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Paramount to patient safety is the ability for nurses to make clinical decisions free from human error. Yet, the dynamic clinical environment in which nurses work is characterized by uncertainty, urgency, and high consequence, necessitating that nurses make quick and critical decisions. The aim of this study was to examine the influence of human and environmental factors on the decision to administer among new graduate nurses in response to alert generation during bar code-assisted medication administration. The design for this study was a descriptive, longitudinal, observational cohort design using EHR audit log and administrative data. The study was set at a large, urban medical center in the United States and included 132 new graduate nurses who worked on adult, inpatient units. Research variables included human and environmental factors. Data analysis included descriptive and inferential analyses. This study found that participants continued with administration of a medication in 90.75% of alert encounters. When considering the response to an alert, residency cohort, alert category, and previous exposure variables were associated with the decision to proceed with administration. It is important to continue to study factors that influence nurses' decision-making, particularly during the process of medication administration, to improve patient safety and outcomes.
Assuntos
Educação de Pós-Graduação em Enfermagem , Adulto , Humanos , Análise de Dados , Hospitais , Pacientes Internados , Segurança do PacienteRESUMO
A family history of substance problems is a well-known risk factor for substance use and use disorders; however, much of this research has been conducted in studies with predominantly White subjects. The aim of this study was to examine the associations between family history density of substance problems and drug use, risk for drug use disorder, and prescription drug misuse in a sample of African American adults. Results indicate that family history density of substance problems increased the risk for all drug outcomes in the full sample. However, when subgroup analyses by gender were conducted, family history was not a risk factor among men for prescription drug misuse.
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Educational strategies that allow students to experience patient care in both rural and urban settings are imperative to the recruitment and retention of nurses for medically underserved populations or health professional shortage areas. Two state schools of nursing (one urban-oriented and one rural-oriented) in the Mid-Atlantic region were awarded Health Resources and Service Administration (HRSA) project funding to educate nursing students and registered nurses in community-based primary care settings. This article will discuss an innovative rural-urban baccalaureate nursing student exchange model intended to increase understanding of enhanced RN roles in community-based primary care settings. Two project teams collaborated to create a new learning model, a rural-urban exchange, by implementing a Primary Care Camp. The camp included shared didactic content, reflection exercises, historical and cultural considerations, and clinical immersion to allow students in both programs to have on-site rural and urban learning experiences. Faculty collected informal voluntary student feedback through a debrief after their Primary Care Camp experience to assess their understanding of the enhanced RN Role in primary care and how it may affect their future nursing practice. Student feedback suggests that the students met project goals and appreciated the rural and urban exchange experience. This project is an innovative approach that offers guidance for implementing primary care education in a way that supports the current primary care RN role, builds the future workforce, and provides suggestions for replicability.