The effects of physical environments in medical wards on medication communication processes affecting patient safety

Liu, Wei; Manias, Elizabeth; Gerdtz, Marie

doi:10.1016/j.healthplace.2013.12.017

Cited by 34 publications

(35 citation statements)

References 15 publications

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“…Estudo confirma que os métodos utilizados durante o preparo de medicamentos são falhos na maioria dos sistemas de medicação, e a organização ao desempenhar esta tarefa é afetada negativamente pela escassez ou má utilização de materiais, disposição não funcional de mobiliários (bancadas pequenas, gavetas sem identificação) e ambiente multitarefas (24) .…”

Section: Discussionunclassified

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

et al. 2016

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RESUMO: Objetivou-se avaliar as conformidades e não conformidades no preparo e administração de antibacterianos. Estudo observacional e transversal, realizado de agosto a dezembro de 2014 em unidades de clínica médica de um hospital-escola em Fortaleza-Ceará. A amostra foi composta por 265 doses de antibacterianos, que tiveram suas etapas de preparo e administração observadas com dois checklist nos três turnos de trabalho. Os dados foram analisados por estatística descritiva e analítica, e todos os procedimentos éticos foram seguidos. Destaca-se que a não conformidade mais frequente em ambas as etapas foi o cumprimento dos preceitos da semiotécnica 265 (100%). A organização foi associada com o erro na escolha do medicamento (p=0,027), e o uso da prescrição e confirmação do nome do paciente não tiveram relação com os erros (p=0,942). Assim, conclui-se que modificações comportamentais no processo de trabalho precisam ser implementadas para reduzir as não conformidades e consequentemente os erros de medicação. DESCRITORES: Antibióticos; Segurança do paciente; Erros de medicação; Enfermagem; Serviços de enfermagem. CONFORMIDADES E NÃO CONFORMIDADES COMPLIANCE AND NON-COMPLIANCE IN THE PREPARATION AND ADMINISTRATION OF ANTIBACTERIAL DRUGSABSTRACT: The present study aimed to assess compliance and non-compliance in the preparation and administration of antibacterial drugs. Observational and cross-sectional study conducted from August to December 2014 in medical wards of a teaching hospital in Fortaleza-Ceará. The sample was composed by 265 doses of antibacterial drugs whose preparation and administration stages were observed during the three work shifts, with two checklists. Data were analyzed using descriptive statistics, and all ethical procedures were fulfilled. The most frequent non-compliance observed in both stages was compliance withthe requirements of the several techniques performed by nursing professionals (semiotechnique), 265 (100%). The hospital organization was associated with error in the choice of the (p=0.027), and the use of prescription and confirmation of patient's identity were not related to the errors (p=0.942). Thus, it is concluded that behavioral changes in the work process should be implemented to reduce non-compliance and, consequently, medication errors. CUMPLIMIENTO Y INCUMPLIMIENTO EN EL PREPARO Y ADMINISTRACCIÓN DE ANTIBACTERIANOS:IMPLICACIONES PARA LA SEGURIDAD DEL PACIENTE RESUMEN: El presente estudio tuvo como objetivo evaluar el cumplimiento y el incumplimiento en la preparación y administración de fármacos antibacterianos. Estudio observacional y transversal realizado entre agosto y diciembre de 2014 en las alas médicas de un hospital universitario en Fortaleza-Ceará. La muestra fue compuesta por 265 dosis de fármacos antibacterianos cuya etapas del preparación y administración fueron observados durante los tres turnos de trabajo, con dos listas de comprobación. Los datos fueron analizados utilizando estadística descriptiva, y se cumplieron todos los procedimientos éticos. El incu...

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Section: Discussionunclassified

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

et al. 2016

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“…There is evidence of the need to consider the dimension about the environment in relation to actions pertinent to health services, as well as to enable strategic actions aimed at (re) thinking about health practices and their consequent implications for patient safety (12) . On the epidemic with errors involving medicines in hospital institutions, a study in Shiraz, southwest Iran evaluated a sample of 202 patients who were exposed to several medicine classes during the treatment of the underlying disease, and it was identified that not only antimicrobials are the most commonly used medicines, as are those where errors occur most frequently, at a percentage of 24.3% (13) .…”

Section: Discussionmentioning

confidence: 99%

Environmental variables and errors in the preparation and administration of medicines

et al. 2018

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Objective: to identify the relationship between environmental factors and errors in the preparation and administration of antibacterial. Method: an observational, cross-sectional study conducted between August and December, 2014 in two clinical units. The sample consisted of 265 doses of medication, observed in different shifts that through a form had the environmental conditions of noise, illumination, humidity, temperature and physical space measured in the preparation and administration stages. Results: the physical dimension for the preparation was inadequate in one unit (3.8m 2 ), and the items illumination, temperature and noise were extremely oscillating in the three shifts and in the two clinics, with averages generally higher than the recommended for the hospital environment, however, variations in illumination and noise were not statistically signifi cant to cause dose errors or erroneous medicine choice (p> 0.05). Conclusion: the environmental variables analyzed may favor medication errors in both the preparation and administration stages. Descriptors: Antibacterial; Patient Safety; Medication Errors; Nursing; Use of Medications. RESUMO Objetivo: identifi car a relação entre os fatores ambientais e os erros de preparo e administração de antibacterianos. Método: estudo observacional, transversal, realizado entre agosto a dezembro de 2014 em duas unidades clínicas. A amostra foi composta de 265 doses de medicamentos, observadas em diferentes turnos, que por meio de um formulário tiveram as condições ambientais de ruído, iluminação, umidade, temperatura e espaço físico mensuradas nas etapas de preparo e administração. Resultados: a dimensão física para o preparo foi inadequada em uma unidade (3,8m 2 ), e os itens iluminação, temperatura e ruído foram extremamente oscilantes nos três turnos e nas duas clínicas, com médias geralmente acima do recomendado para o ambiente hospitalar, porém, as variações de iluminação e ruído não foram estatisticamente signifi cativas para provocar erros de dose ou de escolha errada do medicamento (p>0,05). Conclusão: as variáveis ambientais analisadas podem favorecer erros de medicação tanto na etapa de preparo quanto na administração. Descritores: Antibacterianos; Segurança do Paciente; Erros de Medicação; Enfermagem; Uso de Medicamentos. RESUMENObjetivo: identifi car la relación entre los factores ambientales y los errores de preparación y administración de antibacterianos. Método: estudio observacional, transversal, realizado entre agosto y diciembre de 2014 en dos unidades clínicas. La muestra fue compuesta de 256 dosis de medicamentos, observadas en diferentes turnos, que por medio de un formulario tuvieron las condiciones ambientales de ruido, iluminación, humedad, temperatura y espacio físico medidos en las etapas de preparación y administración. Resultados: la dimensión física para la preparación fue inadecuada en una unidad (3,8m 2 ), y los elementos iluminación, temperatura y ruido fueron extremadamente oscilantes en los tres turnos y en las dos clínicas, ...

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“…In one of these studies, Beales et al (1978) use ethnographic data collected over five years to investigate conflict, misunderstanding, poor design, and poor administration in small healthcare facilities of Great Britain. In the other, Liu et al (2014) use ethnographic data from two general medical units of an acute care hospital in Australia to investigate how physical environments affect communication processes for managing medications and patient safety in acute care hospital settings. In the third study, Choi and Bosch (2013) use more limited observational data to compare family presence and interaction in a patient-centered unit with that in a traditional unit.…”

Section: Research Studies With Social Orientationmentioning

confidence: 99%

“…(2) Communication, or lack of it, is a common problem in small healthcare facilities in UK (Beales et al, 1978). (3) Environmental interruptions can affect communication processes about medications, and unit layout issues can be a factor affecting communication difficulties (Liu et al, 2014). (4) The patientcentered unit may help increase family presence in the patient rooms and family interaction with patients, when compared with the traditionally designed unit (Choi and Bosch, 2013).…”

Section: Research Studies With Social Orientationmentioning

confidence: 99%

Research on nursing unit layouts: an integrative review

Rashid

2015

Facilities

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STRUCTURED ABSTRACTPurpose: To present an integrative review of the research studies on nursing unit layouts.Methodology: Studies selected for review were published between 1956 and 2014. For the purpose of this review, a framework for integrative review was developed using research orientations. The three primary dimensions-technical, psychological, and social-of the designed environment and various combinations of these dimensions were used to define the research orientations of these studies.Findings: Of all the publications reviewed for the paper, 21 presented technical orientations, 16 psychological orientations, 3 social orientations, 20 psychotechnical orientations, 10 sociotechnical orientations, 2 psychosocial orientations, and 13 presented psychosociotechnical orientations. With only a few exceptions, several issues related to nursing unit layouts were investigated no more than one time in any one category of research orientations. Several other seemingly important issues including patient and family behavior and perception, health outcomes, and social and psychosocial factors in relation to unit layouts have not been studied adequately.Research implications: Future studies on nursing unit layouts will need to focus on patient and family behavior and perception, health outcomes, and social and psychosocial factors in different units. They will also need to focus on developing theories concerning the effects of layouts on the technical, psychological, and social dimensions of nursing units.Originality/value: Despite a long history of research on nursing unit layouts, an integrative review of these studies is still missing in the literature. This review fills in the gap using a novel framework developed based on research orientations.

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The effects of physical environments in medical wards on medication communication processes affecting patient safety

Cited by 34 publications

References 15 publications

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

Conformidades E Não Conformidades No Preparo E Administração De Antibacterianos

Environmental variables and errors in the preparation and administration of medicines

Research on nursing unit layouts: an integrative review

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