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Sjuksköterskors uppfattningar om avvikelser och avvikelserapportering inom vården: en kvalitativ studie
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2012 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Syfte: Att undersöka sjuksköterskors uppfattningar om avvikelser i vården och om bakomliggande orsaker till dessa samt inställningar till avvikelserapportering och -hantering. Studien syftade även till att undersöka uppfattningar om hur nyanställda sjuksköterskor påverkas av rådande inställningar till detta på en vårdavdelning. Metod: Kvalitativ metod med explorativ design. Bekvämlighetsurval tillämpades och data samlades in med hjälp av semistrukturerade intervjuer med sex sjuksköterskor från en medicinsk vårdavdelning på ett svenskt universitetssjukhus. Dataanalysen genomfördes med fenomenografisk metod. Resultat: Sjuksköterskornas generella uppfattningar om förekommande avvikelser inom vården kan sammanfattas som säkerhetsbrister för patienter och personal. Orsakerna till avvikelser kan indelas i flera kategorier varav ”hög arbetsbelastning” är den mest omfattande. Närapå samtliga orsaker kan härledas till brister i organisation och/eller ledning. Att avvikelser inträffar anses allvarligt men mänskligt och ofrånkomligt. Sjuksköterskorna har olika attityder till avvikelserapportering t.ex. att man ser det som ett led i förbättringsarbetet eller utser syndabockar. Generellt uppfattas att avvikelser underrapporteras. Ett antal faktorer såsom graden av säkerhetsrisk, tidsbrist samt tvivel på uppföljning uppfattas som avgörande för om man väljer att rapportera en avvikelse eller inte. Sjuksköterskorna efterfrågar feedback och information om rapporterade avvikelser. Nyanställda sjuksköterskor uppfattas påverkas starkt av andra sjuksköterskor gällande attityder till avvikelser såväl som avvikelserapportering.

Abstract [en]

Aim: To examine nurses' opinion about errors in their profession and the underlying causes of these. A further aim was to study attitudes towards error reporting and to examine whether more experienced colleagues’ opinion concerning error making and error reporting had any effect on newly employed inexperienced nurses. Methods: The study was qualitative with an explorative design. Convenience sampling was applied and data was collected by semi-structural interviews. Six nurses from a medical care unit participated in the study and data was analyzed with a phenomenographic method. Results: The major category of nurses' views about error making included lack of patient safety and working environment issues is another category. It could all be summed up in one major category called ”lack of safety” including both patients and personnel. Several categories were identified as causes of error making, among those high workload is the most frequently mentioned cause. Nearly all of the causes can be traced to lacking in organization and/or management. The fact that errors occur are regarded as severe but human and inevitable. Several attitudes towards reporting errors were emerged from the data, for example regarding it as a tool of improvement work or finding scapegoats. The most common view was that errors are underreported and a number of factors regarding nurses' willingness to report the errors were found, for example severeness of the error, lack of time and doubt in follow up. Nurses wished to get feedback and information about reported errors. Inexperienced nurses were highly influenced by their senior colleagues concerning both error making and error reporting.

Place, publisher, year, edition, pages
2012. , 42 p.
Keyword [en]
quality of care, patient safety, error making, error reporting, nurse
Keyword [sv]
vårdkvalitet, patientsäkerhet, avvikelser, avvikelserapportering, sjuksköterska
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-176926OAI: oai:DiVA.org:uu-176926DiVA: diva2:537835
Subject / course
Caring Sciences
Educational program
Freestanding course
Uppsok
Medicine
Supervisors
Examiners
Available from: 2012-06-28 Created: 2012-06-27 Last updated: 2012-06-28Bibliographically approved

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