Applying an ecological restoration approach to study patient safety culture in an intensive care unit.

Autor:	Gimenes, Fernanda Raphael Escobar, Torrieri, Mayara Carvalho Godinho Rigobello, Gabriel, Carmen Silvia, Rocha, Fernanda Ludmilla Rossi, Silva, Ana Elisa Bauer de Camargo, Shasanmi, Rebecca O, Cassiani, Silvia Helena De Bortoli
Předmět:	MEDICATION error prevention ACTION research CONTENT analysis CORPORATE culture DISCUSSION FOCUS groups INTENSIVE care nursing INTENSIVE care units INTERPROFESSIONAL relations MEDICATION errors NURSES' attitudes PATIENT safety PHARMACISTS PHOTOGRAPHY RESEARCH funding STATISTICAL sampling THEMATIC analysis
Zdroj:	Journal of Clinical Nursing (John Wiley & Sons, Inc.); Apr2016, Vol. 25 Issue 7-8, p1073-1085, 13p
Abstrakt:	Aims and objectives To gain an understanding of medication safety culture and other quality issues in a Brazilian intensive care unit using a restorative approach. Background Patient safety should be considered one of the pillars of quality in health care. Thus, patient safety culture is increasingly being explored as a guide for quality improvement efforts. Design A qualitative approach. Methods Participatory photographic research methods from the field of ecological restoration were adapted in this study. This study used focus groups, then subsequent nurse-led photo-narrated walkabouts, and photo elicitation with 23 nurses and one physician in interactive phases of data collection and analysis over an eight-month timeframe. Results The core themes identified were: the 'medication system shapes patient safety' and the 'feeling of helplessness in the face of the prevailing organization culture'. Participants discussed supports exiting in the intensive care unit that shape medication safety, the barriers that impede safe medication management, the solutions to improve medication safety and the creation of a better medication safety culture. Conclusions The methods used allowed participants to visualise sound practices as well as key safety issues, reflect on their day-to-day work, re-think potential improvements, and enact changes to improve medication safety and medication safety culture. However, the patient safety culture is also marked by administrative pressure. The hospital needs to adopt participatory management, where the health professionals can act together with the organisational leaders to promote a just culture. Relevance to clinical practice The participatory photographic research methods from the field of ecological restoration provided participants with a tool to promote patient safety culture and engage policy change dialogue. However, it will be important in future restorative research to track-specific safety outcomes over time to assess the cost-benefit of the adoption of participatory management models. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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