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論文
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Yuno, Noriyo ; Kato, Mayumi ; Miyasaka, Michio ; Taniguchi, Yoshimi ; 油野, 規代 ; 加藤, 真由美 ; 宮坂, 道夫 ; 谷口, 好美
概要:
Background and Purpose: When a medical accident occurs, risk managers must respond, and because there is no time for the
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m to take adequate physical and mental rest, they become exhausted. On the other hand, risk managers with nursing experience perform their duties based on nursing management expertise and skills, using the ability to build interpersonal relationships that they have cultivated in the course of their nursing duties. However, the competency with which nurses perform their duties in response to accidents has not been clarified. The purpose of this study was to identify the types of competencies demonstrated by risk managers in responding to medical accidents． Methods: We conducted unstructured interviews with seven nurse risk managers in seven acute hospitals, and their responses were reviewed. Narrative analysis was used in this study. Theme analysis was performed using structural analysis elements defined by Riessman. Results: Six themes were identified as competencies used in responding to medical accidents, namely: “the ability to get to the heart of the problem,” “the ability to identify the lead clinician,” “the ability to have sympathy in responding to the patient and family members,” “the ability to arrange opportunities for all parties involved in saving the patient’s life,” “the ability to introduce the perspective of care in a situation in which all parties involved refuse to compromise, ” “the ability to not be controlled by emotions and maintain objectivity.” Conclusion: The competencies demonstrated by nurse risk managers in responding to medical accidents were based on the nursing philosophy of responding to medical accidents with patient-centered care, and drew on nursing management skills accumulated through experience as a nurse manager. It is necessary to develop a training system for developing human resources capable of using nursing skills to respond to medical accidents.
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論文
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北岡-東口, 和代
概要:
本研究は, 精神科勤務の看護者のバーンアウトと医療事故との因果関係を検討したものである. 精神科を主とする16病院に勤務する全看護者1,684名を対象に自己記入式質問紙調査を行い, 1,295名の有効データを得た. データ収集は研究用日本版
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Maslach Burnout Inventory-General Survey, 臨床看護職者の仕事ストレッサー測定尺度, General Coping Questionnaire特性版, 医療事故に関する質問紙を用いて行った. 最終的に仕事ストレッサー, コーピングスタイル, バーンアウトと医療事故との関係を示した因果関係モデルが構築され, 次のことが示唆された. 仕事量の多さや患者との関係に由来する負担感や葛藤が続くと, バーンアウトの最初の現象である疲弊感が生じる. この疲弊感は, シニシズム的態度というバーンアウトの次の現象を生む. 患者に対する冷淡で無関心な態度は患者関係にうまく対応できない看護者で特にみられるが, 職場の上司や同僚関係に悩んでいる看護者もそのような態度に陥りやすくなると考えられた. 看護者のこのようなバーンアウト状態が医療事故発生を導く. 特に感情表出型のコーピングスタイルをとる看護者はバーンアウトに陥りやすく, 医療事故発生に繋がりやすい集団と考えられた.
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