King's College London, Florence Nightingale School of Nursing and Midwifery, UK.
King's College London, Florence Nightingale School of Nursing and Midwifery, UK.
Int J Nurs Stud. 2015 Jan;52(1):403-20. doi: 10.1016/j.ijnurstu.2014.07.003. Epub 2014 Jul 18.
To explore the factors contributing to Registered Nurse medication administration error behaviour.
A narrative review.
Electronic databases (Cochrane, CINAHL, MEDLINE, BNI, EmBase, and PsycINFO) were searched from 1 January 1999 to 31 December 2012 in the English language. 1127 papers were identified and 26 papers were included in the review. Data were extracted by one reviewer and checked by a second reviewer.
A thematic analysis and narrative synthesis of the factors contributing to Registered Nurses' medication administration behaviour. Bandura's (1986) theory of reciprocal determinism was used as an organising framework. This theory proposes that there is a reciprocal interplay between the environment, the person and their behaviour. Medication administration error is an outcome of RN behaviour.
The 26 papers reported studies conducted in 4 continents across 11 countries predominantly in North America and Europe, with one multi-national study incorporating 27 countries. Within both the environment and person domain of the reciprocal determinism framework, a number of factors emerged as influencing Registered Nurse medication administration error behaviour. Within the environment domain, two key themes of clinical workload and work setting emerged, and within the person domain the Registered Nurses' characteristics and their lived experience of work emerged as themes. Overall, greater attention has been given to the contribution of the environment domain rather than the person domain as contributing to error, with the literature viewing an error as an event rather than the outcome of behaviour.
The interplay between factors that influence behaviour were poorly accounted for within the selected studies. It is proposed that a shift away from error as an event to a focus on the relationships between the person, the environment and Registered Nurse medication administration behaviour is needed to better understand medication administration error.
探讨导致注册护士给药错误行为的因素。
叙述性回顾。
从 1999 年 1 月 1 日至 2012 年 12 月 31 日，以英文在电子数据库（Cochrane、CINAHL、MEDLINE、BNI、EmBase 和 PsycINFO）中进行检索。共确定了 1127 篇论文，其中 26 篇论文纳入综述。由一位评审员提取数据，另一位评审员进行核对。
使用班杜拉（1986 年）的相互决定论理论作为组织框架，对导致注册护士给药行为的因素进行主题分析和叙述性综合。给药错误是 RN 行为的结果。
26 篇论文报告了在四大洲 11 个国家进行的研究，主要集中在北美和欧洲，其中一项多国研究纳入了 27 个国家。在相互决定论框架的环境和人两个领域中，出现了一些影响注册护士给药错误行为的因素。在环境领域中，出现了两个关键主题：临床工作量和工作环境；在人领域中，注册护士的特征及其工作经历也成为主题。总的来说，更多地关注环境领域对错误的贡献，而不是人领域，将错误视为事件而不是行为的结果。
所选研究中对影响行为的因素之间的相互作用考虑不足。有人建议，需要从将错误视为事件转移到关注人与环境以及注册护士给药行为之间的关系，以更好地理解给药错误。
