Determination of The Risks of Medical Sets in Pediatric Services and Associated Factors

Year 2019, Volume: 6 Issue: 2, 321 - 328, 01.06.2019

Handan Boztepe , Sevil Çınar Bahise Coşkun Aydın

Abstract

DOI:10.17681/hsp.469396

Purpose: This descriptive study was conducted to
determine the risks of medical sets on patient safety and associated factors in
pediatric services.

Materials and
Methods: This descriptive study was conducted between May 15 and December
15 2016 in the clinics of Hacettepe University İhsan Doğramacı Children’s
Hospital.  In the study, 812 medical sets
were evaluated in a total of 400 patients.

Results: The entrainment state of the medical devices was determined as
40,5%. A statistically significant correlation was found between the complexity
of the medical sets and the activity level of the children and the number of
sets. 72,6% of the nurses stated that they had problems with medical sets. The
problems that they have experienced were as follows: entanglement of medical
sets (60,7%), the sets are left under a body part (42,9%), the entanglement of
sets around an extremity (38,1%), and confusion in medications due to the
presence of numerous sets (34,5%).

Conclusion: The increase in the number of medical sets and the activity
level of the children increases the risk of being exposed to patient safety
violations caused by the set entanglements of the children. The findings of the
study indicate the need of developing applicable solutions to prevent the
entanglement of medical sets in pediatric patients.

Keywords

Nurses, medical line entanglement, medical line safety

Pediatri Servislerinde Tıbbi Setlerin Yarattığı Riskler ve İlişkili Olan Faktörlerin Belirlenmesi

Abstract

DOI:10.17681/hsp.469396

Amaç:
Bu
çalışma, pediatri servislerinde hastaların güvenlikleri açısından tıbbi
setlerin yarattığı riskler ve ilişkili olan faktörlerin belirlenmesi amacıyla
tanımlayıcı olarak yapılmıştır.

Gereç ve
Yöntem: Tanımlayıcı özellikteki araştırma Hacettepe Üniversitesi İhsan
Doğramacı Çocuk Hastanesi’nin kliniklerinde 15 Mayıs -15 Aralık 2016 tarihleri
arasında yapılmıştır. Araştırmada toplam 400 hastada 812 tıbbi set
değerlendirilmiştir.

Bulgular: Tıbbi
setlerin dolaşıklık durumu %40,5 olarak belirlenmiştir. Çocukların aktivite
düzeyine ve set sayısına göre tıbbi setlerin karışık olma durumu arasında
istatistiksel olarak anlamlı ilişki bulunmuştur. Hemşirelerin %72,6’sı tıbbı
setlerle ilgili sorun yaşadıklarını ifade etmişlerdir. Yaşadıkları sorunlar
sırasıyla, tıbbi setlerin birbirine dolaşması (%60,7), setlerin bir vücut
bölümünün altında kalması (%42,9), setlerin bir ekstremitenin etrafına
dolaşması (%38,1), çok fazla set olmasından dolayı ilaç uygulamalarında
karışıklık olmasıdır (%34,5).

Sonuç: Medikal
setlerin sayısının artması ve çocukların aktivite düzeyi, set
dolaşıklıklarından kaynaklanan hasta güvenliği ihlallerine maruz kalma riskini
arttırmaktadır. Bu araştırmanın bulguları pediatrik hastalarda tıbbi setlerin
dolaşıklığını önlemek için uygulanabilir çözümlerin geliştirilmesinin
gerekliliğini ortaya koymuştur.

Keywords

Hemşireler, medikal setlerin dolaşması, medikal setlerin güvenliği

References

• 1. World Health Organization (WHO). What İs Patient Safety? Erişim:28.7.2018 Available from: http://www.who.int/patientsafety/en 2. JCI, Joint Commission International. America’s hospitals: improving quality and safety. The Joint Commission’s Annual Report; 2014. 3. Fortescue EB, Kaushal R, Landrigan CP, McKenna KJ, Clapp MD, Federico F, et al. Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients. Pediatr. 2003;111(4):722-729. 4. Johnstone MJ, Kanitsaki O. Clinical risk management and patient safety education for nurses: A critique. Nurse Education Today. 2007;27(3):185–191. 5. Statistics N, C, O, H. Health, United States, 2013 with Special Feature on Prescription Drugs; 2014. 6. TC. Ministry of Health Turkey Public Hospitals Institution Statistics; 2014. 7. Noonan C, Quigley S, Curley M. Skin integrity in hospitalized infants and children: A prevalence survey. J of Pediatr Nurs. 2006;21(6): 445-453. 8. Goodin HJ, Ryan-Wenger NA, Mullet J. Pediatric Medical Line Safety: The Prevalence and Severity of Medical Line Entanglements. J of Pediatr Nurs. 2012;27(6):725-733. 9. Drago DA, Dannenberg AL. Infant mechanical suffocation deaths in the United States, 1980-1997. Pediatr 1999;103(5):59-67. 10. Emery JL, Taylor EM, Carpenter RG, Waite AJ. Apnea monitors and accidental strangulation. BMJ. 1992;304(6819):117. 11. Garros D, King WJ, Brady-Fryer B, Klassen TP. Strangulation with intravenous tubing: a previously undescribed adverse advent in children. Pediatr. 2003;111(6):732-734. 12. Lunetta P, Laari M. Strangulation by intravenous tubes. The Lancet. 2005;365(9470):1542. 13. Drew CS. Unintentional strangulation in children: A professional approach to the problem. Int J of Trauma Nurs. 2001;7(2):60-63. 14. Risk of strangulation of infants by IV tubing and monitor leads [notice to hospitals]. Ottawa (ON): Health Canada, Health Products and Food Branch; 2002 Jul. 15. Cesarano FL, Piergeorge AR. The spaghetti syndrome: A new clinical entity. Critical Care Medicine. 1979;7(4):182. 16. Needham DM, Sinopoli DJ, Thompson DA, Holzmueller CG, Dorman T, Lubomski LH, et al. A system factors analysis of “line, tube, and drains” incidents in the intensive care unit. Critical Care Medicine. 2005;33(8):1701–1707. 17. Stevens R, Lane G, Milkovich S, Stool D, Rider G, Stool S. Prevention of accidental childhood strangulation: A clinical study. Annals Otology Rhinology Laryngology. 2000;109(9):797–802. 18. Institute for Safe Medication Practices (ISMP). Strangulation by IV tubing. ISMP Medication Safety Alert. Erişim:28.6.2018 Available from: http://www.ismp.org/Newsletters/acutecare/articles/A3Q05Action.asp. 2005. 19. Hockenberry MJ, Wilson D, Rodgers CC. Wong's Essentials of Pediatric Nursing-E-Book. Elsevier Health Sciences; 2016