Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway.
Faculty of Health and Social Care, LAB University of Applied Sciences, 53850 Lappeenranta, Finland.
Int J Environ Res Public Health. 2020 Mar 19;17(6):2028. doi: 10.3390/ijerph17062028.
Quality-of-care improvement and prevention of practice errors is dependent on nurses' adherence to the principles of patient safety. This paper aims to provide a systematic review of the international literature, to synthesise knowledge and explore factors that influence nurses' adherence to patient-safety principles. Electronic databases in English, Norwegian, and Finnish languages were searched, using appropriate keywords to retrieve empirical articles published from 2010-2019. Using the theoretical domains of the Vincent's framework for analysing risk and safety in clinical practice, we synthesized our findings according to 'patient', 'healthcare provider', 'task', 'work environment', and 'organisation and management'. Six articles were found that focused on adherence to patient-safety principles during clinical nursing interventions. They focused on the management of peripheral venous catheters, surgical hand rubbing instructions, double-checking policies of medicines management, nursing handover between wards, cardiac monitoring and surveillance, and care-associated infection precautions. Patients' participation, healthcare providers' knowledge and attitudes, collaboration by nurses, appropriate equipment and electronic systems, education and regular feedback, and standardization of the care process influenced nurses' adherence to patient-safety principles. The revelation of individual and systemic factors has implications for nursing care practice, as both influence adherence to patient-safety principles. More studies using qualitative and quantitative methods are required to enhance our knowledge of measures needed to improve nurse' adherence to patient-safety principles and their effects on patient-safety outcomes.
提高医疗质量和预防实践错误依赖于护士对患者安全原则的遵守。本文旨在对国际文献进行系统回顾，综合知识并探讨影响护士遵守患者安全原则的因素。使用适当的关键词，在英语、挪威语和芬兰语的电子数据库中进行检索，以检索 2010 年至 2019 年发表的实证文章。使用 Vincent 框架分析临床实践中风险和安全的理论领域，根据“患者”、“医疗保健提供者”、“任务”、“工作环境”和“组织和管理”来综合我们的发现。共发现 6 篇文章，重点关注临床护理干预期间对患者安全原则的遵守情况。它们集中在管理外周静脉导管、外科手部揉搓说明、药物管理双核对政策、病房之间的护理交接、心脏监测和监测以及与护理相关的感染预防措施。患者的参与、医护人员的知识和态度、护士之间的协作、适当的设备和电子系统、教育和定期反馈以及护理过程的标准化都影响护士对患者安全原则的遵守。个体和系统因素的揭示对护理实践具有影响，因为它们都影响对患者安全原则的遵守。需要使用定性和定量方法进行更多研究，以提高我们对提高护士遵守患者安全原则所需措施的认识及其对患者安全结果的影响。
