BİR EĞİTİM VE ARAŞTIRMA HASTANESİNDE İŞ YÜKÜNÜN HASTA GÜVENLİĞİ ÜZERİNDEKİ ETKİSİNİN BELİRLENMESİ
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2011-07-26
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Araştırmanın amacı; kamuya ait bir eğitim ve araştırma hastanesinde iş yükünün,
hasta güvenliği üzerinde etkisinin belirlenmesi ve iş yüküne bağlı olarak tıbbi
hatalarının meydana gelme sıklıklarının saptanmasıdır.
Araştırmanın evrenini, Ankara İli’nde bulunan Ankara Çocuk Sağlığı ve
Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesi’nin amaçlı
örneklem yöntemi ile seçilen, birbirinden farklı özelliklere sahip dört ayrı
kliniğindeki toplam 73 hemşire ve hemşirelerin bildirdikleri hasta güvenliğini tehdit
eden tüm olay bildirimleri oluşturmaktadır. Araştırma 16 Haziran 2009- 16 Eylül
2009 tarihleri arasında yapılmıştır. Araştırmanın verileri, benzer çalışmalarda
kullanılan, alanyazın ve uzman görüşü alınarak hazırlanan toplam dört ayrı formla
toplanmıştır. Araştırma sonucu iş yükü ile elde edilen veriler Excel programında,
hata bildirimi ile elde edilen veriler ise SPSS 13.0 programında analiz edilmiştir.
Araştırma kapsamında 3 aylık süre boyunca, dört ayrı klinikte toplam 7619
hastaya, 108 yatak kapasitesi ile 55 aktif çalışan hemşire tarafından bakım hizmeti
verilmiştir. Yoğun Bakım Ünitesi’nde 24 saat içinde hastaya verilen bakım saati
10,4, Süt Çocuğu Servisi’nde 2,0, Büyük Çocuk 2 Servisi’nde 2,1, Hematoloji
Onkoloji Servisi’nde ise 3,0 olarak bulunmuştur. Hasta bağımlılık düzeyine göre
verilmesi gereken 24 saatlik bakım saatleri, Yoğun Bakım Ünitesi’nde 19,7, Süt
Çocuğu Servisi’nde 13,5, Büyük Çocuk 2 Servisi’nde 9,5, Hematoloji Onkoloji
Servisi’nde ise 10,3 olarak saptanmıştır. Hasta bağımlık düzeyine göre verilmesi
gereken bakım saati üzerinden yapılan hesaplamalarda, birimlerde çalışması gereken
toplam hemşire sayısı 205 olarak bulunmuştur.
Araştırmada, toplam 236 hata bildirimi alınmıştır. Hataların türlerine göre
dağılımı incelendiğinde, tanı ve bakım süreci hatalarının %68,7, ilaç hatalarının
%29,6, düşmelerin ise %1,7 oranında gözlendiği saptanmıştır. Hatalar, risk
derecelerine göre 2 ile 5 arasında sınıflandırılmış ve hataların %59,2’sinin hemşirelik
hizmetlerini dolaylı etkileyen, %40,7’sinin ise hemşirelik hizmetlerini doğrudan
etkileyen nedenlerle ilişkilendirildiği belirlenmiştir. Hata risk dereceleri ile servisler
arasında ve hata risk dereceleri ile hasta bağımlılık düzeyleri arasında anlamlı
istatistiksel ilişki bulunmuş, hata risk dereceleri ile çalışma saatleri arasında ve
bakılan hasta sayısı arasında anlamlı istatistiksel ilişki bulunamamıştır.
Description
DETERMINATION OF WORKLOAD’S EFFECT ON PATIENT SAFETY IN
A TRAINING AND RESEARCH HOSPITAL
ABSTRACT:The aim of the study is determination of workload’s effect on patient safety and to indicate the occurence frequency of medical errors depending on workload. The population of study is 73 nurses selected four seperate clinic which are different features and selected with purposeful sampling method of Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH in Ankara, and all event notifications threatening patient safety and to be informed by nurses. This research was made between June 16,2009 – September 16, 2009. The data was collected with four separate form prepared with expert options and literature and used in similar studies. The workload data obtained from the research was analyzed in Excel program and the error notifications data obtained from the research was analyzed in SPSS 13.0. Patient care service has been given to 7619 patients with 108 bed in four different clinics during 3 months period by 55 active working nurses within this research. It was found that patient care hours in 24 hours is 10,4 in intensive care unit, 2,0 in nursling service (2 years of age from one month), 2,1 in older child (2) service and 3,0 in hematology and oncology service. And also the patient care hours which must be given according to the level of patient dependency in 24 hours was determined like this: 19,7 in intensive care unit, 13,5 in nursling service, 9,5 in older child (2) service and 10,3 in hematology and oncology service. Calculations which was made on patient care hours which must be given according to the level of patient dependency was showed that the number of required nurses was 205. In this study, total 236 event reports was given. When distribution of errors’ types were examined, it was observed that the errors ratio in diagnosis and treatment process is 68,7 %, in medication 29,6 % and in falls 1,7 %. Errors were classified according to their degree of risk between 2 – 5. And also it was observed that 59,2 % of errors were associated with causes indirectly effect on nursing care and 40,7% of them were associated with causes directly effect on nursing care. It was found that significant statistical relationship between levels of patient dependency and error risk degree, and service and error risk degree. Altough there wasn’t significant statistical relationship between error risk degree and working hours, and error risk degree and number of cared patients.
ABSTRACT:The aim of the study is determination of workload’s effect on patient safety and to indicate the occurence frequency of medical errors depending on workload. The population of study is 73 nurses selected four seperate clinic which are different features and selected with purposeful sampling method of Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji EAH in Ankara, and all event notifications threatening patient safety and to be informed by nurses. This research was made between June 16,2009 – September 16, 2009. The data was collected with four separate form prepared with expert options and literature and used in similar studies. The workload data obtained from the research was analyzed in Excel program and the error notifications data obtained from the research was analyzed in SPSS 13.0. Patient care service has been given to 7619 patients with 108 bed in four different clinics during 3 months period by 55 active working nurses within this research. It was found that patient care hours in 24 hours is 10,4 in intensive care unit, 2,0 in nursling service (2 years of age from one month), 2,1 in older child (2) service and 3,0 in hematology and oncology service. And also the patient care hours which must be given according to the level of patient dependency in 24 hours was determined like this: 19,7 in intensive care unit, 13,5 in nursling service, 9,5 in older child (2) service and 10,3 in hematology and oncology service. Calculations which was made on patient care hours which must be given according to the level of patient dependency was showed that the number of required nurses was 205. In this study, total 236 event reports was given. When distribution of errors’ types were examined, it was observed that the errors ratio in diagnosis and treatment process is 68,7 %, in medication 29,6 % and in falls 1,7 %. Errors were classified according to their degree of risk between 2 – 5. And also it was observed that 59,2 % of errors were associated with causes indirectly effect on nursing care and 40,7% of them were associated with causes directly effect on nursing care. It was found that significant statistical relationship between levels of patient dependency and error risk degree, and service and error risk degree. Altough there wasn’t significant statistical relationship between error risk degree and working hours, and error risk degree and number of cared patients.
Keywords
business