ISSN 2097-6046(网络)
ISSN 2096-7446(印刷)
CN 10-1655/R
主管:中国科学技术协会
主办:中华护理学会
护士职业发展

ICU护士经历护理缺失事件真实体验的质性研究

  • 李传圣 ,
  • 迟俊涛 ,
  • 方晓明 ,
  • 李雯 ,
  • 李晓红
展开
  • 264000 烟台市 烟台毓璜顶医院重症医学科(李传圣),护理部(迟俊涛),乳腺外科(方晓明),胃肠外科(李雯),产科(李晓红)
李传圣:男,本科(硕士在读),护师,E-mail:779014195@qq.com

收稿日期: 2023-09-20

  网络出版日期: 2024-04-15

A qualitative study of the experiences of nurses experiencing missed nursing care events in the ICU

  • LI Chuansheng ,
  • CHI Juntao ,
  • FANG Xiaoming ,
  • LI Wen ,
  • LI Xiaohong
Expand

Received date: 2023-09-20

  Online published: 2024-04-15

摘要

目的 了解ICU护士经历护理缺失事件后的真实感受,以便有针对性地为其提供积极有效的应对措施。方法 运用质性研究中的现象学研究法,对17名烟台市某三级甲等医院经历护理缺失事件的ICU护士进行半结构化访谈,采用内容分析法进行资料分析。结果 17名经历护理缺失事件护士的真实体验可归纳为4个主题、15个亚主题。主题1:原因,人力资源、物力资源、患者因素、中断事件和ICU特殊性;主题2:应对,报告意愿低、逃避和反思;主题3:期待,完善制度、团队协作、期待理解和相关培训;主题4:认知,重视不足、认识不足和促进成长。结论 临床工作中针对经历护理缺失事件的护士应采取相应措施消除相关影响因素;建议通过加强相关培训及心理干预,提高护士认知水平,促进其积极应对,以期避免护理缺失事件发生。

本文引用格式

李传圣 , 迟俊涛 , 方晓明 , 李雯 , 李晓红 . ICU护士经历护理缺失事件真实体验的质性研究[J]. 中华急危重症护理杂志, 2024 , 5(4) : 352 -358 . DOI: 10.3761/j.issn.2096-7446.2024.04.013

Abstract

Objective To understand the real feelings of ICU nurses after experiencing missed nursing care events,in order to provide them with positive and effective countermeasures in a targeted manner. Methods Using the phenomenological research method in qualitative research,we conducted semi-structured interviews with 17 ICU nursing staff experiencing missed nursing care events in a tertiary class A hospital in Yantai City,content analysis was used for data analysis. Results The experiences of 17 nurses experiencing missed nursing care events could be categorized into 4 themes and 15 sub-themes. Theme 1:Causes,human resources,physical resources,patient factors,disruptive events,and the specificity of the ICU;Theme 2:Coping,low willingness to report,avoidance,and reflection;Theme 3:Expectations,improving the system,teamwork,and expectation of understanding and relevant training;Theme 4:Cognition,valuing deficiencies,lack of recognition and promoting growth. Conclusion Measures should be taken in clinical work to eliminate relevant influencing factors for nurses experiencing missed nursing care events. It is recommended to improve the cognitive level of nurses and promote their positive coping by strengthening relevant training and psychological interventions with a view to avoid the occurrence of missed nursing care events.

参考文献

[1] World Health Organization. Global patient safety action plan2021-2030[EB/OL]. (2021-08-03)[2023-06-02]. https://www.who.int/publications/i/item/9789240032705.
[2] Sauro KM,Soo A,Quan HD,et al.Adverse events among hospitalized critically ill patients:a retrospective cohort study[J]. Med Care,2019,58(1):38-44.
[3] Kalisch BJ,Landstrom GL,Hinshaw AS.Missed nursing care:a concept analysis[J]. J Adv Nurs,2009,65(7):1509-1517.
[4] 营晓,张海燕,么莉,等. 护理缺失的研究进展[J]. 中国护理管理,2021,21(8):1266-1271.
Ying X,Zhang HY,Yao L,et al.The research progress of the missed nursing care[J]. Chin Nurs Manag,2021,21(8):1266-1271.
[5] Lake ET,Germack HD,Viscardi MK.Missed nursing care is linked to patient satisfaction:a cross-sectional study of US hospitals[J]. BMJ Qual Saf,2016,25(7):535-543.
[6] Du HX,Yang YY,Wang XH,et al.A cross-sectional observational study of missed nursing care in hospitals in China[J]. J Nurs Manag,2020,28(7):1578-1588.
[7] Recio-Saucedo A,Dall'Ora C,Maruotti A,et al. What impact does nursing care left undone have on patient outcomes? Review of the literature[J]. J Clin Nurs,2018,27(11/12):2248-2259.
[8] 王斯涵,王微. 护理缺失测评工具及影响因素研究进展[J]. 护理研究,2022,36(14):2523-2527.
Wang SH,Wang W.Research progress of evaluation tools and influencing factors of missed nursing care[J]. Chin Nurs Res,2022,36(14):2523-2527.
[9] Jones TL,Hamilton P,Murry N.Unfinished nursing care,missed care,and implicitly rationed care:state of the science review[J]. Int J Nurs Stud,2015,52(6):1121-1137.
[10] 桑明,卫建华,张萍,等. 心脏外科患者术后有创机械通气撤机锻炼体验的质性研究[J]. 中华护理杂志,2023,58(16):1970-1976.
Sang M,Wei JH,Zhang P,et al.A qualitative study on the experience of weaning from invasive mechanical ventilation in patients after cardiac surgery[J]. Chin J Nurs,2023,58(16):1970-1976.
[11] Bragadóttir H,Burmeister EA,Terzioglu F,et al.The association of missed nursing care and determinants of satisfaction with current position for direct-care nurses—an international study[J]. J Nurs Manag,2020,28(8):1851-1860.
[12] Mandal L,Seethalakshmi A.Experience of missed nursing care:a mixed method study[J]. Worldviews Evid Based Nurs,2023,20(3):212-219.
[13] Chiappinotto S,Palese A.Unfinished nursing care reasons as perceived by nurses at different levels of nursing services:findings of a qualitative study[J]. J Nurs Manag,2022,30(7):3393-3405.
[14] Alfuqaha OA,Alhalaiqa FN,Alqurneh MK,et al.Missed nursing care before and during the COVID-19 pandemic:a comparative cross-sectional study[J]. Int Nurs Rev,2023,70(1):100-110.
[15] Cho SH,Kim YS,Yeon KN,et al.Effects of increasing nurse staffing on missed nursing care[J]. Int Nurs Rev,2015,62(2):267-274.
[16] Chapman R,Rahman A,Courtney M,et al.Impact of teamwork on missed care in four Australian hospitals[J]. J Clin Nurs,2017,26(1/2):170-181.
[17] 冯娅婷,陈长英. 河南省三级甲等医院ICU护理人力资源配置对护理质量和患者结局的影响[J]. 中华护理杂志,2021,56(4):490-495.
Feng YT,Chen CY.The effects of ICU nursing human resources in tertiary hospitals in Henan on the quality of nursing and patient outcomes[J]. Chin J Nurs,2021,56(4):490-495.
[18] 国家卫生健康委关于印发《关于实施医院护士岗位管理的指导意见》的通知[EB/OL]. (2012-05-04)[2023-06-05]. http://www.nhc.gov.cn/wjw/gfxwj/201304/67d11ef015f34688aab66b1e56d6bab2.shtml.
Circular of the National Health Commission of the People's Republic of China on the Issuance of 《Guidelines on the implementation of position management for hospital nurses》[EB/OL]. (2012-05-04)[2023-06-05].http://www.nhc.gov.cn/wjw/gfxwj/201304/67d11ef015f34688aab66b1e56d6bab2.shtml.
[19] Lopez-Dicastillo O,Zabaleta-Del-Olmo E,Mujika A,et al. “Missed nursing care” in health promotion:raising awareness[J]. J Nurs Manag,2020,28(8):1997-2000.
[20] 刘文婷,尹安春. ICU护士患者安全文化认知水平现状及其影响因素研究[J]. 中国实用护理杂志,2016,32(3):161-165.
Liu WT,Yin AC.The Current status of the patient safety culture in intensive care unit nurses and influencing factors[J]. J Pract Nurs,2016,32:161-165.
[21] Kim SY,Ko Y.Influence of the team effectiveness of nursing units on nursing care left undone and nurse-reported quality of care[J]. Healthcare(Basel),2023,11(10):1380.
[22] Dehghan-Nayeri N,Ghaffari F,Shali M.Exploring Iranian nurses' experiences of missed nursing care:a qualitative study:a threat to patient and nurses' health[J]. Med J Islam Repub Iran,2015,29:276.
[23] 竺传钰. ICU护士生命意义感水平及其相关心理社会因素[D]. 济南:山东大学,2022.
Zhu CY.Meaning in life and its related psychosocial factors in ICU nurses[D]. Jinan:Shandong University,2022.
[24] 杨建华,关华,熊洪,等. 四川省一线护士压力应对与疫情反刍性沉思的关系:心理一致感的中介作用[J]. 职业卫生与应急救援,2021,39(6):625-630,636.
Yang JH,Guan H,Xiong H,et al.Parallel mediating role of sense of coherence between coping style and COVID-19 pandemic related rumination of front-line nurses[J]. Occup Health Emerg Rescue,2021,39(6):625-630,636.
[25] 黄冬梅,王键,张燕茹,等. 情绪干预对心内科护士工作压力源和心理健康状态的影响[J]. 工业卫生与职业病,2021,47(1):30-33.
Huang DM,Wang J,Zhang YR,et al.Effect of emotional intervention on the stress source and mental health status of cardiology nurses[J]. China Ind Econ,2021,47(1):30-33.
[26] 杨小文,刘雨安,王洁,等. ICU护士对重症监护室护理缺失现象感知的质性研究[J]. 医院管理论坛,2022,39(11):58-62.
Yang XW,Liu YA,Wang J,et al.Qualitative study of ICU nurses' perception of missed nursing care in intensive care units[J]. Hospital Management Forum,2022,39(11):58-62.
[27] Villamin C,Anderson J,Fellman B,et al.Perceptions of missed care across oncology nursing specialty units[J]. J Nurs Care Qual,2019,34(1):47-53.
[28] 中国医院协会. 中国医院协会患者安全目标(2017版)[EB/OL]. (2016-10-26)[2023-12-10].https://www.cha.org.cn/site/content/9773fc6a8ebec5fdb57dc97ddf282e14.html.
China Hospital Association. Chinese hospital association patient safety goals(2017)[EB/OL]. (2016-10-26)[2023-12-10].https://www.cha.org.cn/site/content/9773fc6a8ebec5fdb57dc97ddf282e14.html.
[29] 詹昱新,刘云访,杨中善,等. 神经外科ICU护士对患者安全文化认知与实践的质性研究[J]. 中华护理杂志,2020,55(9):1315-1319.
Zhan YX,Liu YF,Yang ZS,et al.A qualitative research on cognition and practice of NICU nurses on patient safety culture[J]. Chin J Nurs,2020,55(9):1315-1319.
[30] 沈志莹,钟竹青,丁四清,等. 我国护理管理信息化的研究进展[J]. 中华护理杂志,2020,55(3):397-401.
Shen ZY,Zhong ZQ,Ding SQ,et al.Research progress of nursing management informatization in China[J]. Chin J Nurs,2020,55(3):397-401.
文章导航

/