عوامل مرتبط با خطاهای دارویی در پرستاران بخش‌های داخلی مراکز آموزشی- درمانی دانشگاه علوم پزشکی ایران در سال 1398

زمینه و هدف: اشتباهات دارویی جزء شایع‌ترین حوادث موجود در حرفه پرستاری است، نتیجه چنین اشتباهاتی، افزایش مدت بستری بیمار در بیمارستان و افزایش هزینه‌های مراقبت و درمان خواهد بود که گاهی می‌تواند منجر به آسیب شدید و یا حتی مرگ بیمار گردد. هدف از انجام این پژوهش تعیین عوامل مرتبط با خطاهای دارویی در پرستاران بخش‌های داخلی مراکز آموزشی درمانی دانشگاه علوم پزشکی ایران بود.روش بررسی : در این مطالعه توصیفی ،241 پرستار شاغل در بخش‌های داخلی مراکز آموزشی درمانی دانشگاه علوم پزشکی ایران، از خرداد 1398 تا شهریور 1398 مورد بررسی قرار گرفتند. ابزار گردآوری اطلاعات دراین مطالعه پرسشنامه اطلاعات جمعیت شناختی، پرسشنامه دیدگاه پرستاران از عوامل مرتبط بر خطاهای دارویی بیژنی و همکاران (1392) بود که جهت جمع‌آوری داده‌ها پرسشنامه‌ها توسط پرستاران تکمیل شد. سپس داده‌ها توسط نرم ‌افزار آماری spss نسخه 16 و با به ‌کارگیری آزمون‌های آماری مورد تحلیل قرار گرفتند .یافته‌ها: یافته‌ها نشان داد که خستگی ناشی از کار با میانگین 0.85 ± 3.11 بیشترین علت خطای دارویی در بُعد مربوط به پرستار بوده است. همچنین در بُعد بخش، تراکم زیاد کارها با میانگین 0.85 ± 3.09 و در بُعد مدیریت پرستاری، کمبود تعداد پرستار نسبت به تعداد بیمار با میانگین 0.61 ± 3.53 بیشترین علت خطای دارویی بوده‌اند. عامل مدیریت پرستاری با میانگین 0.51 ± 2.77 بیشترین و عامل بخش با میانگین 0.54 ± 2.55 کمترین میانگین نمره را در بین عوامل مرتبط با خطاهای دارویی از دیدگاه پرستاران مورد پژوهش داشته‌اند.نتیجه‌گیری کلی: با توجه به یافته‌ها، بیشترین عوامل مرتبط با خطاهای دارویی از دیدگاه پرستاران به ترتیب مدیریت پرستاری، پرستار و شرایط بخش‌های داخلی مورد مطالعه بود. بنابراین پیشنهاد می‌شود در جهت کاهش خطاهای دارویی ، نحوه مدیریت پرستاری مورد بازنگری قرار گرفته و همچنان می‌توان با برگزاری کارگاه‌های مرتبط با خطاهای دارویی باعث کاهش بروز خطاهای دارویی پرستاران شد.

The Influential Factors in the Medication Errors by the Nurses of the Internal Wards of the Teaching Hospitals Affiliated to Iran University of Medical Sciences (2019)

Background Aims: Medication errors are common incidences in the nursing profession, which could lead to the increased length of hospital stay and treatment costs and occasionally severe damage to the patients or even mortality. The Many studies have investigated medication errors, with a few considering medication errors as a severe issue in the clinical setting. Other findings have confirmed that the cooperation of medical personnel and medical system could influence the rate of medication errors. Considering the essential role of nurses in all the steps of medication preparation to administration, limited studies have evaluated nurses rsquo; viewpoint regarding the influential factors in the incidences of medical malpractices, and mostly the viewpoints of emergency ward or ICU nurses have been investigated. The present study aimed to determine the influential factors in the medication errors by the nurses of the internal wards of the teaching hospitals affiliated to Iran University of Medical Sciences.Materials Methods: This descriptive study was conducted on 241 nurses employed in the internal wards of the teaching hospitals affiliated to Iran University of Medical Sciences in Tehran, Iran during JuneSeptember 2019. Data were collected using a demographic questionnaire and the questionnaire of nurses rsquo; views on medication errors designed by Bijani et al. (2013), which were completed by the nurses. Demographic data included age, gender, marital status, number of children, education level, interest in the nursing profession, nursing profession work experience (years), occupation status, working shift schedule, economic status, clinical workplace, workplace changes in recent months, and number of the off days in the past month. The questionnaire of nurses rsquo; views on the influential factors in medication errors has been developed by Bijani et al. (2013) with 22 items in three domains of the factors related to nurses in medication errors (11 items), factors related to the ward in medication errors (seven items), and factors related to the nursing management in medication errors (four items). The scoring system for each item is based on the significance of each factor on a fourpoint Likert scale (Very Low, Low, Moderate, and High), and each option is assigned a score within the range of 14, respectively. The mean score of each domain was calculated, with the low mean scores indicating the low significance of the domain in the incidence of medication errors and the high mean scores indicating the high significance of the domain in the viewpoint of the nurses. The questionnaire was completed by the nurses in a selfreport manner and delivered to the researcher after one week. Data analysis was performed in SPSS version 16 using statistical tests.Results: According to the results, exhaustion due to heavy workload (mean score: 3.11 ± 0.85) was the most common cause of medication errors in the dimension of medication errors by nurses. In the dimension of hospital ward, heavy workload (mean score: 3.09 ± 0.85) was the most frequent cause of medication errors, and in the dimension of nursing management, the insufficient number of nurses in proportion to the number of patients (mean score: 3.53 ± 0.61) was the most common cause of medication errors. In addition, the factor of nursing management (mean score: 2.77 ± 0.51) had the highest mean value, while the factor of ward (mean score: 2.55 ± 0.54) had the lowest mean value among the influential factors in the incidence of medication errors in the viewpoint of the surveyed nurses. Lack of educational workshops (mean score: 2.3 ± 0.81) was the least significant cause of medication errors. The numerical indices of the influential factors in the incidence of medication errors in the domains of nurses, wards, and nursing management based on the demographic characteristics of the nurses indicated that only the number of children had a significant correlation with the incidence of medication errors (P=0.023), and the achieved mean score by the nurses without children was significantly lower compared to those with children (P=0.017). The incidence of medication errors in the domains of ward and nursing management had no significant correlations with the demographic characteristics of the nurses (P>0.05).Conclusion: According to the results, the most significant influential factors in the incidence of medication errors in the viewpoint of the nurses were respectively nursing management, nurses, and the conditions of the internal wards. Therefore, it is suggested that to reduce the incidence of medication errors, the approaches to nursing management be revised. In addition, the implementation of educational workshops regarding medication errors could effectively decrease the incidence of medication errors by nurses, which should be considered by the authorities of educational centers. The incidence of medication errors could be reduced through academic education and by applying theoretical and practical courses during master rsquo;s and bachelor rsquo;s degree education. Regarding the related factors to the ward, it is recommended that the workload of nurses be decreased by increasing the nursing staff in proportion to patients, so that the working hours and working shifts of nurses could decrease to change their schedule, which could in turn minimize the incidence of medication errors.