| Objectives:To investigate the current situation of nurses’ medication near-miss and to know the current status of reporting intention of nurses’ medication near-miss and explore the influencing factors:based on the social-ecological system theory.To guide for nursing managers to implement targeted interventions,and improve patient safety and hospital quality and safety management level.Methods:This study was a cross-sectional study.A convenience sampling method was used to select 2625 nurses in seven tertiary care hospitals in Jinan City from March 10,2021,to December 20,2021,to conduct a questionnaire survey.The study instruments were a general information questionnaire,near-miss reporting intention questionnaire,10-Item Personality Inventory-Chinese version(TIPI-C),Professional Self-Concept of Nurses Instrument(PSCNI),the barriers to medication near-miss reporting scale,Social Support Rating Scale(SSRS),Transformational Leadership Questionnaire(TLQ),and the Work Environment Questionnaire(WEQ).SPSS 26.0 was used for statistical analysis,and the main methods were:descriptive analysis,reliability analysis,Mann-Whitney U test,Kruskal-Wallis H test,Spearman’s correlation analysis,and hierarchical linear regression analysis.Results:1.Current status of nurses’ medication near-miss25.3%of nurses reported the experience of medication near-miss,of which 56.8%chose to report them,and the reporting method was mainly verbal(80.6%).Medication near-miss more often happened in the day shift(41.6%),concentrated between 10:00 to 16:00(36.7%),mainly in temporary medical prescriptions(55.0%)and long-term medical prescriptions(40.7%);the frequency of 0 to 1 time per three months was the highest at 90.7%;the types were mostly medication dispensing errors(37.2%)and prescription errors(21.1%),primarily due to overwork(32.8%),not strictly implementing the checking process(29.8%),and similarity appearance of the two drugs(17.0%).2.The status quo of nurses’ intention to report medication near-miss and its relationship with general informationThe median value score was 6(5,6)for the nurses’ intention to report medication near-miss,which was at a high level with significant differences in whether they were only-child,educational level,professional title,personnel relationship,work department,years in this department,years in nursing,work hours/week,and medication near-miss experience(all P<0.05).3.Factors influencing the reporting intention of nurses’ medication near-missHierarchical linear regression analysis results showed that only-child β=0.051,P=0.006),college or less degree(β=0.050,P=0.009),professional attitude β=0.124,P<0.001),social support(β=0.081,P<0.001),transformational leadership(β=0.052,P=0.016),and collegiality(β=0.066,P=0.030)had a significant positive predictive effect on the reporting intention of nurses’ medication near-miss;whereas had medication near-miss experience(β=-0.129,P<0.001),work department(ICU(β=-0.052,P=0.021)、outpatient and emergency(β=-0.046,P=0.023)and pediatrics(β=-0.068,P=0.001)and the medication near-miss reporting barriers(β=-0.161,P<0.001)were significant negative predictors.Conclusions:1.The prevalence of self-reported medication near-miss by nurses was low,the reporting rate was comparatively low,and the main method of reporting was verbal,while the reporting intention of medication near-miss among nurses was at a high level.2.The reporting intention of nurses’ medication near-miss was at a high level,which was influenced by experience with medication near-miss,only-child,work department(ICU、outpatient and emergency、pediatrics),college or less degree,the medication near-miss reporting barriers,professional attitudes,social support,transformational leadership,and collegiality.Nursing managers can strengthen the reporting intention of nurses’ medication near-miss by promoting the formation of transformational leadership styles in primary care managers,reducing barriers to reporting medication near-miss,improving professional attitudes,enhancing social support,etc. |
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