Engaging nurses to strengthen medication safety: Fostering and capturing change with restorative photographic research methods

Authors

  • Fernanda Raphael Escobar Gimenes PhD,

    Professor, Corresponding author
    1. University of São Paulo at Ribeirão Preto College of Nursing, Pirassununga, São Paulo, Brazil
    • Correspondence: Fernanda Raphael Escobar Gimenes, University of São Paulo at Ribeirão Preto College of Nursing, Av. Bandeirantes 3.900—Monte Alegre, Ribeirão Preto, São Paulo, Brazil. Email: fregimenes@eerp.usp.br

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  • Patricia Beryl Marck PhD,

    Professor and Director
    1. School of Nursing, Faculty of Health & Social Development, University of British Columbia - Okanagan Campus, Kelowna, Canada
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  • Elisabeth Gulden Atila RN,

    1. Newcastle Private Hospital, New South Wales, Australia
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  • Silvia Helena de Bortoli Cassiani PhD

    Full Professor and Director
    1. University of São Paulo at Ribeirão Preto College of Nursing, São Paulo, Brazil
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Abstract

We used participatory photographic research methods adapted from the field of ecological restoration to engage Brazilian intensive care unit nurses in a critical review of medication safety in their work environment. Using focus groups, practitioner-led photo walkabouts with photo narration, and photo elicitation focus groups in iterative phases of data collection and analysis, nurses developed and implemented several practical and cultural improvements for their unit. Participants focussed on organizing the medication room for efficient workflow and accessible supplies, improving reporting practices, and reconsidering how they could manage safety issues in their unit and in the hospital as a whole. Our results demonstrated that restorative photographic research methods enabled participants to (re)think and redesign their work environment in keeping with several recommended practices for improving medication management. It also validated the need for continuous evidence-informed improvements if nurses hope to optimize medication safety in the complex systems of intensive care.

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