ODNOS MEDICINSKIH SESTER DO TVEGANIH VEDENJ PRI UPORABI ZDRAVIL KOT DEJAVNIKA POVZROČITVE NAPAK

• Main Author: Bračič, Andrej
• Other Authors: Lobnikar, Branko
• Format: Master Thesis
• Language: Slovenian
• Published: [A. Bračič] 2015
• Subjects: varnost; zdravila; etnografija; akcijsko raziskovanje; safety; medications; ethnography; action research; info:eu-repo/classification/udc/615.03(043.2); sami
• Online Access: https://dk.um.si/IzpisGradiva.php?id=46785; https://dk.um.si/Dokument.php?id=69511&dn=; http://www.cobiss.si/scripts/cobiss?command=DISPLAY&base=cobib&rid=2065572&fmt=11

Napake pri ravnanju z zdravili so najpogostejši preprečljivi vzroki neželenih dogodkov in evropske zdravstvene oblasti naj bi jih upoštevale prioritetno pri organiziranju zdravstvenih politik. V Sloveniji ni mogoče zaslediti veliko raziskav v povezavi z neželenimi dogodki pri uporabi zdravil, tako nam obstoječi podatki ne ponujajo celovitega vpogleda v področje varnosti pri uporabi zdravil. Raziskovalna metodologija: Podatki v raziskavi so bili zbrani na podlagi adaptiranega etnografskega pristopa. S pomočjo tehnike prikritega opazovanja z udeležbo posameznih tehnikov zdravstvene nege na enem izmed oddelkov Univerzitetnega kliničnega centra Ljubljana v procesu ravnanja z zdravili, z analizo pacientovih dokumentacij in pogovorov o varnosti v obliki delno strukturiranega skupinskega intervjuja z izvajalci zdravstvene nege so poudarjena posamezna tvegana vedenja iz prakse. Opravljena je primerjava pridobljenih podatkov s primerljivimi študijami v tujini. Rezultati: V raziskavi, opravljeni na enem izmed oddelkov Univerzitetnega kliničnega centra Ljubljana, je bilo izpostavljenih enajst tveganih vedenj v procesu razdeljevanja peroralnih zdravil. V sami raziskavi smo dokazali velik obseg tveganih vedenj za nastanek napak pri uporabi zdravil, v pogovorih o varnosti pa so se izluščili le nekateri dejavniki, ki vplivajo na njihov nastanek. Sklep: Dejanski obseg napak na področju uporabe zdravil je neprimerno večji, kot ga je mogoče predvideti na podlagi prostovoljne prijave odklonov oziroma z izvajanjem obstoječih nadzorov. Šele z uvidom dejanskega stanja v praksi je mogoče kompetentno opredeliti ukrepe, na podlagi katerih odpravimo sistemske vzroke za obstoj tveganega vedenja. Errors in the handling of medications are the most common preventable causes of undesirable events. European health authorities should consider them a priority in the organization of health policies. In Slovenia there are not many researches associated with undesirable events in the use of drugs available, so our existing data does not provide a comprehensive insight into the field of safety in the use of medications. Research methodology: The data in the study was collected on the basis of the adjusted ethnographic approach. Individual risk behaviours in practice are exposed by using the technique of covert participant observation of separate nurses in one of the departments of UKC Ljubljana in the process of treatment with drugs, by analyzing the patient's documentation and in discourse with nursing personnel about safety in the form of partially structured group interviews. A comparison of the obtained data with comparable studies abroad was carried out. Results: In the study carried out in one of the departments of the UKC Ljubljana eleven risk behaviours were exposed in the process of distribution of oral medications. A large range of risky behaviors which influence the occurrence of errors in the use of medications was proven. Only some of the factors that affect the formation of the errors were exposed during the discourse about safety. Conclusion: The true extent of errors in the use of medications is much more comprehensive than it can be predicted on the basis of voluntary report of deviations or the execution of existing controls. Only with an insight of the actual situation in practice the safety measures which eliminate systemic causes for the existence of risky behavior can be competently defined. safety, medications, ethnography, action research