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影响护士自发报告药物不良反应的因素:综合评价。

Factors that condition the spontaneous reporting of adverse drug reactions among nurses: an integrative review.

机构信息

Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.

National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.

出版信息

J Nurs Manag. 2016 Mar;24(2):151-63. doi: 10.1111/jonm.12310. Epub 2015 May 14.

Abstract

AIM

To describe and synthesise previous research on factors conditioning the spontaneous reporting of adverse drug reactions among nurses.

BACKGROUND

Spontaneous reports of adverse drug reactions by health-care providers, are a main instrument for the continuous evaluation of the risk-benefit ratio of every drug. Under-reporting of adverse drug reactions by all health-care providers, in particular by nurses, is a major limitation to this system.

EVALUATION

An integrated review of the literature was conducted using MEDLINE, CINAHL, Embase, Scopus databases and Google Scholar. After evaluation for appropriateness related to inclusion/exclusion criteria, 16 studies were included in the final analysis and synthesis.

KEY ISSUES

Two factors emerged from the study: (1) intrinsic factors related to nurses' knowledge and attitudes; (2) extrinsic factors related to nurses' interaction with health-care organisations and to the relationship between nurses and physicians. Nurses' attitudes that hinder reporting include ignorance, insecurity, fear and lethargy.

CONCLUSIONS

Nurses are not fully aware of their role in adverse drug reaction reporting. Nurses must acquire greater knowledge to implement specific skills into their daily clinical practice.

IMPLICATIONS FOR NURSING MANAGEMENT

To improve nurses' reporting of adverse drug reactions, it is necessary to develop management approaches that modify both intrinsic and extrinsic factors.

摘要

目的

描述并综合既往研究,以阐明影响护士主动报告药物不良反应的因素。

背景

医护人员主动报告药物不良反应是对每种药物风险-效益比进行持续评估的主要手段。所有医护人员(尤其是护士)药物不良反应报告的低报,是该系统的主要局限性。

评估

使用 MEDLINE、CINAHL、Embase、Scopus 数据库和 Google Scholar 对文献进行综合回顾。在评估与纳入/排除标准的相关性后,最终纳入并分析了 16 项研究。

关键问题

研究中出现了两个因素:(1)与护士知识和态度相关的内在因素;(2)与护士与医疗保健组织的相互作用以及护士与医生之间的关系相关的外在因素。阻碍报告的护士态度包括无知、不安全感、恐惧和冷漠。

结论

护士对其在药物不良反应报告中的作用认识不足。护士必须获得更多的知识,将特定技能融入日常临床实践中。

护理管理意义

为了提高护士对药物不良反应的报告率,有必要制定管理措施,以改变内在和外在因素。

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