护士关于将药物与食物混合的知识和实践：来自发展中国家的一项多中心横断面研究。
Nurses' knowledge and practice regarding mixing medications with food: a multicenter cross-sectional study from a developing country.
机构信息
Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine.
出版信息
J Health Popul Nutr. 2023 Jun 5;42(1):52. doi: 10.1186/s41043-023-00396-0.
BACKGROUND
Different pharmaceutical characteristics of the dosage form (DF) have a direct effect on how easily oral solid medicine is swallowed. The practice of crushing tablets or opening the capsule occurs daily in the hospital, and most nurses are unknowledgeable regarding these issues. Coadministration of medications with food can cause changes in drug absorption and lead to an alteration in gastrointestinal motility, which can cause an unexpected effect on the dissolution and absorption of the drug. Therefore, this study aimed to investigate nurses' knowledge and practices regarding the mixing of medications with food or drink in Palestine.
METHODS
From June 2019 to April 2020, a cross-sectional study was conducted, encompassing nurses working in government hospitals across various districts of Palestine. The data were collected through face-to-face interviews, using questionnaires that assessed nurses' understanding and implementation of mixing medications with food. The sampling method employed was convenience sampling. To analyze the gathered information, the Statistical Package for the Social Sciences version 21 (IBM-SPSS) was utilized.
RESULTS
A total of 200 nurses participated in the study. The data show a significant difference between the median knowledge scores according to the department of work (p < 0.001). The highest median [interquartile] knowledge score of 15 [12-15] was found for nurses working in the neonatal intensive care unit. In addition, nurses in the pediatric ward and the men's medical ward had high scores of 13 [11.5-15] and 13 [11-14], respectively. In general, the results show that 88% of nurses modified oral DF prior to administration to patients. Regarding the type of food used, mixing medicine into juice was the most common procedure performed by nurses (approximately 84%); 35% of nurses used orange juice to mix with medicine. The most common reason for crushing was to administer medications to patients with a nasogastric tube (41.5%). In regard to medications, aspirin was the most frequently used drug that was crushed by the nurses (44%); however, 35.5% of nurses did not feel sufficiently trained to carry out this practice. Concerning the sources of information, 58% of nurses usually asked pharmacists for information about medications.
CONCLUSIONS
The results of this study show that crushing and mixing medications with food is common among nurses, and most nurses are unaware of the dangerous effect of this practice on patient health. Pharmacists, as medication experts, should participate in sharing knowledge about unnecessary crushing situations or when crushing should be avoided and try to find an alternative, when available, to aid administration.
背景
剂型（DF）的不同药物特性直接影响口服固体药物的吞咽难易程度。在医院，每天都会有压碎药片或打开胶囊的操作，而大多数护士对此并不了解。将药物与食物一起服用可能会改变药物的吸收，并导致胃肠道运动发生变化，从而对药物的溶解和吸收产生意想不到的影响。因此，本研究旨在调查巴勒斯坦护士在将药物与食物或饮料混合方面的知识和实践情况。
方法
本研究采用横断面研究设计，于 2019 年 6 月至 2020 年 4 月期间，选取巴勒斯坦各地区政府医院的护士作为研究对象。通过面对面访谈的方式收集数据，并采用问卷评估护士对将药物与食物混合的理解和执行情况。采用便利抽样法进行采样。采用 IBM SPSS 21 版（IBM-SPSS）对收集到的信息进行分析。
结果
共有 200 名护士参与了本研究。数据显示，根据工作部门，知识得分中位数存在显著差异（p<0.001）。在新生儿重症监护病房工作的护士得分最高（中位数[四分位距]为 15 [12-15]），儿科病房和男性医疗病房的护士得分也较高，分别为 13 [11.5-15]和 13 [11-14]。总的来说，结果表明 88%的护士在给患者给药前会改变口服药物剂型。在使用的食物类型方面，将药物混入果汁中是护士最常进行的操作（约 84%）；约 35%的护士使用橙汁混合药物。压碎药物最常见的原因是给有鼻胃管的患者用药（41.5%）。在药物方面，护士最常压碎的药物是阿司匹林（44%）；然而，35.5%的护士认为自己没有接受过足够的培训来进行这种操作。在信息来源方面，58%的护士通常向药剂师咨询药物信息。
结论
本研究结果表明，压碎并将药物与食物混合在护士中很常见，大多数护士不知道这种做法对患者健康的潜在危险影响。药剂师作为药物方面的专家，应参与分享关于不必要的压碎情况的知识，或在需要时避免压碎，并尝试寻找替代方法，以帮助给药。
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