Effects of working conditions on intravenous medication errors in a Japanese hospital.
Effects of working conditions on intravenous medication errors in a Japanese hospital.
复制标题
日本医院工作条件对静脉用药错误的影响。
DOI：
10.1111/j.1365-2934.2006.00597.x
复制
发表时间：
2006
影响因子：
5.5
通讯作者：
Y. Yamazaki
中科院分区：
文献类型：
--
作者：
Y. Seki;Y. Yamazaki
目的
本研究的目的是定量探讨哪些工作条件会影响日本一家医院与静脉注射药物相关的医疗未遂错误的发生。
背景
尽管据报道，压力、疲劳和缺乏经验等工作条件会导致医疗事故，但针对这些条件的对策却被推迟，许多日本医疗机构的工作条件已经恶化。
方法
2001 年，向日本一家医院四个病房的 90 名护士发送了一份自我报告问卷，分析了可能导致静脉注射药物相关差错的工作条件。88 名受试者做出了回应（回应率：97.8%）。在 88 名护士参加工作的 534 人日中，525 人日的数据用于分析。
结果
在 525 人日中，险些发生错误的次数为 94 次（17.9%）。三个班次（白班，19.2％；晚班，19.2％；夜班，12.5％）之间的未遂错误发生率没有显着差异。在白班期间，当护理服务因工作量而延迟较长时间时，报告错误的频率明显更高。在夜班期间，由于工作量而导致护理服务延迟较长时间以及在当前病房的经验年限较短时，会报告错误。此外，白班期间工作前感知疲劳程度较低的护士，以及护士工作年限较长且晚班睡眠时间较长的护士，与其他护士相比，出现差错的频率明显更高。后面这些因素可能是鼓励在错误发生之前发现错误的重要条件。
结论
当前病房的工作量和缺乏经验是可能导致错误的两个条件。此外，缺乏疲劳和作为护士的长期经验可能有助于鼓励在错误发生之前发现错误。改善工作条件非常重要，以便医护人员能够在患者受到伤害之前发现错误并减少错误发生的数量。
AIM
The aim of this study was to explore quantitatively which working conditions influence the occurrence of medical near-miss errors related to intravenous medication at a hospital in Japan.
BACKGROUND
Although working conditions such as stress, fatigue and inexperience have been reported to contribute to medical errors, countermeasures to these conditions have been delayed, and working conditions have deteriorated in many Japanese medical sites.
METHODS
A self-reporting questionnaire analysing working conditions that can lead to near-miss errors relating to intravenous medication was sent to 90 nurses working in four wards of one Japanese hospital in 2001. Eighty-eight subjects responded (response rate: 97.8%). Among 534 person-days in which 88 nurses attended works, 525 person-days of data were used for the analyses.
RESULTS
Among 525 person-days, the number of near-miss errors was 94 (17.9%). There was no significant difference in the occurrence of near-miss errors among the three shifts (day shift, 19.2%; evening shift, 19.2%; night shift, 12.5%). During the day shift, errors were reported at a significantly higher frequency when the nursing services were delayed longer due to workload. During the evening shift, errors were reported when the nursing services were delayed longer due to workload and when years of experience at the current ward were shorter. In addition, nurses whose perceived level of fatigue before work was lower during the day shift, and nurses whose years of experience as a nurse were longer and who had longer sleep duration during the evening shift experienced near-miss errors with a significantly higher frequency than other nurses. These latter factors could be important conditions that encourage the detection of errors before they occur.
CONCLUSIONS
Workload and lack of experience at the current ward are two conditions that can lead to errors. Furthermore, lack of fatigue and long experience as a nurse may help encourage the detection of errors before they occur. It is important to improve working conditions so that health care workers can detect errors before patients are harmed and decrease the number of errors that occur.
DOI：
10.1001/jama.274.1.35
发表时间：
1995-07
期刊：
JAMA
影响因子：
--
作者：
L. Leape;D. Bates;D. Cullen;J. Cooper;H. Demonaco;T. Gallivan;R. Hallisey;J. Ives;N. Laird;G. Laffel
通讯作者：
L. Leape;D. Bates;D. Cullen;J. Cooper;H. Demonaco;T. Gallivan;R. Hallisey;J. Ives;N. Laird;G. Laffel