Fisher Christine M, Kim Abby J, Elder Joshua J
Department of Pharmacy (CMF, AJK, JJE), Norton Children's Hospital, Louisville, Kentucky, Department of Pharmacy (AJK), Children's Hospital Colorado, Aurora, Colorado.
J Pediatr Pharmacol Ther. 2017 Sep-Oct;22(5):332-337. doi: 10.5863/1551-6776-22.5.332.
Medication errors involving chemotherapy are a serious source of avoidable medical harm that can result in chemotherapy-related adverse drug events. Efforts to reduce errors in the past decade have largely focused on chemotherapy errors at the prescriber level, using computerized or automated technology, but little has been done to ensure chemotherapy is administered accurately at the nursing level. The current study implemented a pharmacist-led, supplemental, institution-specific training program to nursing staff regarding the use of chemotherapy and to address knowledge deficits in newly hired nursing personnel.
Inpatient pediatric oncology nurses were eligible to participate in a 3-session educational program regarding chemotherapy principles, adverse event management, and supportive care. Pre- and posttests were administered during the sessions to assess baseline and acquired knowledge. An attitudes survey was given to nurses prior to their first session and after the last session to assess the nurse's comfort with administration and management of chemotherapy.
Posttest scores following program implementation show a significant increase in baseline knowledge. Scores increased by 14.1% (p < 0.001) overall; they increased 6% (p = 0.266), 22% (p = <0.001), and 16.5% (p = <0.001) after sessions 1, 2, and 3, respectively. All respondents requested additional classes for orientation or continuing education.
A pharmacist-led, educational program significantly improves knowledge of chemotherapy administration and monitoring in pediatric oncology nurses and was well received by participants as an additional training opportunity.
涉及化疗的用药错误是可避免医疗伤害的严重来源,可能导致与化疗相关的药物不良事件。在过去十年中,减少错误的努力主要集中在处方层面的化疗错误上,采用计算机化或自动化技术,但在确保护理层面准确进行化疗方面做得很少。本研究实施了一项由药剂师主导的、针对特定机构的补充培训计划,以提高护理人员对化疗使用的认识,并解决新入职护理人员的知识缺陷。
儿科住院肿瘤护理人员有资格参加一个为期三节课的教育计划,内容涉及化疗原则、不良事件管理和支持性护理。在课程期间进行前测和后测,以评估基线知识和所学知识。在护士参加第一节课之前和最后一节课之后进行态度调查,以评估护士对化疗给药和管理的舒适度。
项目实施后的后测分数显示基线知识有显著提高。总体分数提高了14.1%(p < 0.001);在第1、2和3节课后,分数分别提高了6%(p = 0.266)、22%(p = <0.001)和16.5%(p = <0.001)。所有受访者都要求提供额外的入职培训或继续教育课程。
由药剂师主导的教育计划显著提高了儿科肿瘤护理人员对化疗给药和监测的知识,并且作为一个额外的培训机会受到参与者的好评。