Safety in medication preparation and administration, in light of restorative health care research
DOI:
https://doi.org/10.5935/1415-2762.20130070Keywords:
Safety Management, Patient Safety, Intensive Care Units, Environmental Remediation, Research, PhotographyAbstract
The objective was to obtain the views of the nursing professionals from an intensive care unit (ICU) of São Paulo State, in relation to the aspects existing in the processes of medication preparation and administration that, according to professionals, may contribute to patient safety or, on the other hand, may be seen as barriers to safe medication administration. The study was divided into four phases. We used diverse data collection techniques: focus groups, photo narration, photo elicitation, and field observation. Data collection and analysis proceeded in an iterative fashion, according to the restorative approach to health systems research. Six themes were obtained from the analysis: identifying the healthcare environment as a contributor to safety in medication preparation and administration; identifying risks in the healthcare environment; realizing environmental care as a risk factor for occupational accidents; having to live with the feeling of "impotence" in the face of prevailing organizational culture; living with workaround on a day-to-day basis; and glimpsing possibilities of changes in the healthcare environment. The experience of using the restorative approach to health systems research helped the understanding of the barriers and the measures aimed at the safety of medication preparation and administration. The themes obtained also showed that the existing problems in the ICU affect the safety of both patients and professionals. Therefore, leaders should review how to manage safety within the institution.Downloads
References
1. World Health Organization. Global status report on noncommunicable diseases 2010. Geneva: World Health Organization; 2011. ix, 164 p.
2. World Health Organization. WHO Patient Safety. WHO patient safety research: better knowledge for safer care. Geneva: World Health Organization; 2009. 12 p.
3. Marck PB, Kwan JA, Preville B, et al. Building safer systems by ecological design: using restoration science to develop a medication safety intervention. Qual Saf Health Care. 2006;15(2):92-7.
4. Marck P, Cassiani SHdB. Teorizando sobre sistemas: uma tarefa ecológica para as pesquisas na área de segurança do paciente. Revista Latinoam Enferm. 2005; 13:750-3.
5. Marck P. Field notes from research and restoration in the backcountry of modern health care. Can J Nurs Res. 2006; 38(2):11-23.
6. Marck PB. Ethics in hard places: the ecology of safer systems in modern health care. Health Ethics Today. 2004; 14(1):4.
7. Guedes RMDA, Lima FDPA, Assunção AA. O programa de qualidade no setor hospitalar e as atividades reais da enfermagem: o caso da medicação. Ciênc Saúde Coletiva. 2005; 10:1063 74.
8. Hassan E, Badawi O, Weber RJ, Cohen H. Using technology to prevent adverse drug events in the intensive care unit. Crit Care Med. 2010; 38(6Suppl):S97-S105.
9. Lockett D, Willis A, Edwards N. Through seniors’ eyes: an exploratory qualitative study to identify environmental barriers to and facilitators of walking. Can J Nurs Res. 2005; 37(3):48 65.
10. Marck PB, Lang A, Macdonald M, Griffin M, Easty A, Corsini-Munt S. Safety in home care: a research protocol for studying medication management. Implement Sci. 2010; 5:43.
11. Raduenz AC, Hoffmann P, Radunz V, Dal Sasso GT, Maliska IC, Marck PB. Nursing care and patient safety: visualizing medication organization, storage and distribution with photographic research methods. Rev Latinoam Enferm. 2010; 18(6):1045-54.
12. Gallesio AO. Improving quality and safety in the ICU: a challenge for the next years. Curr Opin Crit Care. 2008; 14(6):700-7.
13. Toffoletto MC, Padilha KG. Consequences of medical errors in intensive and semi-intensive care units. Rev Esc Enferm USP. 2006; 40(2):247-52.
14. Bohomol E, Ramos LH, D’Innocenzo M. Medication errors in an intensive care unit. J Adv Nurs. 2009; 65:1259-67.
15. Mendes W, Martins M, Rozenfeld S, Travassos C. The assessment of adverse events in hospitals in Brazil. Int J Qual Health Care. 2009; 21:279-84.
16. Srivastava P, Hopwood N. A practical iterative framework for qualitative data analysis. Int J Qual Methods. 2009; 8(1):9.
17. Faria Westphal M, Bogus CM, Mello Faria Md. Grupos focais: experiencias precursoras em programas educativos em saude no Brasil. Boletín de la Oficina Sanitaria Panamericana (OSP). 1996; 120(6):472-82.
18. World Health Organization. World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action. Geneva: World Health Organization; 2005.
19. Thorne S. Interpretive description. Left Coast Press; 2008.
20. Ressel LB, Beck CLC, Gualda DMR, Hoffmann IC, Silva RMd, Sehnem GD. O uso do grupo focal em pesquisa qualitativa. Texto Contexto Enferm. 2008; 17:779-86.
21. Maurente V, Tittoni J. Imagens como estratégia metodológica em pesquisa: a fotocomposição e outros caminhos possíveis. Psicol Soc. 2007; 19:33-8.
22. Neiva-Silva L, Koller SH. O uso da fotografia na pesquisa em Psicologia. Estudos Psicol. 2002; 7(2):13.
23. Wang C, Burris MA. Empowerment through photo novella - portraits of participation. Health Educ Q. 1994; 21(2):171-86.
24. Wang C, Burris MA. Photovoice: concept, methodology, and use for participatory needs assessment. Health Educ Behav. 1997; 24(3):369-87.
25. Higgs ES. Nature by design: people, natural process, and ecological design. Cambridge: Mit Press; 2003.
26. Frith H, Harcourt D. Using photographs to capture women’s experiences of chemotherapy: reflecting on the method. Qual Health Res. 2007;17(10):1340-50.
27. Harper D. Talking about pictures: a case for photo elicitation. Visual Studies. 2002; 17(1):13.
28. Clark-Ibanez M. Framing the social world with photo-elicitation interviews. Am Behav Sci. 2004; 47(12):1507-27.
29. John WC. Research Design: qualitative, quantitative, and mixed methods approaches. Los Angeles: SAGE Publications; 2009.
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