Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT, England, United Kingdom.
University of York, York, England, United Kingdom.
Int J Nurs Stud. 2014 Feb;51(2):334-45. doi: 10.1016/j.ijnurstu.2013.07.001. Epub 2013 Jul 30.
To explore (a) how nurses feel about disclosing patient safety incidents to patients, (b) the current contribution that nurses make to the process of disclosing patient safety incidents to patients and (c) the barriers that nurses report as inhibiting their involvement in disclosure.
A systematic search process was used to identify and select all relevant material. Heterogeneity in study design of the included articles prohibited a meta-analysis and findings were therefore synthesised in a narrative review.
A range of text words, synonyms and subject headings were developed in conjunction with the York Centre for Reviews and Dissemination and used to undertake a systematic search of electronic databases (MEDLINE; EMBASE; CENTRAL; PsycINFO; Health Management and Information Consortium; CINAHL; ASSIA; Science Citation Index; Social Science Citation Index; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effects; Health Technology Assessment Database; Health Systems Evidence; PASCAL; LILACS). Retrieval of studies was restricted to those published after 1980. Further data sources were: websites, grey literature, research in progress databases, hand-searching of relevant journals and author contact.
The title and abstract of each citation was independently screened by two reviewers and disagreements resolved by consensus or consultation with a third person. Full text articles retrieved were further screened against the inclusion and exclusion criteria then checked by a second reviewer (YB). Relevant data were extracted and findings were synthesised in a narrative empirical synthesis.
The systematic search and selection process identified 15 publications which included 11 unique studies that emerged from a range of locations. Findings suggest that nurses currently support both physicians and patients through incident disclosure, but may be ill-prepared to disclose incidents independently. Barriers to nurse involvement included a lack of opportunities for education and training, and the multiple and sometimes conflicting roles within nursing.
Numerous potential benefits were identified that may result from nurses having a greater contribution to the disclosure process, but the provision of support and training is essential to overcome the reported barriers faced by nurses internationally.
探讨（a）护士对向患者披露患者安全事件的感受，（b）护士目前对向患者披露患者安全事件所做的贡献，以及（c）护士报告的阻碍其参与披露的障碍。
系统搜索过程用于识别和选择所有相关材料。由于纳入文章的研究设计存在异质性，因此无法进行荟萃分析，研究结果以叙述性综述的形式综合呈现。
与约克评论与传播中心合作制定了一系列文本词、同义词和主题词，并用于对电子数据库（MEDLINE；EMBASE；CENTRAL；PsycINFO；健康管理与信息联盟；CINAHL；ASSIA；科学引文索引；社会科学引文索引；Cochrane 系统评价数据库；效应摘要数据库；健康技术评估数据库；健康系统证据；PASCAL；LILACS）进行系统搜索。检索的研究仅限于 1980 年后发表的研究。其他资料来源包括：网站、灰色文献、正在进行的研究数据库、相关期刊的手工检索以及作者联系。
两位评审员独立筛选每条引文的标题和摘要，如有分歧，则通过协商或咨询第三位评审员解决。检索到的全文文章进一步根据纳入和排除标准进行筛选，然后由第二位评审员（YB）进行检查。提取相关数据并进行叙述性实证综合。
系统的搜索和选择过程确定了 15 篇出版物，其中包括来自不同地点的 11 项独特研究。研究结果表明，护士目前通过事件披露为医生和患者提供支持，但可能对独立披露事件准备不足。护士参与的障碍包括缺乏教育和培训机会，以及护理角色的多样性和有时的冲突性。
从护士对披露过程做出更大贡献可能带来的诸多潜在益处，以及为护士提供支持和培训以克服国际上护士面临的报告障碍。
