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所报道患者家中用药事件的促成因素–文本挖掘分析
Author(s) -
Härkänen Marja,
Franklin Bryony Dean,
Murrells Trevor,
Rafferty Anne Marie,
VehviläinenJulkunen Katri
Publication year - 2020
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14532
Subject(s) - harm , incident report , medicine , patient safety , descriptive statistics , family medicine , emergency medicine , pediatrics , health care , psychology , social psychology , statistics , mathematics , forensic engineering , engineering , economics , economic growth
Abstract Aims To describe the characteristics of medication administration (MA) incidents reported to have occurred in patients’ own homes (reporters’ profession, incident types, contributing factors, patient consequence, and most common medications involved) and to identify the connection terms related to the most common contributing factors based on free text descriptions. Design A retrospective study using descriptive statistical analysis and text mining. Methods Medication administration incidents ( N = 19,725) reported to have occurred in patients’ homes between 2013–2018 in one district in Finland were analysed, describing the data by the reporters’ occupation, incident type, contributing factors, and patient consequence. SAS® Text Miner was used to analyse free text descriptions of the MA incidents to understand contributing factors, using concept linking. Results Most MA incidents were reported by practical (lower level) nurses (77.8%, N = 15,349). The most common category of harm was ‘mild harm’ (40.1%, N = 7,915) and the most common error type was omissions of drug doses (47.4%, N = 9,343). The medications most commonly described were Marevan [warfarin] ( N = 2,668), insulin ( N = 811), Furesis [furosemide] ( N = 590), antibiotic ( N = 446), and Panadol [paracetamol] ( N = 416). The contributing factors most commonly reported were ‘communication and flow of information’ (25.5%, N = 5,038), ‘patient and relatives’ (22.6%, N = 4,451), ‘practices’ (9.9%, N = 1,959), ‘education and training’ (4.8%, N = 949), and ‘work environment and resources’ (3.0%, N = 598). Conclusion There is need for effective communication and clear responsibilities between home care patients and their relatives and health providers, about MA and its challenges in home environments. Knowledge and skills relating to safe MA are also essential. Impact These findings about MA incidents that have occurred in patients’ homes and have been reported by home care professionals demonstrate the need for medication safety improvement in home care.