Medication Safety in ICU through the Eyes of Nursing Practitioners: A Restorative Approach

Thursday, 15 July 2010

Fernanda R. E. Gimenes
Department of Nursing Generality and Specialized, University of Sao Paulo at Ribeirao Preto College of Nursing, Ribeirão Preto, Brazil
Silvia H. De Bortoli Cassiani, DNS, RN
Department of Nursing Generality and Specialized, University of São Paulo at Ribeirão Preto, College of Nursing, Ribeirao Preto, Brazil
Patricia B. Marck, PhD
Faculty of Nursing, University of Alberta, Edmonton, AB, Canada

Learning Objective 1: The learner will be able to understand visual research methods to study medication safety on one Brazilian intensive care unit with practicing nurses.

Learning Objective 2: The learner will be able to learn about an innovative methodological approach for identifying and studying risk and safety in health care environments.

Purpose: To analyze the medication safety on one Brazilian intensive care unit with practicing nurses. 

Methods: Adapting from previous work in ecological restoration and nursing, we will use focus groups, environmental photo walkabouts, photo narration and photo elicitation in iterative phases of data collection and analysis to study medication safety with ICU nursing staff. In Phase 1, semi-structured, tape recorded focus groups will be conducted and analyzed to identify issues related to medication safety in the study unit such as practices, rules and routines as well as physical environment and cultural practices where medication preparation and administration occur. In Phase 2, the principal investigator will use the Phase 1 findings as a starting point to conduct a tape recorded photo walkabout in the ICU environment with an experienced nurse to capture and narrate photos of the ICU environment related to medication safety. Following initial analysis of the Phase 2 data, in Phase 3, we will review unit photos and preliminary narrative themes with ICU practitioners in a second set of tape recorded focus groups. Using the images, emerging themes, and a Digital Photography Assessment Tool to elicit reflection and critical analysis of the situations identified in the photos, participants will be encouraged to discuss medication safety in the context of their work environment.

Results: It is anticipated that the findings will increase our understanding of barriers and facilitators to medication safety and help participants generate ideas for improving medication safety on their unit. Conclusion: A restorative approach to visual research methods allows practitioners, decision makers, educators, student, and researchers to study medication safety across countries and cultures and build common understandings of this complex, multifaceted safety concern in health care.