Asian Nurs Res.  2010 Mar;4(1):19-31.

Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training

Affiliations
  • 1Research Institute of Nursing Science, Seoul National University College of Nursing, Seoul, Korea.
  • 2Nursing Policy Research Institute, Yonsei University College of Nursing, Seoul, Korea. ehcho@yuhs.ac
  • 3Columbia University School of Nursing, New York, USA.

Abstract

PURPOSE
The purposes of this study were to develop a taxonomy for detection of errors related to hypertension management and to apply the taxonomy to retrospectively analyze the documentation of nurses in Advanced Practice Nurse (APN) training. Method: We developed the Hypertension Diagnosis and Management Error Taxonomy and applied it in a sample of adult patient encounters (N = 15,862) that were documented in a personal digital assistantbased clinical log by registered nurses in APN training. We used Standard Query Language queries to retrieve hypertension-related data from the central database. The data were summarized using descriptive statistics. Result: Blood pressure was documented in 77.5% (n = 12,297) of encounters; 21% had high blood pressure values. Missed diagnosis, incomplete diagnosis and misdiagnosis rates were 63.7%, 6.8% and 7.5% respectively. In terms of treatment, the omission rates were 17.9% for essential medications and 69.9% for essential patient teaching. Contraindicated anti-hypertensive medications were documented in 12% of encounters with co-occurring diagnoses of hypertension and asthma.
CONCLUSION
The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.

Keyword

medical error; handheld computers; practice guideline; advanced practice nursing; hypertension; nursing education

MeSH Terms

Adult
Advanced Practice Nursing
Asthma
Blood Pressure
Computers, Handheld
Diagnostic Errors
Education, Nursing
Humans
Hypertension
Informatics
Medical Errors
Patient Safety
Retrospective Studies
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