看護師長による医療事故当事者および看護チームへの支援—チームで取り組む再発防止

Support of Nurse Managers for Nurses Involved in Adverse Patient Events: Working on Patient Safety Tasks as a Team

要旨

目的：看護師長による医療事故当事者，看護チームへの支援の構造とプロセスを明らかにする．

方法：医療事故当事者，看護チームの支援に関わった経験のある看護師長26名が研究参加者となった．Grounded theory approachに基づくデータ収集とデータ分析を行った．

結果：【チームで取り組む再発防止】をコアカテゴリーとし，《事故に関する情報の伝達》，《チーム内に生じる反応の把握》，《チーム全体の安心感の保証》《チームで乗り越えるための方向づけ》，《事故の乗り越えの後押し》，《患者の安全の脅かし》という7つのカテゴリーから構成される支援プロセスが明らかになった．

考察：医療事故は看護チーム全体に心理的影響を与え得るものであり，再発防止の取り組みだけでなく，チーム内に生じる反応を把握しながら，スタッフの心理的な安心感を保証し，チームで困難を乗り越えるための支援の重要性が示唆された．

　The purpose of this study was to clarify the structure and processes of nurse manager support for their staff nurses after adverse patient events. Participants were 26 nurse managers. Semistructured interviews were conducted and data were analyzed by a grounded theory approach. The core category that emerged from this study was “working on patient safety tasks as a team.” The other categories that emerged from the data included “sharing information and discussing the events with staff nurse,” “perceiving the reactions of all team members,” “assuring a sense of security,” “directing nurses on how to address difficulties,” “threatening patients safety,” and “supporting nurses involved in overcoming their experience.” These findings suggested the psychological impact of adverse patients events on staff nurses, and the necessity not only to work on a task-oriented approach to assure patients safety, but also to assure a sense of security for all staff nurses.