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重症监护病房(ICU)护士在静脉用药配制与给药过程中的知识、行为、培训及态度。一项意大利多中心研究。

Knowledge, behaviours, training and attitudes of nurses during preparation and administration of intravenous medications in intensive care units (ICU). A multicenter Italian study.

作者信息

Di Muzio Marco, De Vito Corrado, Tartaglini Daniela, Villari Paolo

机构信息

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.

Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy.

出版信息

Appl Nurs Res. 2017 Dec;38:129-133. doi: 10.1016/j.apnr.2017.10.002. Epub 2017 Oct 16.

Abstract

BACKGROUND

Medication errors can put at risk the life of patients hospitalized in the ICUs. These errors occur more frequently in the ICUs due to their peculiar medical framework. There is not much information about the knowledge, attitudes, behaviours and training needs of the nurses who work in ICUs towards the medication errors.

OBJECTIVE

This study aims at describing the knowledge, attitudes, behaviours and training needs of the Italian nurses who work in ICUs towards the use of IV drugs, and identifying the strategies that nurses can adopt to prevent the occurrence of medication errors.

MATERIALS AND METHODS

Cross-sectional study. The survey was carried out through a self-administrated questionnaire and it was addressed to 529 Italian nurses who work in the ICUs of Southern, Centre and Northern Italy hospitals (average age of the sample 39.9, SD=9.1, 68.1% females). The questionnaire, made of 36 items divided into 7 sections, was validated after the results of the pilot study.

RESULTS

The study highlighted the importance of the role, behaviours and knowledge of the nurses to prevent the medication errors. The results of the multivariate analysis of the multicentre study show a relation among correct behaviours and positive attitudes, even if it is not statistically significant. Worth mentioning is the fact that the achievement of a university degree affects negatively the correct behaviours (OR 0.56, 95% CI 0.34-0.95), as well as the years of work (OR 0.97, 95% CI 0.94-0.99).

CONCLUSIONS

The results of this multicentre study are encouraging. Nurses who have a good command of the English language (sufficient, good, and excellent) dedicate more than an hour per week to the bibliography update. Extending and deepening the knowledge of the nurses in a cyclical way might be an effective strategy to keep a high level of security of the drugs in the ICUs. The study highlighted that almost all the surveyed nurses (93%) are aware that an adequate knowledge of the drugs dosage calculation is essential to reduce the occurrence of medication errors in the drugs preparation phase.

摘要

背景

用药错误会危及重症监护病房(ICU)住院患者的生命。由于其特殊的医疗框架,这些错误在ICU中更为频繁地发生。关于在ICU工作的护士对用药错误的知识、态度、行为和培训需求的信息并不多。

目的

本研究旨在描述意大利ICU护士在使用静脉药物方面的知识、态度、行为和培训需求,并确定护士可采用的预防用药错误发生的策略。

材料与方法

横断面研究。通过自填式问卷进行调查,对象为意大利南部、中部和北部医院ICU工作的529名护士(样本平均年龄39.9岁,标准差=9.1,女性占68.1%)。该问卷由36个项目组成,分为7个部分,在预试验结果后进行了验证。

结果

该研究强调了护士在预防用药错误方面的作用行为和知识的重要性。多中心研究的多变量分析结果显示正确行为和积极态度之间存在关联,尽管在统计学上不显著。值得一提的是,获得大学学位对正确行为有负面影响(比值比0.56,95%置信区间0.34 - 0.95),工作年限也有影响(比值比0.97,95%置信区间0.94 - 0.99)。

结论

这项多中心研究的结果令人鼓舞。英语水平良好(足够、良好和优秀)的护士每周花在更新文献上的时间超过一小时。以循环方式扩展和深化护士的知识可能是在ICU保持高水平药物安全的有效策略。该研究强调,几乎所有接受调查的护士(93%)都意识到对药物剂量计算有足够的了解对于减少药物准备阶段用药错误的发生至关重要。

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