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首页> 外文期刊>The joint commission journal on quality and patient safety >Disclosing Errors To Patients: Perspectives Of Registered Nurses
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Disclosing Errors To Patients: Perspectives Of Registered Nurses

机译：向患者透露错误：注册护士的观点

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Background: Disclosure of medical errors has been conceptualized as occurring primarily in the physician-patient dyad. Yet, health care is delivered by interprofessional teams, in which nurses share in the culpability for errors, and hence, in responsibility for disclosure. This study explored nurses' perspectives on disclosure of errors to patients and the organizational factors that influence disclosure. Methods: Between October 2004 and December 2005, 11 focus groups were conducted with 96 registered nurses practicing in one of four health care organizations in the Puget Sound region of Washington State. Focus groups were analyzed using qualitative content analysis. Findings: Nurses reported routinely independently disclosing nursing errors that did not involve serious harm, but felt the attending physician should lead disclosures when patient harm had occurred or when errors involved the team. Nurses usually were not involved in the error disclosure discussion among the team to plan for the disclosure or in the actual disclosure, leading to ethically compromising situations in nurses' communication with patients and families. Awareness of existing error disclosure policies was low. Nonetheless, these nurses felt that hospital policies that fostered a collaborative process would be helpful. Nurse managers played a key role in creating a culture of transparency and in being a resource for error disclosures. Discussion: Nurses conceived of the disclosure process as a team event occurring in the context of a complex health care system rather than as a physician-patient conversation. Nurses felt excluded from these discussions, resulting in their use of ethically questionable communication strategies. The findings underscore the need for organizations to adopt a team disclosure process. Health care organizations that integrate the entire health care team into the disclosure process will likely improve the quality of error disclosure.
机译：背景：医疗错误的披露已被概念化为主要发生在医患双方。但是，医疗保健是由跨专业团队提供的，在该团队中，护士共同承担起犯错的责任，并因此承担公开的责任。这项研究探讨了护士对向患者披露错误以及影响披露的组织因素的观点。方法：2004年10月至2005年12月，在华盛顿州普吉特海湾地区的四个医疗保健组织之一中，对96名注册护士进行了11个焦点小组的培训。使用定性内容分析法对焦点小组进行了分析。调查结果：护士定期例行报告，他们公开的护理错误并没有造成严重伤害，但是当发生患者伤害或团队涉及错误时，主治医师应负责披露。护士通常不参与团队之间的错误披露讨论，以计划披露或实际披露，从而导致护士与患者和家人之间的沟通出现道德上的妥协。现有错误披露政策的意识很低。但是，这些护士认为，促进协作过程的医院政策将有所帮助。护士经理在建立透明文化和成为错误披露资源方面发挥了关键作用。讨论：护士将披露过程视为在复杂的医疗体系中发生的团队事件，而不是医患对话。护士感到被排除在这些讨论之外，从而导致他们使用具有道德上可疑的沟通策略。调查结果强调组织需要采用团队披露程序。将整个医疗团队整合到披露流程中的医疗组织可能会提高错误披露的质量。

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