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旨在减少用药错误的干预措施的有效性:系统评价结果的综合分析

The effectiveness of interventions designed to reduce medication administration errors: a synthesis of findings from systematic reviews.

作者信息

Lapkin Samuel, Levett-Jones Tracy, Chenoweth Lynn, Johnson Maree

机构信息

Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.

School of Nursing and Midwifery, Faculty of Health, University of Newcastle, Callaghan, New South Wales, Australia.

出版信息

J Nurs Manag. 2016 Oct;24(7):845-858. doi: 10.1111/jonm.12390. Epub 2016 May 11.

Abstract

AIM

The aim of this overview was to examine the effectiveness of interventions designed to improve patient safety by reducing medication administration errors using data from systematic reviews.

BACKGROUND

Medication administration errors remain unacceptably high despite the introduction of a range of interventions aimed at enhancing patient safety. Systematic reviews of strategies designed to improve medication safety report contradictory findings. A critical appraisal and synthesis of these findings are, therefore, warranted.

METHODS

A comprehensive three-step search strategy was employed to search across 10 electronic databases. Two reviewers independently examined the methodological rigour and scientific quality of included systematic reviews using the Assessment of Multiple Systematic Reviews protocol.

RESULTS

Sixteen systematic reviews were eligible for inclusion. Evidence suggest that multifaceted approaches involving a combination education and risk management strategies and the use of bar code technology are effective in reducing medication errors.

CONCLUSION

More research is needed to determine the benefits of routine double-checking of medications during administration by nurses, outcomes of self-administration of medications by capable patients, and associations between interruptions and medications errors.

IMPLICATIONS FOR NURSING MANAGEMENT

Medication-related incidents must be captured in a way that facilitates meaningful categorisation including contributing factors, potential and actual/risk of harm and contextual information on the incident.

摘要

目的

本综述旨在利用系统评价的数据,考察旨在通过减少用药错误来提高患者安全的干预措施的有效性。

背景

尽管采取了一系列旨在提高患者安全的干预措施,但用药错误率仍然高得令人无法接受。对旨在提高用药安全的策略进行的系统评价报告了相互矛盾的结果。因此,有必要对这些结果进行批判性评价和综合分析。

方法

采用全面的三步检索策略,在10个电子数据库中进行检索。两名评价者使用《多个系统评价评估方案》独立检查纳入的系统评价的方法严谨性和科学质量。

结果

16项系统评价符合纳入标准。有证据表明,涉及教育与风险管理策略相结合以及使用条形码技术的多方面方法在减少用药错误方面是有效的。

结论

需要更多研究来确定护士在给药过程中进行常规双人核对的益处、有能力的患者自行给药的效果以及干扰与用药错误之间的关联。

对护理管理的启示

必须以有助于进行有意义分类的方式记录与用药相关的事件,包括促成因素、潜在和实际的/伤害风险以及事件的背景信息。

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