PDF(Pubmed)
Abstract：
Paramount to patient safety is the ability for nurses to make clinical decisions free from human error. Yet, the dynamic clinical environment in which nurses work is characterized by uncertainty, urgency, and high consequence, necessitating that nurses make quick and critical decisions. The aim of this study was to examine the influence of human and environmental factors on the decision to administer among new graduate nurses in response to alert generation during bar code-assisted medication administration. The design for this study was a descriptive, longitudinal, observational cohort design using EHR audit log and administrative data. The study was set at a large, urban medical center in the United States and included 132 new graduate nurses who worked on adult, inpatient units. Research variables included human and environmental factors. Data analysis included descriptive and inferential analyses. This study found that participants continued with administration of a medication in 90.75% of alert encounters. When considering the response to an alert, residency cohort, alert category, and previous exposure variables were associated with the decision to proceed with administration. It is important to continue to study factors that influence nurses\' decision-making, particularly during the process of medication administration, to improve patient safety and outcomes.
摘要：
对患者安全而言，最重要的是护士能够在没有人为错误的情况下做出临床决策。然而，护士工作的动态临床环境具有不确定性，紧迫性,和高后果，护士必须做出快速和关键的决定。这项研究的目的是研究人和环境因素对新毕业护士在条形码辅助药物管理过程中产生警报的决策的影响。这项研究的设计是描述性的，纵向,使用EHR审计日志和管理数据进行观察队列设计。这项研究是在一个大的，美国城市医疗中心，包括132名新毕业的成人护士，住院单位。研究变量包括人为因素和环境因素。数据分析包括描述性和推断性分析。这项研究发现，参与者在90.75％的警觉遭遇中继续服用药物。当考虑对警报的响应时，居住队列，警报类别,和以前的暴露变量与继续给药的决定相关.重要的是继续研究影响护士决策的因素，特别是在用药过程中，以提高患者的安全性和治疗效果。
