşirelerin yaş, çalışma yılı, haftalık çalışma saati ve günlük bakılan hasta sayıları ortalamalarının sırasıyla 30.46±6.96, 7.1±6.31, 44.92±5.71, 15.42±11.89 yıl olduğu belirlendi. Hemşirelerin %54.2’si ilaç uygulamalarını yapmadan önce ilaç prospektüsünü kontrol ettiği, %74.5’inin ilaç uygulama öncesinde ilaç ve besin alerjisi öyküsünü her zaman hayati önemi olan bir durum olduğunu düşündüğü, %97.9’unun beklenmeyen yan/toksik etkileri bildirdiği saptandı. Araştırmaya katılan hemşireler ile yapılan derinlemesine görüşmeler sonucunda ise doğru ilaç uygulama ilkeleri yaklaşımı, doğru yanıt takip etme yaklaşımı ve hemşirelerin ilaç uygulama sonrası takip etme durumları olmak üzere üç tema belirlenmiştir.

Sonuç: Çalışmada, hemşirelerin doğru ilaç uygulama ilkeleri konusunda bilgi eksikliği olduğu, iş yükünün fazla olması, hemşire sayısının az olması ve zaman yetersizliği nedenleriyle doğru yanıt ilkesini uygulayamadıkları belirlenmiştir. Hemşirelerin, doğru yanıt takibinin sorumluluğunu hasta veya hasta yakınına verdiği görülmüştür. Doğru yanıt ilkesinin uygulanmama nedenleri değerlendirilerek, hemşire sayısının artırılması, iş yükünün düzenlenmesi, hemşirelerin doğru ilaç uygulama ilkeleri konusunda ve özellikle doğru yanıtın önemi konusunda eğitimler alması önerilmektedir. Ayrıca hemşirelerin görev, yetki ve sorumlulukları konusunda da eğitim ve danışmanlık alması da önerilerimiz arasında yerini almaktadır.

References

  • Blignaut AJ, Coetzee SK, Klopper HC, Ellis SM. Medication administration errors and related deviations from safe practice: an observational study. J Clin Nurs. 2017;(21–22):3610–23.
  • Rohde E, Domm E. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature. J Clin Nurs. 2018;27(3-4):e402-11.
  • Avraham R, Shor V, Hurvitz N, Shvartsur R, Kimhi E. Transferability of Medication Administration Simulation Training to Clinical Settings. Teach Learn Nurs. 2018;13(4):258–62.
  • Edwards S, Axe S. The 10 ‘R’s of safe multidisciplinary drug administration. Nurse Prescribing. 2015;13(8):398–406.
  • Salmasi S, Khan TM, Hong YH, Ming LC, Wong TW. Medication Errors in the Southeast Asian Countries: A Systematic Review. PLoS One. 2015;10(9):e0136545.
  • WHO WHO. Medication Without Harm WHO Global Patient Safety Challenge. 2017 [cited 2023 Aug 10]; Available from: http://apps.who.int/bookorders.
  • Niemann D, Bertsche A, Meyrath D, et al. A prospective three-step intervention study to prevent medication errors in drug handling in paediatric care. J Clin Nurs. 2015;24(1–2):101–14.
  • Martyn JA, Paliadelis P, Perry C. The safe administration of medication: Nursing behaviours beyond the five-rights. Nurse Educ Pract. 2019;37:109–14.
  • ICN IC of N. Patient safety 2012 [Internet]. [cited 2023 Dec 30]. Available from: www.icn.ch
  • Yu X, Li C, Gao X, Liu F, Lin P. Influence of the medication environment on the unsafe medication behaviour of nurses: A path analysis. J Clin Nurs. 2018;27(15–16):2993–3000.
  • Hanson A, Haddad LM. Treasure Island (FL): StatPearls Publishing. 2023 [cited 2023 Aug 23]. Nursing Rights of Medication Administration. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560654/
  • Taft T, Rudd EA, Thraen I, et al. “Are we there yet?” Ten persistent hazards and inefficiencies with the use of medication administration technology from the perspective of practicing nurses. Journal of the American Medical Informatics Association [Internet]. 2023;30(5):809–18.Available from: https://academic.oup.com/jamia/article/30/5/809/7072778
  • WHO. Patient Safety Making health care safer [Internet]. 2017 [cited 2023 Aug 10]. Available from: http://apps.who.int/bookorders.
  • Cohen L, Lawrence M, Keith M. Research Methods in Education. 8th ed. Routledge; 2018.
  • Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. Third. SAGE; 2017.
  • Lichtman M. Qualitative Research in Education. New York: Routledge; 2023.
  • Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 2021;18(3):328–52.
  • Taylor CR, Lynn PB, Bartlett JL. Fundamentals of Nursing: The Art and Science of Person-Centered Care. 9th Edition. Wolters Kluwer; 2015.
  • Jember A, Hailu M, Messele A, Demeke T, Hassen M. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC Nurs. 2018;17:9.
  • Yousef A, Abu Farha R, Da'meh K. Medication administration errors: Causes and reporting behaviours from nurses perspectives. Int J Clin Pract. 2021;75(10):e14541.
  • Hojat M. Empathy in Health Professions Education and Patient Care. London: Springer; 2016.
  • Vicente Oliveros N, Gramage Caro T, Pérez Menendez-Conde C, et al. Effect of an electronic medication administration record application on patient safety. J Eval Clin Pract. 2017;23(4):888-94.
  • Härkänen M, Vehviläinen-Julkunen K, Murrells T, Rafferty AM, Franklin BD. Medication administration errors and mortality: Incidents reported in England and Wales between 2007–2016. Res Social Adm Pharm. 2019;15(7):858-63.
  • van der Veen W, van den Bemt PMLA, Wouters H, et al. Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals. J Am Med Inform Assoc. 2018;25(4):385-92.
  • Salehi T, Seyedfatemi N, Mirzaee MS, Maleki M, Mardani A. Nurses' Knowledge, Attitudes, and Practice in Relation to Pharmacovigilance and Adverse Drug Reaction Reporting: A Systematic Review. Biomed Res Int. 2021;2021:6630404.
  • Griffiths P, Recio-Saucedo A, Dall'Ora C, et al. The association between nurse staffing and omissions in nursing care: A systematic review. J Adv Nurs. 2018;74(7):1474-87.
  • Schutte T, van Eekeren R, Richir M, et al. The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study. Naunyn Schmiedebergs Arch Pharmacol. 2018;391(1):17-26.
  • Tsegaye D, Alem G, Tessema Z, Alebachew W. Medication Administration Errors and Associated Factors Among Nurses. Int J Gen Med. 2020;13:1621-32.
  • Pol-Castañeda S, Carrero-Planells A, Moreno-Mulet C. Use of simulation to improve nursing students' medication administration competence: a mixed-method study [published correction appears in BMC Nurs. 2022;21(1):117.
  • Mohammed T, Mahmud S, Gintamo B, Mekuria ZN, Gizaw Z. Medication administration errors and associated factors among nurses in Addis Ababa federal hospitals, Ethiopia: a hospital-based cross-sectional study. BMJ Open. 2022;12(12):e066531.
  • Ojerinde AC, Adejumo PO. Factors Associated With Medication Errors Among Health Workers In University College Hospital, Nigeria. IOSR-JNHS. 2014;3(3):22–33.
  • Baraki Z, Abay M, Tsegay L, Gerensea H, Kebede A, Teklay H. Medication administration error and contributing factors among pediatric inpatient in public hospitals of Tigray, northern Ethiopia. BMC Pediatr. 2018;18(1):321.
  • Kavanagh A, Donnelly J. A Lean Approach to Improve Medication Administration Safety by Reducing Distractions and Interruptions. J Nurs Care Qual. 2020;35(4):E58-62.
  • Un A, Purkuloglu E, Yururdurmaz F. Determining the Ad-diction Level of Patients in an Accredited Public Hospital and Calculation of the Number of Nurses. Journal Of Health Institutes Of Turkey. 2023;6(2):86–92.
  • Tariq RA, Vashisht R, Sinha A, Scherbak Y. Medication Dispensing Errors and Prevention. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 12, 2024.

Do nurses follow the “Right Response”? Mixed methods research

Year 2025, Volume: 30 Issue: 1, 102 - 111, 29.01.2025
https://doi.org/10.21673/anadoluklin.1415506

Abstract

Aim: Drug administration and management is an important procedure among clinical nursing practices and is one of the significant indicators affecting patient safety and quality of care. It was aimed to determine the nurses’ monitoring of drug effects after drug treatment.

Methods: In the study, sequential explanatory design from exploratory and mixed research methods was used. Quantitative data were collected using a data collection form and qualitative data were collected through in-depth and individual interviews using a semi-structured interview form. The interviews were recorded with a voice recorder.

Results: It was determined that the average age, working years, weekly working hours, and daily number of patients cared for by the nurses were respectively 30.46±6.96, 7.1±6.31, 44.92±5.71, 15.42±11.89 years. It was found that 54.2% of the nurses checked the drug package insert before administering the medication, 74.5% of the nurses always considered the history of drug and food allergy to be of vital importance before drug administration, and 97.9% of the nurses reported unexpected side/toxic effects. As a result of in-depth interviews with the nurses participating in the study, three themes were identified: the approach of right drug administration principles, the approach of following the right response, and the follow-up status of nurses after drug administration.

Conclusion: In the study, it was determined that nurses lacked knowledge about the right medication, and could not implement the right response due to high workload, low number of nurses, and lack of time. It was observed that nurses gave the responsibility of right response follow-up to the patient or the patient’s relatives. By evaluating the reasons for not implementing the right response, it is recommended that the number of nurses should be increased, the workload should be regulated, and nurses should receive training on the right drug administration and especially on the importance of the right response. It is also recommended that nurses receive training and counseling on their duties, authorities, and responsibilities.

References

  • Blignaut AJ, Coetzee SK, Klopper HC, Ellis SM. Medication administration errors and related deviations from safe practice: an observational study. J Clin Nurs. 2017;(21–22):3610–23.
  • Rohde E, Domm E. Nurses' clinical reasoning practices that support safe medication administration: An integrative review of the literature. J Clin Nurs. 2018;27(3-4):e402-11.
  • Avraham R, Shor V, Hurvitz N, Shvartsur R, Kimhi E. Transferability of Medication Administration Simulation Training to Clinical Settings. Teach Learn Nurs. 2018;13(4):258–62.
  • Edwards S, Axe S. The 10 ‘R’s of safe multidisciplinary drug administration. Nurse Prescribing. 2015;13(8):398–406.
  • Salmasi S, Khan TM, Hong YH, Ming LC, Wong TW. Medication Errors in the Southeast Asian Countries: A Systematic Review. PLoS One. 2015;10(9):e0136545.
  • WHO WHO. Medication Without Harm WHO Global Patient Safety Challenge. 2017 [cited 2023 Aug 10]; Available from: http://apps.who.int/bookorders.
  • Niemann D, Bertsche A, Meyrath D, et al. A prospective three-step intervention study to prevent medication errors in drug handling in paediatric care. J Clin Nurs. 2015;24(1–2):101–14.
  • Martyn JA, Paliadelis P, Perry C. The safe administration of medication: Nursing behaviours beyond the five-rights. Nurse Educ Pract. 2019;37:109–14.
  • ICN IC of N. Patient safety 2012 [Internet]. [cited 2023 Dec 30]. Available from: www.icn.ch
  • Yu X, Li C, Gao X, Liu F, Lin P. Influence of the medication environment on the unsafe medication behaviour of nurses: A path analysis. J Clin Nurs. 2018;27(15–16):2993–3000.
  • Hanson A, Haddad LM. Treasure Island (FL): StatPearls Publishing. 2023 [cited 2023 Aug 23]. Nursing Rights of Medication Administration. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560654/
  • Taft T, Rudd EA, Thraen I, et al. “Are we there yet?” Ten persistent hazards and inefficiencies with the use of medication administration technology from the perspective of practicing nurses. Journal of the American Medical Informatics Association [Internet]. 2023;30(5):809–18.Available from: https://academic.oup.com/jamia/article/30/5/809/7072778
  • WHO. Patient Safety Making health care safer [Internet]. 2017 [cited 2023 Aug 10]. Available from: http://apps.who.int/bookorders.
  • Cohen L, Lawrence M, Keith M. Research Methods in Education. 8th ed. Routledge; 2018.
  • Creswell JW, Plano Clark VL. Designing and Conducting Mixed Methods Research. Third. SAGE; 2017.
  • Lichtman M. Qualitative Research in Education. New York: Routledge; 2023.
  • Braun V, Clarke V. One size fits all? What counts as quality practice in (reflexive) thematic analysis? Qual Res Psychol. 2021;18(3):328–52.
  • Taylor CR, Lynn PB, Bartlett JL. Fundamentals of Nursing: The Art and Science of Person-Centered Care. 9th Edition. Wolters Kluwer; 2015.
  • Jember A, Hailu M, Messele A, Demeke T, Hassen M. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC Nurs. 2018;17:9.
  • Yousef A, Abu Farha R, Da'meh K. Medication administration errors: Causes and reporting behaviours from nurses perspectives. Int J Clin Pract. 2021;75(10):e14541.
  • Hojat M. Empathy in Health Professions Education and Patient Care. London: Springer; 2016.
  • Vicente Oliveros N, Gramage Caro T, Pérez Menendez-Conde C, et al. Effect of an electronic medication administration record application on patient safety. J Eval Clin Pract. 2017;23(4):888-94.
  • Härkänen M, Vehviläinen-Julkunen K, Murrells T, Rafferty AM, Franklin BD. Medication administration errors and mortality: Incidents reported in England and Wales between 2007–2016. Res Social Adm Pharm. 2019;15(7):858-63.
  • van der Veen W, van den Bemt PMLA, Wouters H, et al. Association between workarounds and medication administration errors in bar-code-assisted medication administration in hospitals. J Am Med Inform Assoc. 2018;25(4):385-92.
  • Salehi T, Seyedfatemi N, Mirzaee MS, Maleki M, Mardani A. Nurses' Knowledge, Attitudes, and Practice in Relation to Pharmacovigilance and Adverse Drug Reaction Reporting: A Systematic Review. Biomed Res Int. 2021;2021:6630404.
  • Griffiths P, Recio-Saucedo A, Dall'Ora C, et al. The association between nurse staffing and omissions in nursing care: A systematic review. J Adv Nurs. 2018;74(7):1474-87.
  • Schutte T, van Eekeren R, Richir M, et al. The adverse drug reaction reporting assignment for specialist oncology nurses: a preliminary evaluation of quality, relevance and educational value in a prospective cohort study. Naunyn Schmiedebergs Arch Pharmacol. 2018;391(1):17-26.
  • Tsegaye D, Alem G, Tessema Z, Alebachew W. Medication Administration Errors and Associated Factors Among Nurses. Int J Gen Med. 2020;13:1621-32.
  • Pol-Castañeda S, Carrero-Planells A, Moreno-Mulet C. Use of simulation to improve nursing students' medication administration competence: a mixed-method study [published correction appears in BMC Nurs. 2022;21(1):117.
  • Mohammed T, Mahmud S, Gintamo B, Mekuria ZN, Gizaw Z. Medication administration errors and associated factors among nurses in Addis Ababa federal hospitals, Ethiopia: a hospital-based cross-sectional study. BMJ Open. 2022;12(12):e066531.
  • Ojerinde AC, Adejumo PO. Factors Associated With Medication Errors Among Health Workers In University College Hospital, Nigeria. IOSR-JNHS. 2014;3(3):22–33.
  • Baraki Z, Abay M, Tsegay L, Gerensea H, Kebede A, Teklay H. Medication administration error and contributing factors among pediatric inpatient in public hospitals of Tigray, northern Ethiopia. BMC Pediatr. 2018;18(1):321.
  • Kavanagh A, Donnelly J. A Lean Approach to Improve Medication Administration Safety by Reducing Distractions and Interruptions. J Nurs Care Qual. 2020;35(4):E58-62.
  • Un A, Purkuloglu E, Yururdurmaz F. Determining the Ad-diction Level of Patients in an Accredited Public Hospital and Calculation of the Number of Nurses. Journal Of Health Institutes Of Turkey. 2023;6(2):86–92.
  • Tariq RA, Vashisht R, Sinha A, Scherbak Y. Medication Dispensing Errors and Prevention. In: StatPearls. Treasure Island (FL): StatPearls Publishing; February 12, 2024.
There are 35 citations in total.

Details

Primary Language English
Subjects Fundamentals of Nursing, Nursing (Other)
Journal Section ORIGINAL ARTICLE
Authors

Cevriye Ozdemir 0000-0002-9401-0044

Seda Şahan 0000-0003-4071-2742

Publication Date January 29, 2025
Submission Date January 5, 2024
Acceptance Date March 11, 2024
Published in Issue Year 2025 Volume: 30 Issue: 1

Cite

Vancouver Ozdemir C, Şahan S. Do nurses follow the “Right Response”? Mixed methods research. Anatolian Clin. 2025;30(1):102-11.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.