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Human Factors Contributing to Preventable Adverse Drug Events in Healthcare: A Grounded Theory Approach Pilot Study

机译：人为因素促成医疗保健中可预防的不良药物事件：一项扎根的理论方法试点研究

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摘要

The following thesis details a grounded theory methodology (GT) pilot study of preventable adverse drug events (pADEs) in healthcare. This research used the methodological approach to develop a categorical theory for the chief workplace contributors to intra-hospital intensive care unit (ICU) preventable adverse drug events. While this study represents only a foray into the use of GT to explain pADEs, the results implicate specific areas of concern that may be followed up on in future qualitative or quantitative research. Pursuant of a Straussian grounded theory methodology, this study leaned fundamentally on the interview of individuals with first-hand experience with the phenomenon of interest. A total of 10 participants, eight nurses and two physicians, with varying levels of experience and places of employment, were recruited for these interviews. The resultant data were analyzed, coded, and categorized by the researcher to develop a graphical representation of the emergent data categories. That graphical representation materialized in an axial coding paradigm in which four primary categories describe a core phenomenon. The core phenomenon identified in this study as a main cause of pADEs within ICUs was breakdowns in nursing care. The four overarching categories used to describe the core phenomenon were causal conditions (i.e. communication errors, fatigue, a nursing shortage), strategies (i.e. incident reporting, safety processes, staffing strategies), consequences (i.e. nurse burnout, disconnect with management, running out of time), and contextual conditions (i.e. standard practices, patient satisfaction surveys, time of day). These categories were informed by the data and through selective coding, a final theory was drawn. This study concluded that breakdowns in nursing care can be attributed to an incredible workload, which causes nurses to ignore safety processes.
机译：以下论文详细介绍了针对医疗保健中可预防的不良药物事件（pADE）的扎根理论方法（GT）的初步研究。这项研究使用方法论方法为医院内重症监护病房（ICU）可预防的不良药物事件的主要工作场所贡献者建立了分类理论。尽管这项研究只是尝试使用GT来解释pADE，但结果暗示了可能在未来的定性或定量研究中进行关注的特定领域。根据施特劳斯扎根的理论方法，本研究从根本上依靠对具有感兴趣现象的第一手经验的个人进行访谈。总共招募了10名参与者，八名护士和两名医师，他们具有不同的经验水平和工作地点，以进行访谈。研究人员对结果数据进行了分析，编码和分类，以开发紧急数据类别的图形表示。该图形表示形式体现在轴向编码范例中，其中四个主要类别描述了一种核心现象。在这项研究中被确定为ICU中pADE主要原因的核心现象是护理故障。用于描述核心现象的四个总体类别是因果条件（例如，沟通错误，疲劳，护理不足），策略（例如，事件报告，安全流程，人员配备策略），后果（例如，护士精疲力竭，与管理脱节，精疲力尽）时间）和上下文条件（即标准做法，患者满意度调查，一天中的时间）。这些类别由数据提供，并通过选择性编码得出了最终的理论。这项研究得出的结论是，护理工作中的故障可以归因于令人难以置信的工作量，这导致护士忽略了安全流程。

著录项

  • 作者

    Hilgers, Thomas Ryan.;

  • 作者单位

    Embry-Riddle Aeronautical University.;

  • 授予单位 Embry-Riddle Aeronautical University.;
  • 学科 Systems science.;Nursing.;Cognitive psychology.;Health care management.
  • 学位 M.S.H.F.S.
  • 年度 2018
  • 页码 73 p.
  • 总页数 73
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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