ABSTRACT
AIM: To describe the frequency and types of near misses and the recovery strategies employed by nurses in primary health care. BACKGROUND: Insufficient data are available on the role of nurses in near miss events and related factors in primary health care. METHOD: A prospective descriptive study was carried out at one Urban Primary Health Care Centre, within the Málaga-Guadalhorce Health District (Malaga, Spain), from January to December 2018. Four of the ten nurses volunteered to take part. RESULTS: The nurses recovered 185 near misses, prevailing administrative or communication-related errors, followed by medication-related errors. No near misses were reported on the centre's anonymous error information platform. CONCLUSIONS: A significant number of near misses occurred which could have been avoided with better communication among health care personnel. A striking finding is the failure to inform the health centre, which suggests that improvements in safety culture are needed. IMPLICATIONS FOR NURSING MANAGEMENT: It is the responsibility and the duty of nursing management to be aware of the characteristics and frequency of near misses in primary health care, to implement strategies for improvement and to foster a culture in which the necessary information on actual or potential errors is supplied.
Subject(s)
Medication Errors , Safety Management , Humans , Medical Errors , Primary Health Care , Prospective Studies , SpainABSTRACT
Objetivos. Determinar la concordancia entre la valoración que el cuidador hace sobre encontrar o no dificultad para desempeñar el papel de cuidador y la valoración de la enfermera. Medir el grado de cansancio de una manera cuantitativa y establecer el punto de corte que magnifique los valores predictivos de esta medida con los medios diagnósticos anteriores. Determinar la asociación entre las características definitorias y los factores relacionados de la North American Nursing Diagnosis Association (NANDA) con la presencia de cansancio. Método. Estudio analítico transversal sobre los cuidadores de personas discapacitadas de una zona básica de salud. Muestra aleatoria simple de 49 sujetos. El grado cuantitativo de cansancio se midió con el cuestionario de Zarit; la concordancia con el índice kappa y la asociación con el test de Spearman. Resultados. La concordancia entre la valoración es de 0,54. El cuestionario de Zarit presenta un punto de interés: 43/44. Encontramos asociación entre el diagnóstico y 4 características definitorias y 5 factores relacionados. Conclusiones. La concordancia entre la valoración de la cuidadora y de la enfermera es moderada. Las cuidadoras con más de 43 puntos en la escala de Zarit estarían cansadas con una alta probabilidad. Para minimizar la incertidumbre diagnóstica es importante la valoración de las características definitorias y los factores relacionados que presentan asociación positiva con el diagnóstico
We analyze difficulties in making a diagnosis of caregiver role strain and aim to suggest improvements in nursing interventions. Aims. To determine the concordance between evaluations made by caregivers and nurses on role strain. To quantitatively measure subjective burden and establish a cut-off point to increase predictive values. To determine the associations among defining characteristics and factors related to caregiver role strain. Method. We performed an analytical, cross-sectional study of the care providers of persons with loss of mobility in a basic health area. Forty-nine subjects were selected by simple random sampling. Quantitative measurement of the degree of strain was measured using the Zarit Burden Interview (ZBI). The concordance between determinations was measured using the kappa statistic and associations were measured using Spearman's test. Results. The concordance between caregivers' and nurses' evaluations was 0.54. The ZBI presented a cut-off point of 43/44. Associations were found among the diagnosis and four defining characteristics and five strain-related factors. Conclusions. Moderate concordance was found between caregivers' and nurses' evaluations. Caregivers with a score of more than 43 points on the ZBI had a high probability of experiencing strain. To minimize diagnostic uncertainty, defining characteristics and strain-related factors should be evaluated
