Khatere Khanjankhani, Tina Seirafi, Sajjad Bahariniya, Atefeh Ebrahimi, Seyed Masood Mousavi,
Volume 23, Issue 2 (8-2024)
Abstract
Background and purpose: Medication errors, which are more commonly committed by nursing staff compared to other hospital personnel, can lead to severe and sometimes irreparable complications for patients. This study aimed to investigate the factors contributing to medication errors among nurses in selected hospitals affiliated with Shahid Sadoughi University of Medical Sciences, Yazd.
Methods: This descriptive-analytical cross-sectional study was conducted in 2021. A total of 302 nurses were selected from four teaching hospitals affiliated with Yazd University of Medical Sciences. Data were collected using a standardized questionnaire designed to examine medication errors across three domains: managerial, human, and environmental factors. Data analysis was performed using t-tests, ANOVA, and Pearson's correlation coefficient with SPSS version 26 software.
Results: Managerial factors emerged as the most significant contributors to medication errors. The leading causes of errors within the managerial, human, and environmental domains were: nurse shortages relative to patient numbers (mean ± SD: 4.34 ± 2.44), fatigue due to workload (4.17 ± 0.98), and high work density during shifts (6–12 hours), respectively. A statistically significant relationship was observed between environmental factors and gender (p=0.008)
Conclusion: Strategies to mitigate fatigue from workload, such as balancing nurses' shifts and increasing staffing levels, are recommended to enhance nurses' performance and reduce errors. Additionally, developing standardized protocols, implementing continuous monitoring of medication administration, and fostering a culture of teamwork are critical in minimizing medication errors.
Fatemeh Sadat Vahabzadeh Moghadam, Ahmad Vedadi, Karam Allah Daneshfard,
Volume 23, Issue 3 (11-2024)
Abstract
Background and purpose: A fearless organization fosters psychological safety, ensuring that every member feels secure to express concerns, ask questions, or share mistakes without fear of humiliation, ridicule, or punishment. This research aims to introduce the Fearless Organization Model in Iran's healthcare sector, with a focus on the Ta’amin Ejtemaie hospitals.
Methods: This research employs a mixed-methods approach. In the qualitative phase, methods such as meta-synthesis, expert Delphi, and Shannon’s entropy were used to identify the components of a fearless organization. The quantitative phase involved structural equation modeling (using surveys distributed among the staff of Ta’amin Ejtemaie hospitals in Tehran) to validate the research model.
Results: The Fearless Organization Model consists of two main dimensions: “Behavioral” and “Structural.” The behavioral dimension includes "managers' behavioral components" and "employees' behavioral components." The structural dimension includes "organizational components," "human resource components," and "environmental components." Key characteristics of a fearless organization include: creating psychological security, openness, transparency, accountability, humble listening, quick employee feedback, learning from mistakes, encouraging knowledge sharing, avoiding silence, and promoting open communication. Effective response systems and coherent organizational structures for extracting ideas and concerns, as well as fostering a supportive culture, are essential.
Conclusion: The findings of this study emphasize the importance of addressing both behavioral and structural dimensions in creating a fearless organization. However, the behavioral dimension plays a more significant role than the structural one. Within the behavioral dimensions, "employee behavior" is the most crucial factor. Managers should focus on cultivating behaviors that promote security and openness within the organization. This research can serve as a foundation for further studies on the drivers and barriers to establishing fearless organizations in different contexts.
