临床药师通过肠内喂养管改善护士给药知识、态度和实践的病例对照研究。
Improving knowledge, attitudes, and practice of nurses in medication administration through enteral feeding tubes by clinical pharmacists: a case-control study.
作者信息
Hossaini Alhashemi Samira, Ghorbani Raana, Vazin Afsaneh
机构信息
Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran.
出版信息
Adv Med Educ Pract. 2019 Jul 9;10:493-500. doi: 10.2147/AMEP.S203680. eCollection 2019.
PURPOSE
Administering drugs and food to patients with swallowing disabilities via enteral tubes requires special skills. This task is a nursing duty and vital to ensure that they do this safely. An integrated program training nurses by a clinical pharmacist is likely to result in improved quality of oral drug administration via enteral feeding tubes. This quantitative study was undertaken to determine the efficacy of a clinical pharmacist educational program for improving nurses' knowledge, attitudes, and practice (KAP) concerning administrating medication via feeding tubes.
METHODS
This case-control study was performed to evaluate KAP of intensive-care nurses with regard to drug delivery through enteral feeding tubes before and after their training program. A questionnaire focusing on nurses' KAP was prepared by a clinical pharmacist and reviewed by 18 nurses for its reliability. Then, an educational program was designed for the case group. Two months later, nurses' KAP in the case and control groups were reevaluated. Nurses' practice regarding drug administration through feeding tube was observed three times.
RESULTS
This study was carried out with 82 nurses working in six intensive-care units in two major training hospitals in Shiraz, Iran. The overall knowledge of nurses increased significantly after the training program in the case group, with adequate awareness regarding solid dosage-form crushing increasing from 14% to 63.2% (˂0.001), tube flushing and drug dilution from 32.6% to 81.6% (˂0.001), and knowledge about mixing crushed drugs through a feeding tube from 23.3% to 55.3% (˂0.001). On the contrary, there was no change in the control group. After intervention, nurses' attitudes in the case group had changed significantly, and 50% of them consulted with pharmacists regarding drug administration.
CONCLUSION
An in-service education program by clinical pharmacists can lead to substantial improvements in administration of drugs via enteral feeding tubes.
目的
通过肠内管给吞咽障碍患者给药和喂食需要特殊技能。这项任务是护理职责，对于确保安全操作至关重要。由临床药剂师对护士进行综合培训计划可能会提高通过肠内喂食管进行口服给药的质量。本定量研究旨在确定临床药剂师教育计划在提高护士关于通过喂食管给药的知识、态度和实践（KAP）方面的效果。
方法
本病例对照研究旨在评估重症监护护士在培训计划前后通过肠内喂食管给药的KAP。由临床药剂师编制一份关注护士KAP的问卷，并由18名护士对其可靠性进行审核。然后，为病例组设计一个教育计划。两个月后，对病例组和对照组护士的KAP进行重新评估。观察护士通过喂食管给药的实践三次。
结果
本研究在伊朗设拉子两家主要培训医院的六个重症监护病房工作的82名护士中进行。病例组护士在培训计划后总体知识显著增加，对固体剂型碾碎的充分认识从14%提高到63.2%（<0.001），管冲洗和药物稀释从32.6%提高到81.6%（<0.001），以及关于通过喂食管混合碾碎药物的知识从23.3%提高到55.3%（<0.001）。相反，对照组没有变化。干预后，病例组护士的态度有显著变化，其中50%的人就给药问题咨询药剂师。
结论
临床药剂师的在职教育计划可导致通过肠内喂食管给药有实质性改善。
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