ﺑﺮرﺳﻲ اﺛﺮﺑﺨﺸﻲ ﺑﺮﻧﺎﻣﻪ ﻣﺪﻳﺮﻳﺖ ﺧﻄﺮ ﺑﺮ ﻣﻴﺰان ﺧﻄﺎﻫﺎي داروﻳﻲ ﭘﺮﺳﺘﺎران ﺑﺨﺶﻫﺎي ﻣﺮاﻗﺒﺖ وﻳﮋه

Effect of risk management program on the rate of medication errors among intensive care unit nurses

زﻣﻴﻨﻪ و ﻫﺪف: اﻳﻤﻨﻲ ﺑﻴﻤﺎر ﺑﻪ ﻃﻮر اﻋﻢ و ﺧﻄﺎﻫﺎي داروﻳﻲ ﺑـﻪ ﻃـﻮر اﺧـﺺ، از ﺷـﺎﺧﺺ ﻫـﺎي ﻣﻬـﻢ ﻛﻴﻔﻴـﺖ ﻣﺮاﻗﺒﺖ در ﺑﻴﻤﺎرﺳﺘﺎنﻫﺎ ﻫﺴﺘﻨﺪ. ﻣﺪﻳﺮﻳﺖ ﺧﻄﺮ، روﻳﻜﺮدي ﻣﻬﻢ و اﺻﻠﻲ ﺑﺮاي ﭘﻴﺸـﮕﻴﺮي ﺣـﻮادث ﻧﺎﺷـﻲ از ﺧﻄﺎﻫﺎي داروﻳﻲ اﺳﺖ. ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺗﻌﻴﻴﻦ اﺛﺮﺑﺨﺸﻲ ﺑﺮﻧﺎﻣﻪ ﻣﺪﻳﺮﻳﺖ ﺧﻄـﺮ ﺑـﺮ ﻣﻴـﺰان ﺧﻄﺎﻫـﺎي داروﻳﻲ ﭘﺮﺳﺘﺎران ﺑﺨﺶﻫﺎي ﻣﺮاﻗﺒﺖ وﻳﮋه اﻧﺠﺎم ﮔﺮﻓﺘﻪ اﺳﺖ. روش ﺑﺮرﺳﻲ: ﭘﮋوﻫﺶ ﺣﺎﺿﺮ، ﻳﻚ ﻣﻄﺎﻟﻌﻪ ﻛﺎرآزﻣﺎﻳﻲ ﻏﻴﺮﺗﺼﺎدﻓﻲ از ﻧﻮع ﭘﻴﺶآزﻣـﻮن، ﭘـﺲ آزﻣـﻮن ﺑـﺎ ﻳـﻚ ﮔــﺮوه ﻛﻨﺘـﺮل اﺳﺖ ﻛﻪ در ﺳﺎل 1399 در دو ﺑﻴﻤﺎرﺳﺘﺎن ﺗﻬﺮان اﻧﺠﺎم ﮔﺮﻓﺘﻪ اﺳﺖ. ﻳﻜﻲ از ﺑﻴﻤﺎرﺳﺘﺎنﻫﺎ ﺑﻪﻃﻮر ﺗﺼﺎدﻓﻲ، ﮔـﺮوه آزﻣﻮن و دﻳﮕﺮي ﮔﺮوه ﻛﻨﺘﺮل در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷـﺪ . ﺑﻌـﺪ از اﻋﻤـﺎل ﻣﻌﻴﺎرﻫـﺎي ورود و ﺧـﺮوج،150 ﭘﺮﺳـﺘﺎر در اﻳـﻦ دو ﺑﻴﻤﺎرﺳﺘﺎن )ﻫﺮ ﮔﺮوه 75 ﭘﺮﺳﺘﺎر( ﺑﻪ روش در دﺳﺘﺮس اﻧﺘﺨﺎب ﺷﺪﻧﺪ. ﺑﺮاي ﮔﺮوه آزﻣﻮن، ﺑﺮﻧﺎﻣﻪ ﻣـﺪﻳﺮﻳﺖ ﺧﻄـﺮ اﺟـﺮا ﺷﺪ. اﺑﺰارﻫﺎي ﺟﻤﻊآوري دادهﻫﺎ ﺷﺎﻣﻞ، ﭘﺮﺳﺸﻨﺎﻣﻪ ﺟﻤﻌﻴـﺖ ﺷـﻨﺎﺧﺘﻲ و ﺷـﻐﻠﻲ ﭘﺮﺳـﺘﺎران، ﭘﺮﺳﺸـﻨﺎﻣﻪ ﺧﻮدﮔﺰارﺷـﻲ ﺧﻄﺎي داروﻳﻲ 14 ﻋﺒﺎرﺗﻲ وﻳﻜﻔﻴﻠﺪ و ﭼﻚ ﻟﻴﺴﺖ ﻣﺸﺎﻫﺪهاي ﻛﻴﻔﻴﺖ دارو درﻣﺎﻧﻲ ﭘﺮﺳﺘﺎران ﺑﻮد. دادهﻫﺎ در ﻣﺮﺣﻠﻪ ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ ﺟﻤﻊآوري و ﺑﺎ ﻧﺮماﻓﺰار SPSS ﻧﺴﺨﻪ 16 و آﻣﺎر ﺗﻮﺻﻴﻔﻲ و اﺳﺘﻨﺒﺎﻃﻲ ﺗﺠﺰﻳﻪ و ﺗﺤﻠﻴﻞ ﺷﺪ. ﻳﺎﻓﺘﻪ ﻫﺎ: ﺑﺮاﺳﺎس ﻧﺘﺎﻳﺞ آﻣﺎري آزﻣﻮن ﺗﻲ ﻣﺴﺘﻘﻞ در اﻃﻼﻋﺎت ﺟﻤﻌﻴﺖ ﺷﻨﺎﺧﺘﻲ و ﺷﻐﻠﻲ، ﻫﻤﭽﻨﻴﻦ ﻣﻴﺰان ﺧﻄﺎﻫﺎي داروﻳﻲ ﻗﺒﻞ از ﻣﻄﺎﻟﻌﻪ، ﻫﺮ دو ﮔﺮوه ﻳﻜﺴﺎن ﺑﻮدﻧـﺪ )0/05>p(. ﭘـﺲ از اﻧﺠـﺎم ﻣﺪاﺧﻠـﻪ، ﺗﻔـﺎوت ﻣﻴـﺰان ﺧﻄﺎﻫـﺎي داروﻳﻲ در دو ﮔﺮوه ﺑﻪ ﻟﺤﺎظ آﻣﺎري ﻣﻌﻨﺎدار ﺑـﻮد )0/005

Background & Aim: Patient safety in general and medication errors in particular are the important indicators of hospital care quality. Risk management is an important and fundamental approach to preventing events caused by medication errors. The aim of this study was to determine the effect of risk management program on the rate of medication errors among intensive care unit nurses. Methods & Materials: The present study was a non-randomized pre-test, post-test study with a control group, conducted in 2020 in two hospitals in Tehran. The hospitals were randomly assigned to either an experimental group or a control group. According to the inclusion and exclusion criteria, 150 nurses (75 nurses in each group) were selected by the convenience sampling method. For the experimental group, a risk management program was implemented. Data collection tools included the nurses’ demographic questionnaire, the 14-item Wakefield medication error self-reporting questionnaire, and the nurses’ medication quality checklist. Data was collected before and after the intervention and analyzed by the SPSS software version 16 using descriptive and inferential statistics. Results: The results of independent t-test showed no statistically significant difference between two groups in demographic information and the rate of medication errors before the study (P>0.05). After the intervention, difference in the rate of medication errors was statistically significant between the two groups (P<0.005), indicating a decrease in medication errors in the nurses of the experimental group compared to the control group. The results also showed that the rate of medication error observed in nurses was significantly higher than the error reported by them (P<0.001). Conclusion: The results showed that the implementation of risk management program was effective in reducing nurses’ medication errors. Implementing a risk management program is recommended to nurses as a way to promote safe medication and achieve safe and desirable nursing care.