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帕金森病药物治疗方案对急性和老年护理环境中护士对帕金森病药物知识和管理的影响。

Impact of the Parkinson's disease medication protocol program on nurses' knowledge and management of Parkinson's disease medicines in acute and aged care settings.

机构信息

Aged & Extended Care Nursing, University of Technology Sydney, Health & Ageing Research Unit, South Eastern Sydney Local Health Service, Australia.

出版信息

Nurse Educ Today. 2013 May;33(5):458-64. doi: 10.1016/j.nedt.2012.04.022. Epub 2012 May 22.

Abstract

AIMS

To determine the impact of a Parkinson's medicine education program on nurses' knowledge and practices in two settings where people with Parkinson's disease are cared for: hospitals and residential aged care facilities. The Parkinson's Disease Medication Protocol Program aimed to increase nurse knowledge of Parkinson's medication administration and safety in care management in order to improve health outcomes, function and well-being for the person with Parkinson's.

BACKGROUND

The ageing demographic of the developed world is concomitant with an increase in chronic disease, with Parkinson's disease being one of the most debilitating and costly. Individually complex medication regimens and unique spectrums of symptoms require disease-specific knowledge in nurses. People with Parkinson's disease admitted to hospitals and/or living in residential aged care facilities often have multiple co-morbidities, rendering care more complex still. Nurse ignorance of Parkinson's disease medicines, their uses, side effects and administration regimens, and safe care practices, can cause unnecessary distress and dysfunction for the person.

METHOD

The two pilot studies employed an eighteen month pre/post-test/follow up design at different time frames, using a questionnaire developed by the study team and an expert panel to evaluate nurses' self-assessed 'perceived' knowledge and actual knowledge of Parkinson's disease, Parkinson's medicines and safe care practices, and satisfaction with the targeted Parkinson's education program.

RESULTS/FINDINGS: Nurses in the hospital pilot (2006/8) revealed deficits in pre-test perceived and actual knowledge levels, which increased significantly at post-test and follow-up. In contrast, in the residential aged care pilot (2008/10) the nurses had higher perceived and actual (correct) knowledge relevant to experience at pre-test and these levels increased at follow-up. Both pilot study cohorts were very satisfied with the PDMPP as an education and support vehicle in Parkinson's management.

CONCLUSION

These study results concur with the international literature which identifies that without targeted clinical education nurses do not necessarily have sufficient knowledge to effectively manage Parkinson's medicines and avoid unnecessary negative outcomes arising from delays, errors and omissions, nor do they know how to provide safe and effective care for persons with Parkinson's. A well-developed and resourced Parkinson's medicine education program, such as the PDMPP, has the potential to improve deficits in clinical practice.

摘要

目的

确定帕金森病药物教育计划对两个帕金森病患者护理场所(医院和养老院)护士知识和实践的影响。帕金森病药物管理协议计划旨在提高护士对帕金森病药物管理和安全护理管理的知识,以改善帕金森病患者的健康结果、功能和幸福感。

背景

发达国家人口老龄化与慢性病增加同时发生,其中帕金森病是最具致残性和最昂贵的疾病之一。复杂的个体化药物治疗方案和独特的症状谱需要护士具备疾病特异性知识。住院和/或居住在养老院的帕金森病患者通常有多种合并症,使护理更加复杂。护士对帕金森病药物、用途、副作用和管理方案以及安全护理实践的无知,可能会给患者带来不必要的痛苦和功能障碍。

方法

这两项试点研究采用了不同时间框架的 18 个月预测试/后测试/随访设计,使用由研究团队和专家小组开发的问卷来评估护士对帕金森病、帕金森病药物和安全护理实践的自我评估“感知”知识和实际知识,以及对目标帕金森教育计划的满意度。

结果/发现:医院试点(2006/8)的护士在前测中表现出感知和实际知识水平的缺陷,在后测和随访中显著增加。相比之下,在养老院试点(2008/10)中,护士在预测试中具有与经验相关的较高感知和实际(正确)知识,这些知识在随访中增加。两个试点研究组都非常满意 PDMPP 作为帕金森病管理的教育和支持工具。

结论

这些研究结果与国际文献一致,即如果没有针对性的临床教育,护士不一定具备有效管理帕金森病药物和避免因延迟、错误和遗漏而产生不必要的负面后果的知识,也不知道如何为帕金森病患者提供安全有效的护理。一个成熟且资源充足的帕金森病药物教育计划,如 PDMPP,有可能改善临床实践中的不足。

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