护士在抗菌药物管理中的角色和贡献：综合评价。
Nurse role and contribution to antimicrobial stewardship: An integrative review.
机构信息
National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infections and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia; Department of Medicine, Building 181, University of Melbourne, Grattan St, Melbourne, VIC 3010, Australia.
National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infections and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia; Department of Medicine, Building 181, University of Melbourne, Grattan St, Melbourne, VIC 3010, Australia; Victorian Infectious Diseases Service, The Peter Doherty Institute for Infections and Immunity, 792 Elizabeth St, Melbourne, VIC 3000, Australia.
出版信息
Int J Nurs Stud. 2021 May;117:103787. doi: 10.1016/j.ijnurstu.2020.103787. Epub 2020 Oct 8.
AIM
To examine existing published literature regarding nurses and antimicrobial stewardship, and their potential role and contribution, to identify what is known, to evaluate methodologies used in published research, and to review and integrate findings to inform practice and future priorities for research.
DESIGN
Integrative review.
METHODOLOGY
The approach to this review was informed by Whittemore and Knafl's integrative review methodology. Electronic databases were searched for papers published since the start of the database to November 2019, with abstracts available, related to humans and published in English. Papers were included regardless of practice setting (acute, aged, and primary care) and if they were research based, included nurses as participants and reported specifically on results from nurses or that had implications for nursing practice. Excluded were conference abstracts, and papers focussed solely on nurse prescriber, nurse practitioner, or nurse manager roles.
RESULTS
Fifty-two papers were included in the review. Identified themes were: i) nursing knowledge, learning needs and education; ii) nurse perceptions of the nursing role and motivations for involvement; iii) nursing brokerage and influence on information flow to and from patients; iv) nursing workflow, workload and workarounds; and v) nurse leadership. Methodological quality of the included papers varied, limiting transferability and applicability of findings for some of the included studies.
CONCLUSION
Formal inclusion of nurses in antimicrobial stewardship activities has been associated with improved nurse knowledge, nurse confidence, and in some cases improved clinical outcomes for patients. The review reinforces nursing values as a motivator of nursing actions, and reveals the complex yet significant influence of nurses on antimicrobial prescribing. Potential opportunities to enhance nurses' participation and contribution to antimicrobial stewardship include; formal acknowledgement of the nurse role, educating nurses so that they are aware of how they can contribute, collaborating with nurses in planning and implementing local stewardship activities, and ensuring nurse leaders are involved. However, evidence on this topic remains limited. Research is needed to facilitate greater understanding about the nature, scope and influence of the nurse role in antimicrobial stewardship, how nurses enact and carry out their role, and nurses' support needs. Tweetable abstract: Integrative review explores #nurse role in #antimicrobialstewardship. Nurse contribution, influence significant, but not well understood.
目的
检查现有的关于护士和抗菌药物管理以及他们的潜在角色和贡献的文献，以确定已有的知识，评估已发表研究中使用的方法，并回顾和整合研究结果，为实践和未来的研究重点提供信息。
设计
综合回顾。
方法
本综述方法以 Whittemore 和 Knafl 的综合回顾方法为依据。检索了自数据库开始至 2019 年 11 月，有摘要的，与人类相关且以英文发表的相关文献。无论实践环境（急性、老年和初级保健）如何，只要研究中包含护士并报告护士的具体结果或对护理实践有影响的研究都包括在内。排除会议摘要和仅关注护士处方者、护士从业者或护士管理者角色的论文。
结果
本综述共纳入 52 篇论文。确定的主题有：i）护理知识、学习需求和教育；ii）护士对护理角色的看法以及参与的动机；iii）护理中介和信息在患者之间的流动；iv）护理工作流程、工作量和工作流程；v）护理领导力。纳入论文的方法学质量参差不齐，限制了一些纳入研究结果的可转移性和适用性。
结论
正式将护士纳入抗菌药物管理活动与提高护士知识、护士信心以及在某些情况下提高患者临床结果有关。本综述强化了护理价值观作为护理行动的动机，并揭示了护士对抗菌药物处方的复杂但重要的影响。增强护士参与和对抗菌药物管理的贡献的潜在机会包括：正式承认护士的角色，教育护士使其了解他们如何做出贡献，与护士合作规划和实施本地管理活动，并确保护士领导者参与。然而，关于这个主题的证据仍然有限。需要研究来促进对抗菌药物管理中护士角色的性质、范围和影响的更深入理解，了解护士如何履行和执行他们的角色，以及护士的支持需求。可推文摘要：综合回顾探讨#护士在#抗菌药物管理中的角色。护士的贡献和影响重大，但尚未被充分理解。
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