Document Type : Original Article
Authors
1 MSC in Midwifery, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, PhD Student of Reproductive Health, University of Medical Sciences, Isfahan, Iran
2 Assistant Professor in Reproductive Health, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,
3 MSC in Midwifery, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
4 MSC in Midwifery, Department of Nursing and Midwifery, Islamic Azad University, Kerman, Iran
Abstract
INTRODUCTION: Today, the quality of health services is considered to be providing “error‑free”
services, at the right time, by the right person and with the least resources. In recent years, education
through evidence‑based care has been emphasized by health system policymakers as a way to
improve care standards. Therefore, the purpose of this study is to teach clinical error management
to midwifery students in Shahid Sadoughi University of Medical Sciences in Yazd.
METHODS: The present study was performed using consensus‑based methods based on Delphi
technique to identify the most common errors and the best educational solution for its management
with the participation of 21 midwives by purposive sampling method in Shahid Sadoughi University
of Medical Sciences in Yazd in 2018. The rate of agreement was 75% or more. Descriptive statistical
methods and SPSS‑18 software were used for analysis.
RESULTS: The most important errors mentioned were as follows: In the field of hospital care,
it was the scope of care during labor and in clinical care, it was the scope of prenatal care. The
most important error reduction strategies that were considered in the clinical guide in general were
emphasizing the following: active supervision of instructors during the provision of students’ clinical
services, paying attention to the evaluation of service provision with the least incidence of errors in
end‑of‑course evaluation, make changes in clinical teaching methods, attention to the use of active
teaching methods and the use of educational software. The cases were considered separately in
each of the mentioned errors.
DISCUSSION AND CONCLUSION: Incidence of errors in pregnancy and childbirth as the most errors
of midwifery students in the field of hospital and clinical care was agreed on. Therefore, considering
this issue and the importance of preventing errors to provide quality services to mothers and infants,
it seems that it is time to make changes in clinical education in this field by emphasizing the use of
active educational methods.
Keywords
Ayoobian A. The frequency and reasons of medical errors in cases
referred to Isfahan Legal Medicine Center. Dir Gen 2012;9:109.
2. Ashkan NA, Pouran R, Farhad G, Mohhamadreza M, Mehrnush J.
Designing a medical errors control model for Tehran University
of Medical Science Hospitals. Payavard Salamat 2014;8:1;8(1).
3. Nasiripour AA, Raeissi P, Tabibi SJ, Arani LK. Hidden threats
inducing medical errors in Tehran Public Hospitals. Hormozgan
Med J 2011;15:152-62.
4. Haghshenas M, Vahidshahi K, Amiri A, Rezaee M, Rahmani N,
Pourhossen M, et al. Study the frequency of malpractice lawsuits
referred to forensic medicine department and medical council,
Sari, 2006-2011. J Mazandaran Univ Med Sci 2012;21:253-60.
5. Jafarian A, Parsapoor A, Hajtarkhani A, Asghari F, Imami
Razavi SH, Yalda A. An survey on the complaints registered in
Medical Council Organization of Tehran. IJME 2009;2:67-74
6. Johnson AL, Jung L, SongY, Brown KC, Weaver MT, Richards KC.
Sleep deprivation and error in nurses who work the night shift.
J Nurs Adm 2014;44:17-22.
7. Janing J. Linking teaching approaches and learning styles: How
can it help students? Emerg Med Serv 2001;30:77-80.
8. Holland K, Roxburgh M, Johnson M, Topping K, Watson R,
Lauder W, et al. Fitness for practice in nursing and midwifery
education in Scotland, United Kingdom. J Clin Nurs 2010;19:461-9.
9. Kevin JW, Kendall SF. The student nurses view of the future of
nursing. Clinical nursing j. 2000;18:1-9.
10. Fraser M, Cooper MA. Myles text book for midwives. Midwifery
2003;33(3):752.
11. Mostafazadeh F, Asadzadeh F, Aghdam FK. Application of
evidence-based care in midwifery care. Natl Assoc Iran Gyneocol
Obstet 2011;6:26-32.
12. Thomas D. Clinical Pharmacy Education, Practice and Research:
Clinical Pharmacy, Drug Information, Pharmacovigilance,
Pharmacoeconomics and Clinical Research. The Journal of Clinical
Pharmacology: Elsevier; 2018;9:22-32
13. Azmoude E, Ashrafizaveh A, Tara F, Dinpanah H, Azmoude H.
Management of trauma in pregnancy: A practical approach to
evidence based care. Iran J Obstet Gynecol Infertil 2018;21:101-17.
14. Lang T. An overview of four futures methodologies. Manoa
Journal of Fried and Half-Fried Ideas1995;7:1-43.
15. Hsu CC, Sandford BA. The Delphi technique: Making sense of
consensus. Pract Assess Res Eval 2007;12:10.
16. . Häder M, Häder S. Die delphi-methode als gegenstand
methodischer forschungen. InDie Delphi-Technik in den
Sozialwissenschaften 2000 (pp. 11-31). VS Verlag für
Sozialwissenschaften, Wiesbaden.
17. Linstone HA, Turoff M, Helmer O. The Delphi Method:
Techniques and Applications. 2002.Digital version in free access;.
Available from: http://is njit edu/pubs/delphibook.2018;05.
18. Gómez-Durán EL, Mulà-Rosías JA, Lailla-Vicens JM,
Benet-Travé J, Arimany-Manso J. Analysis of obstetrics and
gynecology professional liability claims in Catalonia, Spain (19862010). J Forensic Leg Med 2013;20:442-6.
19. Nadri S, Sheikhazadi A, Anbari K, Mikaeili R. The evaluation
of the causes of complaint to Khorramabad Medical Council
Organization from 2006 to 2011. yafte. 2013;15(1):25-31
20. Ayoubian A, Mahmoodabadi HB, Dehaghi ZH. Midwifery
errors: A descriptive study in Isfahan forensic medicine general
department. Mater Sociomed 2013;25:175-7.
21. Asadi L, Dafei M, Mojahed S, Abad Zadeh MM. Effectiveness
of the combination of an educational package of “Legitimacy in
Midwifery” and student-centered learning in order to improve the
quality of law and forensics course in midwifery. Educ Strategy
Med Sci 2017;10:508-15.
22. Beigi M, Asadi L, Valiani M, Mardani F. Evaluating different
types of malpractices in midwifery that were referred to the
forensic medicine commission and the medical council between
2006 and 2011 in Isfahan Province, 2013. Iran J Nurs Midwifery
Res 2015;20:426-30.
23. Azimi K, PoorbakhtiarM, TaghizadehZ, Soltani K, GhadipashaM,
Daneshparvar H. A survey on various types of medical
malpractice in relation with pregnancy and delivery, referred to
relevant commissions of the Iranian Legal Medicine Organization.
Iran J Forensic Med 2017;23:132-41.
24. Kamiab F, Afshari P, Keikhahi B, Tadayon M, Vahabi Shekarloo T,
Haghighizadeh MH. A review of reasons of malpractice of
obstetricians, gynecologists and midwives. Sci J Forensic Med.
2016;22:165-71.
25. Asadi L, Beigi M, Valiani M. Maternal and neonatal complications
leading to midwifery errors in referred cases to the Iranian legal
medicine organization and medical council of forensic medicine
from 2006-2011 in Isfahan, Iran. Women Health 2018;5:e64599.
26. VafaeeH, MakaremA, IldarabadiE, KhalafiA, Karimi MoonaghiH.
A survey on effects of teacher-centered teaching and problembased learning methods in incidence of nursing documentation
errors. Educ Dev Judishapur 2016;7:355-65.
27. Noohi E, Mazaheri Y, Arab M. The effect of clinical training using
mobile phone on medication errors of nursing trainees. IJNR 2017;12:8-13.
28. Hatami RadR, Yamani N, Ehsanpour S. Effects of teacher-centered
teaching and peer teaching methods on improving some clinical
skills of midwifery students: A comparative study. Iran J Med
Educ 2017;17:335-42.
29. Safari M, Yazdanpanah B, Islam-Nik P. Comparison of midwifery
students satisfaction with the teaching of gynecology and
infertility by lecture and peer education. Armaghane Danesh
2019;23:722-36.
30. Eccles MP, Grimshaw JM, Shekelle P, Schünemann HJ, Woolf S.
Developing clinical practice guidelines: Target audiences,
identifying topics for guidelines, guideline group composition
and functioning and conflicts of interest. Implement Sci 2012;7:60.
31. Grando A, Peleg M, Glasspool D. A goal-oriented framework
for specifying clinical guidelines and handling medical errors.
J Biomed Inform 2010;43:287-99.
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