線上客觀結構式影像測試於提升護理人員給藥自我效能與辨認給藥錯誤行為之成效

Effectiveness of an Online Objective Structured Video Examination in Promoting Self-efficacy of Medication Administration and Recognition of Medication Errors Among Nurses

背景：「三讀五對」及給藥過程被干擾是導致護理人員給藥錯誤的最常見原因。目的：探討線上「三讀五對」與「給藥過程干擾處理」的給藥客觀結構式影像測試（objective structured videoexaminations, OSVE）介入於提升護理人員給藥自我效能與辨認給藥錯誤行為之成效。方法：採類實驗前測、後測研究設計，以同伴推動抽樣法共招募112位護理人員參與本線上研究。研究工具包括給藥自我效能問卷、四個給藥錯誤行為OSVE及其對應之辨認給藥錯誤行為問題，介入措施為一個正確給藥行為OSVE。成對樣本t檢定用以分析二個變項在前測與後測的差異。結果：112位研究樣本的平均年齡為27.21歲，平均工作年資為4.67年，給藥自我效能於前測得分為38.88（SD=4.45），後測得分為41.69（SD＝4.58），二者達顯著差異（t＝7.11, p＜.001）；辨認給藥錯誤行為前測得分為10.71（SD＝7.16），後測得分為15.32（SD＝4.94），二者也呈顯著差異（t＝5.90, p＜.001）。結　論／實務應用　線上給藥OSVE可立即提升臨床護理人員辨認給藥錯誤行為的正確性，並提高自我效能，未來研究需探討其在提升實際給藥安全的成效。

Background: Failure to follow the “Five Rights” and interruptions during medication administration are the two most common factors underlying nurse-related medication errors. Purpose: This study was designed to examine the effectiveness in terms of improving nurses’ medication administration self-efficacy and recognition of medication errors of an online objective structured video examination (OSVE) intervention focused on the “Five Rights” and “management of interruptions during medication administration”. Methods: A quasi-experimental pretest-posttest research design with a respondent-driven sampling method was employed. One hundred and twelve nurses finished the online survey. Instruments included the self-efficacy of medication administration questionnaire and four online medication error OSVEs addressing the issue of medication error recognition. The intervention was an acute medication behavior OSVE. Paired t-tests were used to assess the pretest / post-test differences between variables. Results: The mean age of the 112 survey respondents was 27.21 years, and the mean years of working experience was 4.67. The mean self-efficacy of medication administration score, which was 38.88 (SD = 4.45) at baseline, increased significantly to 41.69 (SD = 4.58) at post-test (t = 7.11, p < .001). Similarly, the mean score for recognition of medication errors was 10.71 (SD = 7.16) at pre-test and significantly higher (15.32; SD = 4.94) at post-test (t = 5.90, p < .001). Conclusions/Implications for Practice: The online OSVE may be used to improve the recognition of medication errors and self-efficacy of medication administration in nurses. Future research is needed to examine the effect of this intervention in enhancing the safety of medication administration in actual clinical practice settings.