The Journal of Shahid Sadoughi University of Medical Sciences
مجله علمي پژوهشي دانشگاه علوم پزشكي شهید صدوقی يزد
JSSU
Medical Sciences
http://jssu.ssu.ac.ir
20
journal20
2228-5741
2228-5733
fa
jalali
1400
2
1
gregorian
2021
5
1
29
3
online
1
fulltext
fa
بررسی وضعیت خطاهای دارویی از دیدگاه پرستاران دربخش مراقبت ویژه بیمارستانهای شهر یزد در سال 1396
Evaluation of Medication Errors from the Perspective of Nurses in the ICUs of Yazd City
پرستاری
Nursing
پژوهشي
Original article
<div style="text-align: justify;"><strong><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مقدمه:</span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطای دارویی از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شایعترین</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطاهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پزشکی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">است</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">که این نوع خطاها</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بخش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مراقبت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ویژه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به علت آسیبپذیری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و ناتوانی بیماران برای شرکت در فرایند دارو درمانی اهمیت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مضاعفی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دارد. هدف</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">حاضر</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">تعیین</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">فراوانی،</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نوع و علل خطاهای دارویی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بخش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مراقبت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ویژه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بوده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">است</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">.</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"></span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">روش بررسی:</span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">حاضر</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">یک</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">توصیفی- مقطعی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">است. 105 پرستار</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شاغل</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بخش</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مراقبت ویژه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">صورت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">تمام</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شماری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بیمارستانهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شهر یزد</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">سال</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">1396</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">وارد</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شدند. ابزارهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">گردآوری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دادهها،</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پرسشنامه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">اطلاعات</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">جمعیت شناختی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شغلی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پرسشنامه"خطای تجویز دارو"بوده است. که روایی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">محتوی و پایایی آن (ضریب آلفا کرونباخ) مورد تایید قرار گرفته است برای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">تجزیه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">تحلیل</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دادهها</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">آمار</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">توصیفی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">آزمون</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">آماری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">کای اسکوئر</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نرمافزار</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"> SPSS version.16 </span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">استفاده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">گردید.</span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نتایج:</span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">66/7 % پرستاران مورد</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مطالعه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">مرتکب</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دارویی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بودند.</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">40/6% نمونهها یک خطا داشتند. 58/7% خطاها</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نوبت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">کاری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شب رخ</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">داده</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بود</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">.</span></span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;"> در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">داروهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">غیر تزریقی: خطای ناشی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">از دادن دارو بدون تجویز پزشک، اشتباه در محاسبات دارویی، دادن دارو بعد از قطع دستور و در داروهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">تزریقی: عدم توجه به تداخل دارویی در تجویز همزمان آنها، اشتباه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">محاسبات</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دارویی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دادن دارو بدون تجویز پزشک</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دارای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">وقوع</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">زیاد</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بودند.</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">پرستاران،</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">اولین</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">علت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">اصلی بروز</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطاهای</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دارویی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">را</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خستگی پرستاران</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بیان کردند.</span></span> <span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;"></span></span></span><br>
<strong><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نتیجهگیری:</span></span></strong> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">با</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">توجه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به بالا</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">بودن</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">فراوانی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خطاها در مطالعه حاضر (66/7% </span></span><span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">درطی</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">6</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">ماه</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">گذشته)</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">به</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">خصوص</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">در</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">نوبت</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">کاری</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">شب</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">و</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">همچنین</span></span> <span style="font-family:B Nazanin;"><span style="font-size:12.0pt;">دخیل دانستن خستگی پرستاران به عنوان مهمترین عامل بروز خطای دارویی، ضروری به نظر میرسد که مسئولین و مدیران پرستاری مداخلاتی را جهت بهبود شرایط کاری پرستاران اعمال نمایند.</span></span></div>
<div style="text-align: justify;"><strong>Introduction:</strong> Medication error is one of the most common errors in the medical context which has a great importance in the ICUs due to the patients’ inability and vulnerability in participating in the medication therapy. The aim of this study was to determine frequency, types, and reasons of medication errors in the ICUs.<br>
<strong>Methods:</strong> This was a cross-sectional descriptive study, which was conducted on 105 nurses working in the ICUs located in hospitals of Yazd City in 2017 on the basis of census sampling method. The data were collected by means of the demographic and occupational questionnaire and the medication errors questionnaire whose content validity and reliability (Alpha Cronbach's coefficient) have been approved The data were analyzed using descriptive statistics and the Chi-square statistical test through SPSS software V.16.<br>
<strong>Results:</strong> The findings revealed that %66.7 of the nurses had medication errors. %40.6 of the nurses had made medication error only once, and 58.7% of the errors occurred during the night shift. As to the injectable medications, administrating nonprescription medications, making mistakes in dosage calculation, and giving medication after discontinuation were reported with higher frequencies. Regarding the injectable medications, paying no attention to interactions of concomitant drugs, making calculation mistakes, and administrating nonprescription medications were more frequent. Also, the nurses’ fatigue was reported as the first main cause of medication errors in this study.<br>
<strong>Conclusion:</strong> Given the high frequency of medication errors<span dir="RTL">)</span> 66.7% in the last six months<span dir="RTL">(</span> particularly during the night shift as well as the nurses’ fatigue as the most important cause of the error incidences, it appears important that healthcare authorities and nursing managers take account of the approaches that enhance the nurses’ working conditions.</div>
خطاهای دارویی, بخش مراقبت ویژه, پرستاران
Medication errors, Intensive Care Units, Nurses.
3588
3598
http://jssu.ssu.ac.ir/browse.php?a_code=A-10-1656-2&slc_lang=fa&sid=1
Imane
Bagheri
ایمانه
باقری
imane.bagheri66@gmail.com