Biosion USA, Inc., Newark, Delaware, USA.
Villanova University M. Louise Fitzpatrick College of Nursing (Ret), Villanova, Pennsylvania, USA.
J Nurs Scholarsh. 2023 Nov;55(6):1106-1115. doi: 10.1111/jnu.12923. Epub 2023 Jun 26.
Patient medication safety in the acute care setting is a foundational action provided by nurses and healthcare providers for safe patient care. Hospitalization of patients with Parkinson's disease (PD) can be dangerous due to the unique and variable medication regimen required. Patients with PD often have their medication administered inappropriately in the acute care setting (e.g., holding a PD medication in preparation for surgery, not administering the medication on the patient's home schedule, and delaying administration). The research question posed in this study was the following: does a PD medication educational intervention in the clinical setting enhance knowledge, comfort, and competence of practicing nurses in the care of patients with PD regarding their medication safety?
A mixed methods study design was used for this 5-month, two-part study with a sample of practicing RNs at three different hospitals. Part one of the study assessed nurses' initial knowledge of PD and PD medication safety and included an educational intervention. Part two of the study occurred 3 months later and evaluated if knowledge from the educational intervention was retained.
The study was conducted in two parts and included a pre-test, educational intervention, post-test, and follow-up test 3 months later. The educational intervention consisted of a 15-minute video of two PD advanced practice nurses being interviewed regarding the general care of a patient with PD. The pre-test, post-test, and follow-up test were identical and consisted of six questions regarding knowledge, comfort, and self-perceived competency. Participants were additionally asked three open-ended questions at follow-up to gain insight on the effectiveness of the educational intervention.
A total sample of 252 RNs participated in this study. Statistically significant improvements in knowledge, comfort, and self-perceived competency were observed in the post-test scores compared to pre-test scores. These statistically significant improvements were retained after 3 months, despite a 42.9% decrease in the number of responders (n = 252 vs. n = 144). Additionally, compared to the post-test, there were no statistically significant declines in knowledge, comfort, or competency in the follow-up test. Qualitative findings indicated that the training regarding PD medications was retained and found to be valuable, even if it was seldom applied in practice.
A review of the literature and this study both support the need for increased education for practicing nurses as it relates to PD and PD medication safety. Healthcare systems, organizations, and associations that support continuing education for nurses create a stronger workforce. Education has been found to keep nurses up to date on the latest advances in care and treatment while also providing exposure to other areas of nursing beyond their clinical settings.
Promoting better patient outcomes through safe medication administration is a hallmark of nursing care excellence. This study found that supporting the use of an educational intervention of PD medication safety for nurses improved RN levels of knowledge, comfort, and competency up to 3 months later. As the population of those with PD increases, healthcare systems, and nurses must now, more than ever, be poised to care for these individuals. This is a critical point in PD patient care since persons with PD are hospitalized 1.5 times more than their peers without PD.
在急症护理环境中，患者用药安全是护士和医疗保健提供者为确保患者安全护理而提供的基本措施。由于帕金森病（PD）患者所需的独特且多变的药物治疗方案，他们在急症护理环境中的住院治疗可能存在危险。PD 患者的药物通常在急症护理环境中被不当管理（例如，为手术准备 PD 药物、不按患者的家庭时间表给药、延迟给药）。本研究提出的研究问题如下：在临床环境中进行 PD 药物教育干预是否能提高护士对 PD 患者药物安全护理的知识、舒适度和能力？
这是一项为期 5 个月的混合方法研究设计，样本为三家不同医院的执业注册护士。研究的第一部分评估了护士对 PD 和 PD 药物安全性的初始知识，并包括了一项教育干预。研究的第二部分在 3 个月后进行，评估了教育干预是否保留了知识。
研究分为两部分进行，包括预测试、教育干预、后测试和 3 个月后的随访测试。教育干预包括两段 PD 高级执业护士接受采访的 15 分钟视频，内容是关于 PD 患者的一般护理。预测试、后测试和随访测试完全相同，包含六个关于知识、舒适度和自我感知能力的问题。参与者还在随访时被问到三个开放式问题，以了解教育干预的效果。
共有 252 名注册护士参与了这项研究。与预测试相比，后测试的知识、舒适度和自我感知能力得分均有显著提高。这些统计学上的显著提高在 3 个月后仍然存在，尽管应答者人数减少了 42.9%（n=252 与 n=144）。此外，与后测试相比，在随访测试中，知识、舒适度和能力均无统计学显著下降。定性发现表明，PD 药物相关培训得到了保留，且被认为是有价值的，即使在实践中很少应用。
文献综述和本研究均支持增加执业护士的 PD 相关知识和 PD 药物安全知识教育。支持护士继续教育的医疗保健系统、组织和协会可以建立更强大的劳动力。教育可以使护士跟上护理和治疗的最新进展，同时还可以让他们接触到临床环境以外的其他护理领域。
通过安全用药促进更好的患者结局是护理卓越的标志。本研究发现，支持 PD 药物安全教育干预措施可以提高注册护士的知识、舒适度和能力水平，最长可达 3 个月。随着 PD 患者人数的增加，医疗保健系统和护士现在必须比以往任何时候都准备好照顾这些人。这是 PD 患者护理的一个关键时刻，因为 PD 患者的住院率比没有 PD 的同龄人高 1.5 倍。
