University of Antwerp, department of nursing science, Antwerp, Belgium.
J Nurs Scholarsh. 2011 Jun;43(2):171-80. doi: 10.1111/j.1547-5069.2011.01386.x. Epub 2011 Mar 28.
This study aims to identify and compare the relevance of barriers that nurses in nursing homes experience in medication management in Belgium.
The mixed-method study started with an expert meeting in November 2008 and was followed by a cross-sectional survey in February-March 2009, questioning 246 nurses and 270 nurse assistants in 20 nursing homes.
Twelve nurses represented nursing homes in an expert meeting and listed all barriers that might cause suboptimal medication management. Based on the results, a survey was developed in which respondents could indicate whether they were involved in a particular stage of the medication process and if yes, rate the relevance of the barriers in that stage on a continuous scale, varying from 1 =no barrier to 10 =strong barrier. Barriers scored 7 or more were defined as strong.
Nurses experienced a large number of barriers to safe medication management related to the nurse, organization, interdisciplinary cooperation, or to the patient and family. In preparing medication, medication administration and monitoring, being interrupted, not knowing enough on interactions, and barriers in interdisciplinary cooperation caused the most hindrance. In general, barriers in medication monitoring scored the strongest.
In order to improve safe medication management by tailored interventions in nursing homes, through the use of a standard questionnaire, nurses and nurse assistants can give an overview of barriers they experience and rate their relevance. Nurses and nurse assistants had different opinions on the relevance of barriers, especially in the stage of medication monitoring. Job expectations in medication management were not always clear, creating additional barriers in medication safety.
This study provides an overview of potential barriers to safe medication management in nursing homes, which can be addressed in practice. The relevance scoring of the barriers enables prioritization.
本研究旨在识别和比较养老院护士在药物管理中遇到的障碍的相关性。
混合方法研究始于 2008 年 11 月的专家会议，并随后于 2009 年 2 月至 3 月进行了横断面调查，调查了 20 家养老院的 246 名护士和 270 名护士助理。
12 名护士代表养老院参加了专家会议，并列出了可能导致药物管理效果不佳的所有障碍。根据研究结果，开发了一份调查问卷，调查对象可以在问卷中表明他们是否参与了药物处理的特定阶段，如果是，则可以在连续量表上对该阶段的障碍相关性进行评分，从 1=无障碍到 10=严重障碍。评分 7 或以上的障碍被定义为严重障碍。
护士在安全用药管理方面遇到了大量障碍，这些障碍与护士、组织、跨学科合作或患者和家庭有关。在准备药物、给药和监测、被打断、对相互作用了解不足以及跨学科合作中的障碍方面，造成了最大的阻碍。总的来说，药物监测方面的障碍得分最高。
为了通过在养老院中进行有针对性的干预来改善安全用药管理，护士和护士助理可以使用标准问卷概述他们所经历的障碍，并对其相关性进行评分。护士和护士助理对障碍相关性的看法不同，特别是在药物监测阶段。在药物管理方面的工作期望并不总是明确的，这给药物安全带来了额外的障碍。
本研究提供了养老院安全用药管理中潜在障碍的概述，这些障碍可以在实践中得到解决。障碍相关性评分可以进行优先级排序。
