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Le calcul de doses médicamenteuses : une conceptualisation de l'activité infirmière en service de réanimation

Abstract : The administration of injectable medications for inpatients is based on drug dose calculations and is performed by nurses. Errors sometimes occur, with potentially dramatic consequences for patients and systematic questioning of the nursing staff. Surveys and statistics have been carried out, but there is insufficient scientific data on the dose calculation activity. With an approach derived from ergonomic psychology, our research completes these data by documenting the cognitive dimension of the nurses' work by updating the knowledge and procedures they mobilize during the preparation of injectable drugs, taking into account the variability of this activity depending on the products injected, the protocols established in the hospital services, the material conditions, and also the people. The work perform is also based on professional didactics, as training is a major point; a training based on a deep knowledge of the nurses' activities, including possible tensions between activities and professional contexts. Finally, we have convened analysis tools produced in didactics of mathematics to highlight the logics underlying the calculations of drug doses carried out during the preparation of injectable drugs. A questionnaire survey was conducted to reveal the variability of dose calculation activities and to identify a first categorization. A simulation survey with recording of activity traces and simple self-confrontation interviews completed these initial results to model the dose calculation activity involved in the preparation of high-risk injectable drugs infused by smart infusion pumps in the intensive care unit where they are used daily. The combination of the approaches used in the research also led to question the complementarity of computational and professional logics, their possible contradictions, and thus to identify potentially error-generating processes.
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Submitted on : Friday, September 3, 2021 - 11:58:09 AM
Last modification on : Wednesday, November 3, 2021 - 6:40:03 AM

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  • HAL Id : tel-03333879, version 1

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Daniel Benlahouès. Le calcul de doses médicamenteuses : une conceptualisation de l'activité infirmière en service de réanimation. Education. Université de Paris, 2020. Français. ⟨NNT : 2020UNIP7193⟩. ⟨tel-03333879⟩

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