Experiences of Intensive Care Unit Nurses Regarding Patient Safety Practices: A Qualitative Study
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https://doi.org/10.5281/zenodo.8196555Keywords:
Patient Safety, Intensive Care Unit, Experiences, Qualitative Study, NursingAbstract
This study aims to explore Intensive Care Unit nurses' views on patient safety and their experiences regarding the implementation process. This study was designed as an interpretative phenomenological research design using semi-structured interviews and thematic analysis. The focus group interview with nurses (n= 7) was conducted on 15.03.2022 in the level 3 Intensive Care Unit of a private hospital in Istanbul. Descriptive (deductive) analysis was used to analyze the data. In presenting the findings related to the categories and sub-categories in the study, direct quotations from the participant's opinions were included and interpreted. Six main categories emerged from the analysis: Personnel factors for safer patient care; teamwork across units and teamwork within units for safer patient care; Incident reporting and feedback for safer care; Work environment factors for safer patient care; Organizational and managerial factors for safer care. All nurses emphasized the importance of patient safety and stated that the most critical problems related to patient safety were the high number of patients per nurse, lack of equipment, deficiencies in the orientation training of newly recruited nurses, and lack of management support. We found that nurses generally have a positive approach to patient safety and believe that improving patient safety is vital. Although patient safety is an essential concept in health systems, it is seen that the practices are ineffective in daily functioning. More effective mechanisms are needed to improve patient safety.
References
Aboshaiqah, A.E. & Baker, O.G. (2013). Assessment of nurses' perceptions of patient safety culture in a Saudi Arabia hospital. Journal of Nursing Resort Quality, 28(3), 272–80, https://doi.org/10.1097/NCQ.0b013e3182855cde
Afkar, A., Mahboubi, M., Mehrabian, F., Farmanbar, R., Ghahremani, F., & Kazemnejad, E. (2014). Factors predicting pressure ulcers in ICU using the Braden Scale. KUMS, 18, 220-225.
Birgani, A. G. & Asadpoor, S. (2011). Nosocomial infections in the intensive care unit of Ahvaz Arya Hospital (2008-2009). Modern Care Journal, 8(2),86-93.
Choi, M & Ruona, W.E.A. (2011). Individual readiness for organizational change and its implications for human resource and organizational development. Hum Resourc Dev Rev, (10),46–73.
Creswell, J.W. (2013). Qualitative inquiry and research design: Choosing among five approaches. Los Angeles, USA: Sage.
Demir, A. E. & Yücedağ, İ. (2022). Hekim-Hemşire İlişkisinin Bourdieucu İncelemesi. HAFIZA, 4(3), 150–163. https://doi.org/10.56671/hafizadergisi.1206755
Despins, L. A. (2009). Patient safety and collaboration of the intensive care unit team. Critical Care Nurse, 29(2), 85-91. https://doi.org/10.4037/ccH2009281
Farzi, S., Farzi, S., Alimohammadi, N. & Moladoost, A. (2016). Medication errors by the intensive care units' nurses and the Preventive Strategies. Anesthesiology and Pain, 6(4), 33–45.
Farzi, S., Irajpour, A., Saghaei, M., & Ravaghi, H. (2017). Causes of medication errors in intensive care units from the perspective of healthcare professionals. Journal Of Research in Pharmacy Practice, 6(3), 158. https://doi.org/10.4103%2Fjrpp.JRPP_17_47
Feng, X., Bobay, K. & Weiss, M. (2008). Patient safety culture in nursing: a dimensional concept analysis. Journal of Advanced Nursing, 63(3), 310–319.
Gallego, B., Westbrook, M.T., Dunn, A.G., Braithwaite, J. (2012). Investigating patient safety culture across a health system: multilevel modelling of differences associated with service types and staff demographics. Int J Qual Health Care, (24),311–320.
Gibbs A. (1997). Focus groups. Social Research Update. Erişim adresi: http://sru.soc.surrey.ac.uk/SRU19.html. Erişim tarihi: 29 Nisan 2022
Gonçalves, L. A. (2011). Segurança do paciente em Unidade de Terapia Intensiva: carga de trabalho de enfermagem e sua relação com a ocorrência de eventos adversos e incidentes. [Doctoral dissertation], Universidade de São Paulo.
Hasta ve Çalışan Güvenliğinin Sağlanmasına Dair Yönetmelik (2011). Resmî Gazete, 06 Nisan 2011, Sayı: 27897.
Holloway, I. & Wheeler, S. (1996). Qualitative research for nurses. Oxford: Blackwell Science Ltd.
JCI (2014). Accreditiation Standarts for Hospital. Joint Commission Resource, Updated International Patient Safety Goals Text Now. http://tr.jointcommissioninternational.org Erişim: 29 Nisan 2022
JCI (2020a). National Patient Safety Goals Effective January 2021 for the Hospital Program. In (pp. 14). The Joint Commission.
JCI (2020b). National Patient Safety Goals Effective January 2021 for the Nursing Care Center Program. In (pp. 7). The Joint Commission.
Jeffs, L., Abramovich, I. A., Hayes, C., Smith, O., Tregunno, D., Chan, W. H., & Reeves, S. (2013). Implementing an interprofessional patient safety learning initiative: insights from participants, project leads and steering committee members. BMJ Quality & Safety, 22(11), 923–930.
Kendall-Gallagher, D. & Blegen, M. A. (2009). Competence and certification of registered nurses and safety of patients in intensive care units. American Journal of Critical Care, 18(2), 106-113. https://doi.org/10.4037/ajcc2009487
Korkmaz, A. Ç. (2018). Geçmişten günümüze hasta güvenliği. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 6(1), 10–19.
Kvale, S., & Brinkmann, S. (2009). Interviews: Learning the craft of qualitative research interviewing. (2nd ed.) Thousand Oaks, CA: SAGE.
Lincoln, Y. S., & Guba, E. G. (1986). But is it rigorous? Trustworthiness and authenticity in naturalistic evaluation. New Directions for Program Evaluation, (30), 73–84. https://doi.org/10.1002/ev.1427
Listyowardojo, T., Ray-Sannerud, B., Turk, E., Lyons, M., Pytte, M., Leyshon, S., et al. (2014) Mixed methods: Improving the assessment of safety culture in healthcare. DNV-GL Strategic Research & Innovation Position Paper, 11.
Merriam, S.B. (2013). A guide to qualitative research design and practice (Çev. Ed.: Turan S.). Nobel Yay.
Merriam SB. (2009). Qualitative research: A guide to design and implementation. Jossey-Bass.
Mertens, D. M. (2014). Research and evaluation in education and psychology: Integrating diversity with quantitative, qualitative, and mixed methods. SAGE.
Minuzzi, A. P., Salum, N. C., Locks, M. O. H., Amante, L. N., & Matos, E. (2016). Contributions of healthcare staff to promote patient safety in intensive care. Escola Anna Nery, 20, 121–129. https://doi.org/10.5935/1414-8145.20160017
Morgan, D.L. (1997). Focus Groups As Qualitative Research. SAGE
Morgan, P. I. & Ogbonna, E. (2008). Subcultural dynamics in transformation: a multi-perspective study of healthcare professionals. Human Relations, 61(1), 39–65.
Myers, K. K. (2014). Social Identity Issues for Qualitative and Mixed Methods Scholars-Mentors in a Predominantly Quantitative Environment. Management Communication Quarterly, 28(3), 466–473. https://doi.org/10.1177/0893318914536966
Nicklin, W. & McVeety, J.E. (2002). Canadian nurses' perceptions of patients safety in hospitals. Canadian Journal of Nursing Leadership, 15(3), 11–21, https://doi.org/10.12927/cjnl.2002.19154
Patankar, M. S. (2012). Safety culture: Building and sustaining a cultural change in aviation and healthcare. Ashgate Publishing Ltd.
Patton, Q.M. (2014). Qualitative research and evaluation methods (Çev Edt: All, M. ve Demir, S. B). Pegem.
Pronovost, P. J., Goeschel, C. A., Marsteller, J. A., Sexton, J. B., Pham, J. C., & Berenholtz, S. M. (2009). Framework for patient safety research and improvement. Circulation, 119(2), 330–337.
Pronovost, P. J., Berenholtz, S. M., Goeschel, C., Thom, I., Watson, S. R., Holzmueller, C. G. ... & Sexton, J. B. (2008). Improving patient safety in intensive care units in Michigan. Journal of Critical Care, 23(2), 207–221. https://doi.org/10.1016/j.jcrc.2007.09.002
Richardson, A. & Storr, J. (2010). Patient safety: a literative review on the impact of nursing empowerment, leadership and collaboration. International Nursing Review, 57(1), 12–21.
Robson, C. (2015). Scientific research methods real world research. (Çev. Ed.: Ş. Çankır ve N. Demirkasımoğlu). Anı Yay.
Sağlık Kurum ve Kuruluşlarında Hasta ve Çalışan Güvenliğinin Sağlanması ve Korunmasına İlişkin Usul ve Esaslar Hakkında Tebliğ (2009). Resmî Gazete, 29 Nisan 2009, Sayı: 27214.
Sandelowski, M. (2000). Focus on research methods whatever happened to qualitative description? Research in Nursing and Health, 23, 334–340.
Shekelle, P.G., Pronovost, P.J., Wachter, R.M., Taylor, S.L., Dy, S.M., Foy, R., Hempel, S., McDonald, K.M., Ovretveit, J., Rubenstein, L.V., Adams, A.S., Angood, P.B., Bates, D.W., Bickman, L., Carayon, P., Donaldson, L., Duan, N., Farley, D.O., Greenhalgh, T., Haughom, J., Lake, E.T., Lilford, R., Lohr, K.N., Meyer, G.S., Miller, M.R., Neuhauser, D.V., Ryan, G., Saint, S., Shojania, K.G., Shortell, S.M. (2011). Advancing the science of patient safety. Annals of Internal Medicine, 154(10), 693-696.
Sirriyeh, R., Lawton, R., Armitage, G., Gardner, P. & Ferguson, S. (2012). Safety subcultures in health-care organizations and managing medical error. Health Services Management Research, 25(1), 16–23.
SKS Hastane Seti (2020). Erişim adresi: https://shgmkalitedb.saglik.gov.tr/Eklenti/41258/0/skshastane-seti-s-61--09082021pdf. Erişim: 29 Nisan 2022.
Swan, J., Scarbrough, H. & Newell, S. (2010). Why don’t (or do) organizations learn from projects? Management Learning, 41(3), 325–344.
Thomas, L. & Galla, C. (2013). Republished: building a culture of safety through team training and engagement. Postgraduate Medical Journal, 89(1053), 394–401.
Türnüklü, A. (2000). Eğitimbilim araştırmalarında etkin olarak kullanılabilecek nitel bir araştırma tekniği: Görüşme. Kuram ve Uygulamada Egitim Yönetimi Dergisi, 6(4), 543–559.
Van Beuzekom, M., Boer, F., Akerboom, S., & Dahan, A. (2013). Perception of patient safety differs by clinical area and discipline. British Journal of Anaesthesia, 110(1), 107–114.
WHO (2009). Report for Methods and Measures Working Group of WHO Patient Safety. Human Factors in Patient Safety Review of Topics and Tools. 4:03. http://testing.chfg.org/resources/10_qrt01/ WHO_PS_HF_Review Erişim: 29 Nisan 2022.
Yıldırım A. & Şimşek, H. (2006). Sosyal bilimler yöntemlerinde nitel araştırma, (5. Basım). Seçkin Yay.
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