Department of Clinical Pharmacy, School of Pharmacy, Tehran University of Medical Sciences, P.O. Box: 14155/6451, 1417614411 Tehran, Iran.
Int J Clin Pharm. 2012 Oct;34(5):757-64. doi: 10.1007/s11096-012-9673-8. Epub 2012 Jul 12.
As a common practice, medications are given in addition to nutrients through enteral catheters especially in critically ill patients. Nurses are primarily responsible to administer medications in this manner. The correct drug delivery via enteral tubes requires special skills.
This study was designed to evaluate effectiveness of clinical pharmacist-led educational program in progressing nurses' knowledge and practice regarding medications delivery via enteral catheters.
This study has been performed in two teaching hospital affiliated to Tehran University of Medical Sciences.
This is a case-control, interventional study. At first, a knowledge and practice questionnaire regarding drug administration trough enteral feeding tube by intensivist nurses was prepared. This questionnaire was filled by each nurse at pre-intervention phase of the study. Then, the clinical pharmacists provided educational programs including preparing evidence-based booklet and classes for case group nurses. Nurses in case and control groups were evaluated again after 3 months. At pre- and post-intervention phases nurses were observed regarding their practice to administer drugs via enteral tubes as well.
Mean scores of knowledge and practice questions as well as percent of nurses with correct answers were compared between pre- and post-intervention phases in case and control groups.
The mean scores of knowledge and practice questions significantly increased in the case group but decreased or remained unchanged in the control group. In contrast to control group, the percent of nurses with correct answers to each domain of knowledge and practice questions increased significantly in the case group.
This study showed that nurses did not have sufficient baseline knowledge about rules of drug administration via enteral feeding tubes; however, integrated educational program by clinical pharmacists that focus on promoting correct administration of drugs via enteral feeding catheters significantly improved knowledge and practice of nurses. A theory-practice gap was found in this study that may be related to the authority of physicians not nurses in ordering rules for medication administration through enteral catheters.
作为一种常见的做法,特别是在危重症患者中,药物会通过肠内导管与营养物质一起给予。护士主要负责以这种方式给药。正确地通过肠内管输送药物需要特殊的技能。
本研究旨在评估临床药师主导的教育计划在提高护士有关通过肠内导管给药知识和实践方面的效果。
本研究在德黑兰医科大学的两所教学医院进行。
这是一项病例对照、干预性研究。首先,准备一份关于重症监护护士通过肠内喂养管给药的知识和实践问卷。在研究的预干预阶段,每位护士都填写了这份问卷。然后,临床药师为病例组护士提供教育计划,包括编写循证小册子和课程。在 3 个月后,再次对病例组和对照组护士进行评估。在干预前后阶段,还观察了护士通过肠内管给药的实践情况。
比较了病例组和对照组护士在干预前后知识和实践问题的平均得分以及答对问题的护士比例。
病例组的知识和实践问题的平均得分显著增加,而对照组则减少或保持不变。与对照组相比,病例组在知识和实践问题的每个领域答对问题的护士比例显著增加。
本研究表明,护士对通过肠内喂养管给药的规则没有足够的基本知识;然而,临床药师的综合教育计划,重点是促进通过肠内喂养管正确给药,显著提高了护士的知识和实践水平。本研究发现了理论与实践之间的差距,这可能与医生而不是护士在通过肠内导管给药的规则方面的权威有关。