Case study: using participatory photographic methods for the prevention of medication errors

ABSTRACT Objective: To describe the experience of using participatory photographic research methods to engage nurses and researchers in a collaborative study to improve medication safety conditions, particularly in patients with feeding tubes in a nursing home for the elderly (NHE). Method: This qualitative study was conducted in Brazil and proceeded in iterative phases of visual and textual data collection and analysis. Interviews, subsequent nurse-led photo-narrated walkabouts, and photo elicitation were used with nurses. Results: The need to transform the work design and the workplace to improve medication safety and improving medication processes through effective communication was identified. Unsafe workforce is a challenge in achieving safe medication administration practices; and lack of a patient safety culture is a barrier for adaptive learning and growth. Conclusion: Our findings demonstrated the effectiveness of a restorative research approach for supporting nurses to study and act on medication safety.

摘要
研究目的：阐述运用参与式摄影研究方法，推动护士与研究人员开展协作研究，以改善用药安全环境，尤其针对老年护理院（Nursing Home for the Elderly, NHE）内接受喂食管喂养的患者的实践经验。
研究方法：本定性研究于巴西开展，以迭代流程完成视觉与文本数据的收集及分析。研究针对护士群体采用了访谈、后续由护士主导的照片叙事式巡访，以及照片引出法（Photo Elicitation）三种研究手段。
研究结果：研究明确了需通过优化工作设计与工作环境以改善用药安全，以及通过高效沟通完善用药流程的必要性。研究发现，医护人员队伍的不安全作业状态是实现规范给药操作的一大挑战；而患者安全文化的缺失，则成为阻碍适应性学习与成长的壁垒。
研究结论：本研究结果证实，修复性研究方法（Restorative Research Approach）能够有效支持护士针对用药安全问题开展研究并付诸实践行动。