Krivanek Mary Jo, Dolansky Mary A, Kukla Aniko, Ramic Meghan, Guliano James, Waite Pamela, Small Deborah
Southwest General Health Center, United States of America.
CWRU, Frances Payne Bolton School of Nursing, United States of America.
J Prof Nurs. 2019 Mar-Apr;35(2):75-80. doi: 10.1016/j.profnurs.2018.07.005. Epub 2018 Jul 22.
Medication reconciliation is a complex process that occurs during hospitalization at admission, transfer and discharge and at each outpatient clinic visit. Despite numerous quality improvement initiatives implemented by healthcare facilities nationwide to refine the process, medication errors still occur. Medication reconciliation processes are institution specific and undergo constant refinement. Few reports are available on the nursing student's role in this contemporary safety process.
The purpose of this study was to assess the nursing student's education and role in the medication reconciliation process from the perspective of academic faculty and hospital nursing leadership.
Electronic surveys were sent to 90 nurse academic and 160 nurse practice leaders in Ohio during the first quarter of 2015. Surveys were completed by 47% of the academic leaders (42/90) and 23% of the practice leaders (42/160). Survey questions focused on the nursing curriculum regarding medication reconciliation and the student nurse's role in the process during clinical experiences.
Faculty from 75% of the schools of nursing reported that the medication reconciliation curriculum was mostly taught in the classroom. Only 24.4% of the schools taught medication reconciliation in an interdisciplinary context with pharmacy students. During clinical time, 33% of faculty reported that students had direct involvement and 33% had the opportunity to observe the process of medication reconciliation. The majority (80%) of practice nurse leaders reported that their facility does not permit nursing students to perform medication reconciliation. Although medication reconciliation processes are specific to each organization, only 52.8% of the practice leaders reported that they provide faculty or nursing students' formal training on their hospital's medication reconciliation policy or site-specific process.
Students are not receiving adequate education or opportunity to practice medication reconciliation during clinicals. Future alignment of academia, and practice efforts on medication reconciliation are needed.
用药核对是一个复杂的过程，发生在住院期间的入院、转科和出院时，以及每次门诊就诊时。尽管全国的医疗机构实施了众多质量改进措施来完善这一过程，但用药错误仍时有发生。用药核对流程因机构而异，且不断完善。关于护理专业学生在这一现代安全流程中的作用，相关报道较少。
本研究旨在从学术教员和医院护理领导层的角度，评估护理专业学生在用药核对过程中的教育情况和作用。
2015年第一季度，向俄亥俄州的90名护士学术教员和160名护士执业领导发送了电子调查问卷。47%的学术领导（42/90）和23%的执业领导（42/160）完成了调查。调查问题聚焦于护理课程中关于用药核对的内容，以及学生护士在临床实习期间在该过程中的作用。
75%的护理学院教员报告称，用药核对课程主要在课堂上讲授。只有24.4%的学校在跨学科背景下与药学专业学生一起教授用药核对。在临床实习期间，33%的教员报告称学生直接参与其中，33%的学生有机会观察用药核对过程。大多数（80%）执业护士领导报告称，他们所在的机构不允许护理专业学生进行用药核对。尽管用药核对流程因每个组织而异，但只有52.8%的执业领导报告称，他们会就医院的用药核对政策或特定场所流程为教员或护理专业学生提供正式培训。
学生在临床实习期间没有接受足够的用药核对教育或实践机会。未来需要学术界和实践领域在用药核对方面进行协调努力。
