Hemşirelerin Hasta Devir Teslim Etkinliğinin Tıbbi Hatalara Eğilim Düzeylerine Etkisi

Merve Sunay; Cengiz Arıcıoğlu; Gizem Kerimoğlu Yıldız

Araştırma Makalesi

Hemşirelerin Hasta Devir Teslim Etkinliğinin Tıbbi Hatalara Eğilim Düzeylerine Etkisi

Yıl 2023, Cilt: 4 Sayı: 3, 76 - 83, 29.12.2023

Merve Sunay Cengiz Arıcıoğlu Gizem Kerimoğlu Yıldız

Öz

Amaç: Bu çalışmanın amacı hemşirelerin hasta teslim etkinliğinin tıbbi hataya eğilim düzeyleri üzerine etkisini belirlemektir.
Yöntem: Bu çalışma Mart-Nisan 2019 tarihleri arasında bir üniversite hastanesi yataklı servislerinde çalışan ve araştırmaya katılmaya gönüllü olan toplam 120 hemşire oluşturmuştur. Verilerin toplanmasında demografik veri formu, Nöbet devir teslim değerlendirme ölçeği ve Hemşirelikte tıbbi hataya eğilim ölçeği kullanılmıştır.
Bulgular: Hemşirelerin %96,7’si hasta devir teslim işleminin gerekli bir uygulama olduğunu, %90 hastanın genel durumuna göre her vardiyada kritik noktaların vurgulanmasına her zaman dikkat ettiklerini belirtti. Hemşirelerin nöbet devir teslim etkinliği ile tıbbi hataya eğilim düzeyi arasında zayıf düzeyde ve pozitif yönde olumlu bir ilişki bulundu (r:0,34; p:0,00).
Sonuç: Çalışmaya katılan hemşirelerin nöbet devir teslim uygulamasının etkin olması gerektiği ile ilgili olumlu görüşleri olduğu bulunmuştur. Hemşireler teslim sırasında planlı ve organize olmaya dikkat etmektedir. Bunun yanında çalışmada nöbet devir tesliminin etkin olarak yapılmasının tıbbi hataya eğilimi azaltması ise çalışmanın önemli bir diğer bulgusudur.

Anahtar Kelimeler

Hemşire, nöbet devir teslim, tıbbi hataya eğilim

Destekleyen Kurum

Çalışmanın destekleyicisi bulunmamaktadır.

Proje Numarası

Çalışma kapsamında herhangi bir proje başvurusu yapılmamıştır.

Teşekkür

Yazarlar çalışmaya katkı veren ilgili kurumun hemşirelerine içtenlikle teşekkür eder.

Kaynakça

1. Institute for Healthcare Improvement, Overview. 2023, https://www.ihi.org/Topics/PatientSafety/Pages/Overview.aspx, (Accessed: 30.05.2023)
2. The Joint Commission, National Patient Safety Goals. January 2023, https://www.jointcommission.org/standards/national-patient-safety-goals/-/ media/88c13498e39f48d0a56e806db38ad255.ashx (Accessed: 30.05.2023)
3. Korkuta M, Kurt ME. Hasta güvenliği kültürünün Türkiye’deki mevcut durumu ve önemi, Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 2021; 7(1): 19-31.
4. Akalın HE. Klinik araştırmalar ve hasta güvenliği, İyi Klinik Uygulamalar (İKU) Dergisi, 2007; 17: 32–35.
5. Işık O, Akbolat M, Çetin M, et al. Hemşirelerin bakışıyla tıbbi hataların değerlendirilmesi, TAF Preventive Medicine Bulletin, 2012;11(4): 421-30.
6. World Health Organization, World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action, 2005, https://apps.who.int/iris/bitstream/handle/10665/69797/WHO-EIPSPO- QPS-05.3-eng.pdf?sequence=1&isAllowed=y (Accessed: 30.05.2023)
7. International Council of Nurses, Patient Safety. Position Statement, 2012, https://www.icn.ch/sites/default/files/inline-files/D05_Patient_Safety_0.pdf (Accessed: 30.05.2023)
8. Clarke SP, Aiken LH. An international hospital outcomes research agenda focused on nursing: lessons from a decade of collaboration, Journal of Clinical Nursing, 2008; 17(24): 3317.
9. Avşar G. Atabek Armutçu, A, Karaman Özlü, Z. Hemşirelerin Tibbi Hata Eğilim Düzeyleri ve Tibbi Hata Türleri: Bir Hastane Örneği, HSP, 2016; 3(2):115-22.
10. Caymaz M. Sağlık personelinin tıbbi uygulama hataları üzerine bir araştırma. Uluslararası Yönetim ve Sosyal Araştırmalar Dergisi, 2015; 2(4): 1-14.
11. Dhillon BS. Human reliability and error in medical system, Series on industrial & system engineering, 2003; 2: 10-8.
12. Tourangeau AE, Doran DM, Hall LM, et al. Impact of hospital nursing care on 30‐day mortality for acute medical patients, Journal of advanced nursing, 2007;57(1): 32-44.
13. Er F, Altuntaş S. Hemşirelerin Tıbbi Hata Yapma Durumları ve Nedenlerine Yönelik Görüşlerinin Belirlenmesi, Sağlık ve Hemşirelik Yönetimi Dergisi, 2016; 3(3): 132-8.
14. Brady AM, Malone AM, Fleming S. A literature review of the individual and systems factors that contribute to medication errors in nursing practice, J Nurs Manag, 2009; 17: 679-97.
15. Estryn-Behar MR, Milanini-Magny G, Chaumon E, et al. Shift Change Handovers and Subsequent Interruptions: Potential Impacts on Quality of Care. J Patient Saf, 2014; 10: 29-44.
16. Institute of Medicine (US) Committee on Quality of Health Care in America. To Err is Human: Building a Safer Health System. Kohn LT, Corrigan JM, Donaldson MS, editors. Washington (DC): National Academies Press (US); 2000.
17. Weston EJ, Jefferies D, Stulz V, et al. Exploring nurses’ perceptions of clinical handover in regional health care facilities: A exploratory qualitative study. J Nurs Manag, 2022; 30: 3113–22.
18. Johnson M, Sanchez P, Zheng C. Reducing patient clinical management errors using structured content and electronic nursing handover, Journal of Nursing Care Quality, 2016; 31(3): 245–253.
19. Manias E, Geddes F, Watson B, et al. Perspectives of clinical handover processes: A multi-site survey across different health professionals, Journal of Clinical Nursing, 2016; 25; 80–91.
20. Ahn JW, Jang HY, Son YJ. Critical care nurses’ communication challenges during handovers: A systematic review and qualitative meta-synthesis. J Nurs Manag, 2021; 29: 623–34.
21. Kitson AL, Muntlin Athlin A, Elliott J, et al. What’s my line? A narrative review and synthesis of the literature on Registered Nurses’ communication behaviours between shifts. Journal of Advanced Nursing, 2014; 70(6): 1228– 42.
22. Bressan V, Mio M, Palese A. Nursing handovers and patient safety: Findings from an umbrella review, J Adv Nurs, 2020; 76: 927–938.
23. Raeisi A, Rarani MA, Soltani F. Challenges of patient handover process in healthcare services: A systematic review. Journal of Education and Health Promotion, 2019; 8: 173.
24. Ernst KM, McComb S, Ley C. Nurse-to-nurse shift hand offs on medical surgical units: Aprocess within the flow of nursing care, J Clin Nurs, 2018; 27(5–6): e1189-e1201.
25. Brown-Deveaux D, Kaplan S, Gabbe L, et al. Transformational Leadership Meets Innovative Strategy: How Nurse Leaders and Clinical Nurses Redesigned Bedside Hand over to Improve Nursing Practice, Nurse Leader, 2022; 20(3): 290-6.
26. Chiang HY, Hsiao YC, Lee HF. Predictors of Hospital Nurses’ Safety Practices Work Environment, Workload, Job Satisfaction, and Error Reporting, J Nurs Care Qual, 2017; 32: 359-68
27. O’Connell B, Ockerby C, Hawkins M. Construct Validity and Reliability of the Handover Evaluation Scale, Journal of Clinical Nursing, 2014; 23: 560-70.
28. Tuna R, Dallı B. Hemşirelerin Nöbet Devir Teslim Etkinliği ve İlişkili Değişkenler. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2018; 4: 432-7.
29. Ö zata M, Altunkan H. Hemşirelerin Tıbbi Hataya Eğilim Ölçeğinin Geliştirilmesi ve Geçerlilik Güvenirlilik Analizinin Yapılması, II. Uluslarası Sağlıkta Performans ve Kalite Kongresi Bildiri Kitabı, Sağlık Bakanlığı Yayınları, ed: Ertem Kırılmaz, Ankara 2010; 3-20.
30. Aydın Sayılan A, Mert Boğa, S. Hemşirelerin İş Stresi, İş Yükü, İş Kontrolü ve Sosyal Destek Düzeyi ile Tıbbi Hataya Eğilimleri Arasındaki İlişkinin Belirlenmesi. Hemşirelikte Araştırma Geliştirme Dergisi, 2018; 20: 11-22.
31 Andsoy Işık I, Kar G, Öztürk Ö. Hemşirelerin tıbbi hata eğilimlerine yönelik bir çalışma. Sağlık Bilimleri ve Meslekleri Dergisi, 2014; 1: 17-27.
32. Güngör S, Akcoban S, Tosun B. Evaluation of emergency service nurses’ patient handover and affecting factors: A descriptive study. International Emergency Nursing, 2022; 61: 101154
33. Campbell D, Dontje K. Implementing bedside handoff in the emergency department: A practice improvement project, J Emerg Nurs, 2019; 45(2); 149–54.
34. Tortosa-Alted R, Reverte-Villarroya S, Martínez-Segura E, et al. Emergency handover of critical patients. A systematic review, Int Emerg Nurs, 2021; 56: 100997.
35. The Joint Commission, Inadequate hand-off communication, 2017, https:// www.jointcommission.org/assets/1/18/SEA_58_Hand_off_Comms_9_6_17_ FINAL_(1).pdf
36. Tran DT, Johnson M. Classifying nursing errors in clinical management within an Australian hospital. International Nursing Review, 2010; 57: 454-62.
37. Johnson M, Sanchez P, Zheng C. The impact of an integrated nursing handover system on nurses’ satisfaction and work practices, Journal of clinical nursing, 2016; 25(1-2): 257-268.
38. Nagpal K, Vats A, Ahmed K, et al. An evaluation of information transfer through the continuum of surgical care: a feasibility study, Annals of Surgery, 2010; 252: 402.
39. Wong X, Tung YJ, Peck SY, et al. Clinical nursing handovers for continuity of safe patient care in adult surgical wards. JBI Database Syst Rev Implement Rep, 2019; 17: 1003-15.
40. Sand‐Jecklin K, Sherman J. A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation, Journal of clinical nursing, 2014; 23(19-20): 2854-63.
41. Rikos N, Linardakis M, Economou C, et al. The nurses’ own views about the inter-shift handover process. Contemporary nurse, 2019; 55(1): 83-94.
42. Kear TM. Patient handoffs: What they are and how they contribute to patient safety, Nephrology Nursing Journal, 2016; 43(4): 339.
43. Siemsen IM, Madsen MD, Pedersen LF, et al. Factors that impact on the safety of patient handovers: An interview study, Scandinavian Journal of Public Health, 2012; 40: 439-48.
44. Timmerman J, Sitzer V, Eusebio R, et al. Nursing handover: A content analysis of nurses’ handwritten notes. Western Journal of Nursing Research, 2021; 43(7): 631-9.
45. Foster S, Manser T. The effects of patient handoff characteristics on subsequent care: A systematic review and areas for future research, Academic Medicine, 2012; 87: 1105-24.
46. Rixon S, Braaf S, Williams A, et al. The functions and roles of questioning during nursing handovers in specialty settings: An ethnographic study, Contemporary Nurse, 2017; 53; 182-95.
47. Bradley S, Mott S. Adopting a patient-centred approach: An investigation into the introduction of bedside handover to three rural hospitals, J Clin Nurs, 2014; 23: 1927-36.

The Effect of Nurses' Patient Handover Effectiveness on the Levels of Tendency to Medical Errors

Yıl 2023, Cilt: 4 Sayı: 3, 76 - 83, 29.12.2023

Merve Sunay Cengiz Arıcıoğlu Gizem Kerimoğlu Yıldız

Öz

Aim: This study aimed to determine the effect of nurses' patient handover efficiency on the level of tendency to medical error.
Methods: This study was conducted with 120 voluntarily participated nurses working in the inpatient services of a university hospital between March-April 2019. Demographic data form, Nursing Handover Evaluation Scale and Medical Malpractice Tendency in Nursing Scale were used to collect the data.
Results: 96.7% stated patient handover is a necessary practice, 90% always pay attention to highlight critical points in each shift according to the general condition of the patient. A weak and positive correlation was found between nurses' efficiency of handover and their tendency to medical error (r:0.34; p:0.00).
Conclusion: The nurses had positive opinions about the need for an effective handover application. Nurses pay attention to being planned and organized during handovers. Another important finding of the study is that effective handover reduces the tendency to medical errors.

Anahtar Kelimeler

Handover, Nurse, Medical error

Proje Numarası

Çalışma kapsamında herhangi bir proje başvurusu yapılmamıştır.

Kaynakça

1. Institute for Healthcare Improvement, Overview. 2023, https://www.ihi.org/Topics/PatientSafety/Pages/Overview.aspx, (Accessed: 30.05.2023)
2. The Joint Commission, National Patient Safety Goals. January 2023, https://www.jointcommission.org/standards/national-patient-safety-goals/-/ media/88c13498e39f48d0a56e806db38ad255.ashx (Accessed: 30.05.2023)
3. Korkuta M, Kurt ME. Hasta güvenliği kültürünün Türkiye’deki mevcut durumu ve önemi, Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 2021; 7(1): 19-31.
4. Akalın HE. Klinik araştırmalar ve hasta güvenliği, İyi Klinik Uygulamalar (İKU) Dergisi, 2007; 17: 32–35.
5. Işık O, Akbolat M, Çetin M, et al. Hemşirelerin bakışıyla tıbbi hataların değerlendirilmesi, TAF Preventive Medicine Bulletin, 2012;11(4): 421-30.
6. World Health Organization, World alliance for patient safety: WHO draft guidelines for adverse event reporting and learning systems: from information to action, 2005, https://apps.who.int/iris/bitstream/handle/10665/69797/WHO-EIPSPO- QPS-05.3-eng.pdf?sequence=1&isAllowed=y (Accessed: 30.05.2023)
7. International Council of Nurses, Patient Safety. Position Statement, 2012, https://www.icn.ch/sites/default/files/inline-files/D05_Patient_Safety_0.pdf (Accessed: 30.05.2023)
8. Clarke SP, Aiken LH. An international hospital outcomes research agenda focused on nursing: lessons from a decade of collaboration, Journal of Clinical Nursing, 2008; 17(24): 3317.
9. Avşar G. Atabek Armutçu, A, Karaman Özlü, Z. Hemşirelerin Tibbi Hata Eğilim Düzeyleri ve Tibbi Hata Türleri: Bir Hastane Örneği, HSP, 2016; 3(2):115-22.
10. Caymaz M. Sağlık personelinin tıbbi uygulama hataları üzerine bir araştırma. Uluslararası Yönetim ve Sosyal Araştırmalar Dergisi, 2015; 2(4): 1-14.
11. Dhillon BS. Human reliability and error in medical system, Series on industrial & system engineering, 2003; 2: 10-8.
12. Tourangeau AE, Doran DM, Hall LM, et al. Impact of hospital nursing care on 30‐day mortality for acute medical patients, Journal of advanced nursing, 2007;57(1): 32-44.
13. Er F, Altuntaş S. Hemşirelerin Tıbbi Hata Yapma Durumları ve Nedenlerine Yönelik Görüşlerinin Belirlenmesi, Sağlık ve Hemşirelik Yönetimi Dergisi, 2016; 3(3): 132-8.
14. Brady AM, Malone AM, Fleming S. A literature review of the individual and systems factors that contribute to medication errors in nursing practice, J Nurs Manag, 2009; 17: 679-97.
15. Estryn-Behar MR, Milanini-Magny G, Chaumon E, et al. Shift Change Handovers and Subsequent Interruptions: Potential Impacts on Quality of Care. J Patient Saf, 2014; 10: 29-44.
16. Institute of Medicine (US) Committee on Quality of Health Care in America. To Err is Human: Building a Safer Health System. Kohn LT, Corrigan JM, Donaldson MS, editors. Washington (DC): National Academies Press (US); 2000.
17. Weston EJ, Jefferies D, Stulz V, et al. Exploring nurses’ perceptions of clinical handover in regional health care facilities: A exploratory qualitative study. J Nurs Manag, 2022; 30: 3113–22.
18. Johnson M, Sanchez P, Zheng C. Reducing patient clinical management errors using structured content and electronic nursing handover, Journal of Nursing Care Quality, 2016; 31(3): 245–253.
19. Manias E, Geddes F, Watson B, et al. Perspectives of clinical handover processes: A multi-site survey across different health professionals, Journal of Clinical Nursing, 2016; 25; 80–91.
20. Ahn JW, Jang HY, Son YJ. Critical care nurses’ communication challenges during handovers: A systematic review and qualitative meta-synthesis. J Nurs Manag, 2021; 29: 623–34.
21. Kitson AL, Muntlin Athlin A, Elliott J, et al. What’s my line? A narrative review and synthesis of the literature on Registered Nurses’ communication behaviours between shifts. Journal of Advanced Nursing, 2014; 70(6): 1228– 42.
22. Bressan V, Mio M, Palese A. Nursing handovers and patient safety: Findings from an umbrella review, J Adv Nurs, 2020; 76: 927–938.
23. Raeisi A, Rarani MA, Soltani F. Challenges of patient handover process in healthcare services: A systematic review. Journal of Education and Health Promotion, 2019; 8: 173.
24. Ernst KM, McComb S, Ley C. Nurse-to-nurse shift hand offs on medical surgical units: Aprocess within the flow of nursing care, J Clin Nurs, 2018; 27(5–6): e1189-e1201.
25. Brown-Deveaux D, Kaplan S, Gabbe L, et al. Transformational Leadership Meets Innovative Strategy: How Nurse Leaders and Clinical Nurses Redesigned Bedside Hand over to Improve Nursing Practice, Nurse Leader, 2022; 20(3): 290-6.
26. Chiang HY, Hsiao YC, Lee HF. Predictors of Hospital Nurses’ Safety Practices Work Environment, Workload, Job Satisfaction, and Error Reporting, J Nurs Care Qual, 2017; 32: 359-68
27. O’Connell B, Ockerby C, Hawkins M. Construct Validity and Reliability of the Handover Evaluation Scale, Journal of Clinical Nursing, 2014; 23: 560-70.
28. Tuna R, Dallı B. Hemşirelerin Nöbet Devir Teslim Etkinliği ve İlişkili Değişkenler. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 2018; 4: 432-7.
29. Ö zata M, Altunkan H. Hemşirelerin Tıbbi Hataya Eğilim Ölçeğinin Geliştirilmesi ve Geçerlilik Güvenirlilik Analizinin Yapılması, II. Uluslarası Sağlıkta Performans ve Kalite Kongresi Bildiri Kitabı, Sağlık Bakanlığı Yayınları, ed: Ertem Kırılmaz, Ankara 2010; 3-20.
30. Aydın Sayılan A, Mert Boğa, S. Hemşirelerin İş Stresi, İş Yükü, İş Kontrolü ve Sosyal Destek Düzeyi ile Tıbbi Hataya Eğilimleri Arasındaki İlişkinin Belirlenmesi. Hemşirelikte Araştırma Geliştirme Dergisi, 2018; 20: 11-22.
31 Andsoy Işık I, Kar G, Öztürk Ö. Hemşirelerin tıbbi hata eğilimlerine yönelik bir çalışma. Sağlık Bilimleri ve Meslekleri Dergisi, 2014; 1: 17-27.
32. Güngör S, Akcoban S, Tosun B. Evaluation of emergency service nurses’ patient handover and affecting factors: A descriptive study. International Emergency Nursing, 2022; 61: 101154
33. Campbell D, Dontje K. Implementing bedside handoff in the emergency department: A practice improvement project, J Emerg Nurs, 2019; 45(2); 149–54.
34. Tortosa-Alted R, Reverte-Villarroya S, Martínez-Segura E, et al. Emergency handover of critical patients. A systematic review, Int Emerg Nurs, 2021; 56: 100997.
35. The Joint Commission, Inadequate hand-off communication, 2017, https:// www.jointcommission.org/assets/1/18/SEA_58_Hand_off_Comms_9_6_17_ FINAL_(1).pdf
36. Tran DT, Johnson M. Classifying nursing errors in clinical management within an Australian hospital. International Nursing Review, 2010; 57: 454-62.
37. Johnson M, Sanchez P, Zheng C. The impact of an integrated nursing handover system on nurses’ satisfaction and work practices, Journal of clinical nursing, 2016; 25(1-2): 257-268.
38. Nagpal K, Vats A, Ahmed K, et al. An evaluation of information transfer through the continuum of surgical care: a feasibility study, Annals of Surgery, 2010; 252: 402.
39. Wong X, Tung YJ, Peck SY, et al. Clinical nursing handovers for continuity of safe patient care in adult surgical wards. JBI Database Syst Rev Implement Rep, 2019; 17: 1003-15.
40. Sand‐Jecklin K, Sherman J. A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation, Journal of clinical nursing, 2014; 23(19-20): 2854-63.
41. Rikos N, Linardakis M, Economou C, et al. The nurses’ own views about the inter-shift handover process. Contemporary nurse, 2019; 55(1): 83-94.
42. Kear TM. Patient handoffs: What they are and how they contribute to patient safety, Nephrology Nursing Journal, 2016; 43(4): 339.
43. Siemsen IM, Madsen MD, Pedersen LF, et al. Factors that impact on the safety of patient handovers: An interview study, Scandinavian Journal of Public Health, 2012; 40: 439-48.
44. Timmerman J, Sitzer V, Eusebio R, et al. Nursing handover: A content analysis of nurses’ handwritten notes. Western Journal of Nursing Research, 2021; 43(7): 631-9.
45. Foster S, Manser T. The effects of patient handoff characteristics on subsequent care: A systematic review and areas for future research, Academic Medicine, 2012; 87: 1105-24.
46. Rixon S, Braaf S, Williams A, et al. The functions and roles of questioning during nursing handovers in specialty settings: An ethnographic study, Contemporary Nurse, 2017; 53; 182-95.
47. Bradley S, Mott S. Adopting a patient-centred approach: An investigation into the introduction of bedside handover to three rural hospitals, J Clin Nurs, 2014; 23: 1927-36.

Toplam 47 adet kaynakça vardır.

Ayrıntılar

Birincil Dil	Türkçe
Konular	Hemşirelik İşgücü
Bölüm	Araştırma makalesi
Yazarlar	Merve Sunay 0009-0009-5768-8102 Cengiz Arıcıoğlu 0009-0008-6781-4531 Gizem Kerimoğlu Yıldız 0000-0002-6850-7233
Proje Numarası	Çalışma kapsamında herhangi bir proje başvurusu yapılmamıştır.
Yayımlanma Tarihi	29 Aralık 2023
Gönderilme Tarihi	14 Ağustos 2023
Yayımlandığı Sayı	Yıl 2023 Cilt: 4 Sayı: 3

Kaynak Göster

AMA	Sunay M, Arıcıoğlu C, Kerimoğlu Yıldız G. Hemşirelerin Hasta Devir Teslim Etkinliğinin Tıbbi Hatalara Eğilim Düzeylerine Etkisi. YIU Saglik Bil Derg. Aralık 2023;4(3):76-83.

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