Perinatal Hasta Güvenliği ve Hemşirelik Yaklaşımı

Perinatal dönemde maternal, fetal ve yenidoğan güvenliğinin sağlanması tüm sağlık çalışanları için ortak bir hedeftir. Büyük çoğunluğunu genç sağlıklı kadınların oluşturduğu perinatal dönemde anne ve bebekle ilgili istenmeyen olumsuz bir durum çok yıkıcı bir sonucu beraberinde getirebilir. Bu sebeple perinatoloji alanında anne ve bebek güvenliği uygulamaları öncelikli olmalıdır. Kimliklendirme hataları, iletişim problemleri, ilaç güvenliği hataları ve düşmeler perinatal hasta güvenliği sorunlarının başında gelmektedir. İyi bir ekip eğitimi, etkili iletişim, simülasyon uygulamaları, fetal izlem eğitimi, mesleki davranışları ve güvenlik kültürü geliştirme çalışmaları, rol playler, klinik yönergeler ve kontrol listeleri hasta güvenlik uygulamalarının kilit bileşenlerini oluşturmaktadır. Çağdaş perinatoloji uygulamalarında hemşirelik bakımının temel bileşenlerinden biri de hastaların güvenliğini sağlamaktır. Perinataloji hemşiresi hasta güvenliği ile ilgili bilgilerini güncel tutarak, klinik sonuçları izleyerek, ekip çalışmasında aktif rol alarak ve güvenilir bir rol modeli olarak hasta güvenliğine katkıda bulunabilir. Bu derleme, perinatal hasta güvenliğinin güncel klinik yönergeler, standart protokoller aracılığıyla ele alınması ve perinatoloji uygulamalarında aktif rol alan hemşirelerin rollerini belirtmek amacıyla yazılmıştır.

Anahtar Kelimeler:

perinatoloji, hasta güvenliği, hemşire, tıbbi hata, profesyonel rol

Perinatal Patient Safety and Nursing Approach

Ensuring maternal, fetal and neonatal safety in the perinatal period is a common goal for all healthcare professionals. In the perinatal period, which is mostly formed by young healthy women, an undesirable negative situation about the mother and baby can bring a very devastating result. For this reason, mother and baby safety practices should be a priority in perinatology. Identification errors, communication problems, medication safety errors and falls are the main perinatal patient safety problems. Good team training, effective communication, simulation practices, fetal follow-up training, professional behavior and safety culture development studies, role plays, clinical guidelines and checklists constitute the key components of patient safety practices. One of the basic components of nursing care in contemporary perinatology practices is to ensure the safety of patients. Perinatal nurse can contribute to patient safety by keeping their knowledge about patient safety up-to-date, monitoring clinical results, taking an active role in teamwork and as a reliable role model. This review was written to address perinatal patient safety through current clinical guidelines, standard protocols, and to indicate the roles of nurses taking an active role in perinatology practices.

Keywords:

Perinatalogy, patient safety, medical error, nurse, professional role,

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American College of Obstetricians and Gynecologist Committee on Patient Safety and Quality Improvement. (2014). Committee opinion no. 590: Preparing for clinical emergencies in obstetrics and gynecology. Obstetrics & Gynecology, 123(3), 722-725.
Arora KS, Shields L, Grobman WA, D’Alton ME, Lappen JR, Mercer BM. (2016). Triggers, bundles, protocols, and checklists-what every maternal care provider needs to know. American Journal of Obstetrics and Gynecology, 214(4), 444-451.
Bernstein PS, Martin JN, Barton JR, Shields LE, Druzin ML, Scavone BM, et al. (2017). National partnership for maternal safety: consensus bundle on severe hypertension during pregnancy and the postpartum period. Anesthesia & Analgesia, 25(2), 540-547.
Bilgiç D, Şahin NH. (2018). Obstetride hasta güvenliği ve hemşirenin rolü. Türkiye Klinikleri Doğum Kadın Sağlığı ve Hastalıkları Hemşireliği Özel Konular, 4(2), 118-130.
Bonacquisti A, Cohen MJ, Schiller CE. (2017). Acceptance and commitment therapy for perinatal mood and anxiety disorders: Development of an inpatient group intervention. Archives of Women's Mental Health, 20(5), 645-654.
Brown HL. (2017). Quality and safety in obstetrics and gynecology. Clinical Obstetrics and Gynecology, 60(4), 818-828.
Cappadona R, Di Simone E, De Giorgi A, Boari B, Di Muzio M, Greco P, et al., (2020). Individual circadian preference, shift work, and risk of medication errors: A cross-sectional web survey among ıtalian midwives. International Journal of Environmental Research and Public Health, 17(16), 5810-5822.
Cicero MX, Adelgais K, Hoyle JD, Lyng JW, Harris M, Moore B, et al., (2020). Medication dosing safety for pediatric patients: recognizing gaps, safety threats, and best practices in the emergency medical services setting. A position statement and resource document from NAEMSP. Prehospital Emergency Care, 1-13.
Committee on Obstetric Practice. (2017). Committee opinion no. 692: Emergent therapy for acuteonset, severe hypertension during pregnancy and the postpartum period. Obstetrics & Gynecology, 129(4), 90-95.
D’Alton ME, Main EK, Menard MK, Levy BS. (2014). The National partnership for maternal safety. Obstetrics & Gynecology, 123(5), 973-977.
D'alton ME, Friedman AM, Smiley RM, Montgomery DM, Paidas MJ, D'oria R, et al. (2016). National partnership for maternal safety: Consensus bundle on venous thromboembolism. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 45(5), 706-717.
De Rezende HA, Melleiro MM, Shimoda GT. (2019). Interventions to reduce patient identification errors in the hospital setting: a systematic review protocol. JBI Database of Systematic Reviews and Implementation Reports, 17(1), 37-42.
Demir S, Şahin N. (2014). Perinatal hasta güvenliğinde hasta teslimi: Kullanılan iletişim teknikleri. Koç Üniversitesi Hemşirelikte Eğitim ve Araştırma Dergisi, 11(3), 32-37.
DiCuccio MH. (2015). The relationship between patient safety culture and patient outcomes: A systematic review. Journal of Patient Safety, 11(3), 135-142.
Esencan TY, Aslan E. (2015). Jinekoloji ve obstetride tıbbi hatalar ve hasta güvenliği. Sağlık ve Hemşirelik Yönetimi Dergisi, 3(2), 152-161.
Evcili F, Gölbaşı Z. (2020). Perinatal hasta güvenliği: Kavramsal çerçeveden hemşirelik yaklaşımlarına. Türk Fen ve Sağlık Dergisi, 1(1), 14-28.
Heafner L, Suda D, Casalenuovo N, Leach LS, Erickson V, Gawlinski A. (2013). Development of a tool to assess risk for falls in women in hospital obstetric units. Nursing for Women's Health, 17(2), 98-107.
Henneman PL, Fisher DL, Henneman EA, Pham TA, Campbell MM, Nathanson BH. (2010). Patient identification errors are common in a simulated setting. Annals of Emergency Medicine, 55(6), 503-509.
Inanir A, Cakmak B, Hisim Y, Demirturk F. (2014). Evaluation of postural equilibrium and fall risk during pregnancy. Gait Posture, 39, 1122–1125.
International Council of Nurses-ICN. (2006). Safe staffing saves lives. International Nurses Day. Information and Action Tool Kit. Geneva: Switzerland, p. 3-60.
James D, Jukkala A, Azuero A, Auutrey P, Vining L, Miltner R. (2013). Development of the medical intensive care unit shift report communication scale as a measure of nurses’ perception of communication. Nursing: Research and Review,3, 59-65.
Kendig S, Keats JP, Hoffman MC, Kay LB, Miller ES, Simas M, et al. (2017). Consensus bundle on maternal mental health: Perinatal depression and anxiety. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 46(2), 272-281.
Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. (2006). WHO analysis of causes of maternal death: A systematic review. Lancet, 367, 1066-1074.
Kiymaz D, Koç Z. (2018). Identification of factors which affect the tendency towards and attitudes of emergency unit nurses to make medical errors. Journal of Clinical Nursing, 27(5-6), 1160-1169.
Korkmaz AÇ. (2018). Geçmişten günümüze hasta güvenliği. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 6(1), 10-19.
Lipke B, Gilbert G, Shimer H, Consenstein L, Aris C, Ponto L, et al., (2018). Newborn safety bundle to prevent falls and promote safe sleep. MCN: The American Journal of Maternal/Child Nursing, 43(1), 32-37.
Mackintosh N, Rance S, Carter W, Sandall J. (2017). Working for patient safety: a qualitative study of women's help-seeking during acute perinatal events. BMC Pregnancy Childbirth, 17(1):232-245.
Main EK, Goffman D, Scavone BM, Low LK, Bingham D, Fontaine Pl, et al., (2015). National Partnership for Maternal Safety: Consensus bundle on obstetric hemorrhage. Anesthesia & Analgesia, 121(1), 142-148.
Martijn LL, Jacobs AJ, Maassen II, Buitendijk SS, Wensing MM. (2013). Patient safety in midwifery-led care in the Netherlands. Midwifery, 29(1), 60-66.
McCrory JL, Chambers AJ, Dafary A, Redfern MS. (2011). Ground reaction forces during gait in pregnant fallers and non-fallers. Gait Posture 34, 524-528.
McCrory JL, Chambers AJ, Dafary A, Redfern MS. (2013). Ground reaction forces during stair locomotion in pregnancy. Gait Posture 38, 684-690.
Mei Q, Gu Y, Fernandez J. (2018). Alterations of pregnant gait during pregnancy and post-partum. Scientific Reports, 8(1), 1-7.
Mujundar S, Santos D. (2015). Teamwork and communication: An effective approach to patient safety. HMA, 50(1), 19-22.
Nash L, Dixon R, Eaton V, Grzeskowiak LE. (2015). Accuracy of information on medication use and adverse drug reactions recorded in pregnancy hand-held records. The Australian and New Zealand Journal of Obstetrics and Gynaecology, 55(6):547-51.
Nathan AT, Kaplan HC. (2017). Tools and methods for quality improvement and patient safety in perinatal care. Seminars in Perinatology, 41(3), 142-150.
Newsome J, Martin JG, Bercu Z, Shah J, Shekhani H, Peters G. (2017). Postpartum hemorrhage. Techniques in Vascular & Interventional Radiology, 20(4), 266-273.
Raab C, Palmer-Byfield R. (2011). The perinatal safety nurse: Exemplar of transformational leader-ship. MCN: The American Journal of Maternal/Child Nursing, 36(5), 280-287.
Rosenbloom JI, Sabol BA, Chung C, Macones GA, Rampersad RM, Cahill AG, et al., (2019). Improving medication error identification with an inpatient maternal-fetal medicine pharmacist. American Journal of Obstetrics and Gynecology, 220(6), 602-603.
Schaefer C. (2018). Drug safety in pregnancy-a particular challenge. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 61(9), 1129-1138.
Shields LE, Wiesner S, Klein C, Pelletreau B, Hedriana HL. (2017). Early standardized treatment of criticalblood pressure elevations is associated with a reduction in eclampsia and severe maternal morbidity. American Journal of Obstetrics and Gynecology, 216(4), 415-420.
Simpson KR. (2011). Perinatal patient safety and quality. Journal of Perinatal & Neonatal Nursing, 25(2), 103-107.
Simpson KR. (2015). Newborn safety in the hospital. MCN: The American Journal of Maternal/Child Nursing, 40(4), 272.
Şenoğlu A, Taşpınar A, Karaçam Z. (2020). Doğum ve doğum sonu dönemde hasta güvenliği ve ebelerin sorumlulukları. Mustafa Kemal Üniversitesi Tıp Dergisi, 11(40), 66-73.
Tuğrul E, Khorshid L. (2015). Hemşirelerin önemli işlevlerinden biri: hasta teslimi. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 31(1), 95-107.
World Health Organization (WHO). (2018). Maternal mortality. Erişim tarihi: 06.09.2020, http://www.who. int/news-room/fact-sheets/detail/maternal-mortality.
World Health Organization (WHO). (2017). Patient safety: making health care safer. Erişim tarihi: 16.08.2020, https://apps.who.int/iris/handle/10665/255507.
Yıldız FT, Yıldız İ. (2020). Hemşirelerin ilaç uygulama hatalarına yönelik bilgi ve tutumlarının değerlendirilmesi. Türk Fen ve Sağlık Dergisi, 1(1), 29-41.
Yu M, Lee HY, Sherwood G, Kim E. (2018). Nurses' handoff and patient safety culture in perinatal care units: Nurses' handoff evaluation and perception of patient safety culture at delivery room and neonatal unit in South Korea. Journal of Clinical Nursing, 27(7-8), 1442-1450.