Capturing the Changes in the Work Enviroment of Nurses: Using Photographic Research Methods from the Field of Ecological Restoration
Gimenes, Fernanda R. E.
Marck, Patricia B.
Cassiani, Silvia H. De Bortoli
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Session presented on: Thursday, July 25, 2013: Purpose: To examine whether the photographic research methods from the field of ecological restoration help nursing practitioners of a Brazilian ICU to strengthen the safety of their work environment. Methods: We used a qualitative approach, using adapted photographic research methods from the field of ecological restoration, which include focus groups, photo walkabout, photo narration and photo elicitation, in iterative phases of data collection and analysis. In Phase 1, semi-structured, tape recorded focus group was conducted to identify issues related to medication safety. In Phase 2, we conducted photo walkabout with an experienced nurse to narrate photos of the ICU environment. In Phase 3, we reviewed unit photos with practitioners in a second set of focus group to discuss medication safety in the ICU. In phase 4, we returned to the unit with the purpose to detect, through photography, the changes occurred in the ICU work environment and in its culture of safety, in response to FG and photo walkabout/photo narration. Results: The organization of the medication room for efficient workflow and accessible supplies were a major concern for participants. Careful consideration was given to how items were stored within the ICU. Participants were also concerned about the risks for medication errors related to the similarity among ampoules, especially those frequently used in emergency. There were visible changes in the way how nursing practitioners manage the issues related to safety within the ICU and the hospital. Conclusion: Photographic research methods from the field of ecological restoration helped participants to (re)think and to redesign their work environment towards a safer place for medication management. However, some changes may contribute to other risks for patient safety.