Workarounds to Medication Preparation and Administration within an Intensive Care Unit: A Qualitative Study
Bibliographic record
Abstract
Objectives: To gain a comprehensive understanding of medication safety and potential improvements in a Brazilian intensive care unit (ICU), we included an exploration of related workarounds. Methods:We adapted participatory photographic research methods from the field of ecological restoration to study a Brazilian ICU.Using focus groups, nurse-led photo-narrated walkabouts, and photo elicitation in iterative phases of data collection and analysis, we identified a theme of 'living with workarounds on a day-today basis'.Results: Participants recognized barriers within their work environment that might contribute to perpetuating medication workarounds, and the visual methods enabled them identify ideas to minimize workarounds related to these processes of care. Conclusions:The participatory photo methods helped participants and researchers to develop in depth discussions to understand how nurses work around systemic vulnerabilities to optimize the delivery of patient care.The methods also increased participants' awareness of such behaviors and provided opportunities to identify ideas to reduce risk.We expect that similar methods could be successfully used in the future in a variety of practice settings to improve medication processes and other patient safety issues.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.009 | 0.009 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".