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Selected risks in nursing practice
HLADÍKOVÁ, Šárka
Current state: High percentage of risk is associated with providing medical care and therefore it may harm both the patient and the nursing staff (Drahoš, 2007). Objectives: To assess the most frequent risks in nursing care that may harm patients during their hospitalization. Furthermore, the aim is to find out whether the occurrence of these risks changes depending on the type of care provided and also whether the nurses' understanding of the principles of administration of oral medication is affected by the length of their work experience. Methods: The empirical part of this thesis was based on the quantitative research study - data collection method via structured questionnaires. The study was then supplemented by observation of nurses using the audit technique. The research group-participants: The questionnaire was designed for general nurses working in selected wards of Ceske Budejovice Hospital, plc. During the Semester-in-Practice Externship, six nurses in 'The administration of oral medication'audit. Results: The result of the aritmetic mean, results in the nurses stating the risk of fall in patients as the highest risk (3,56), risk of medication error (3.01). According to the addressed nurses from the internal department, the following risks belong to the group of the most significant risks to the patients of the internal department- risk of injury to the patient during hospitalization, risk of nosocomial infection, risk of falls in patient and risk of immobilization syndrome. According to the questionnaire research results, some differences were shown in the knowledge of principles of safe administration of oral medication in connection with the length of work experience of the addressed nurses. Nurses with the longest practise (over 11years) most frequently chose the correct answer in the following parts: expired drug usage and checks, medical refrigeration temperature, preparation and disposal of left-over medication, how to care for tablet splitter, correct action taken when a patient refuses to take medication and filling in the daily medication report. On the other hand, nurses with practise of 5-10 years more often correctly answered questions regarding drug administration system, safe usage of medical trolley cart and optimum storage conditions in medicine fridge. Nurses with the shortest work experience (under 5 years) proved to have the weakest knowledge of administration of oral medication. A conclusion that can be drawn from the audit results is as follows: the most common errors committed by the nurses are usage of generic drugs, lack of hand disinfection, touching medication with bare hands, preparation of meds in corridors instead of at the patient's hospital bed and incorrect drug disposal when the left-over tablets were put back in the packet. Conclusion: From the statistically significant connection between the probability of the risk and the department (type of care), it came to light that risk of injury to patients during their hospitalization, risk of nosocomial infection, risk of falls in patient, risk of immobilization syndrome and risk of aggressive behaviour are more common risks in internal wards rather than in surgical wards. Nurses with work experience over 11 years proved to have the best knowledge of principles of safe administration of oral medication. The audit proved that despite their good knowledge of safe drug administration procedures, the nurses do not always follow these in the workplace. My thesis is a proposal for standard care procedure 'administration of oral medication'.
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