School of Psychology, University of Leeds, Leeds, West Yorkshire, UK
School of Nursing and Midwifery, University of Plymouth, Plymouth, Devon, UK.
BMJ Open Qual. 2024 Oct 28;13(4):e002711. doi: 10.1136/bmjoq-2023-002711.
Resilience in nursing medication administration practice: a systematic review with narrative synthesis.
Little is known about how nurses adapt medication administration practices to preserve safety. The capacity to adapt and respond before harm occurs has been labelled 'resilience'. Current evidence examining medication safety largely focuses on errors and what goes wrong. This review aimed to synthesise evidence for the application of resilience principles and practices in nursing medication administration.
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review, which was registered with PROSPERO.
MEDLINE, EMBASE, PsychINFO and CINAHL databases were searched from 14 August 2020 to 1 January 2021 for English-language studies.
A systematic review of empirical studies of any design relating to resilience and safety in nursing medication administration in the inpatient setting was conducted. Methodological quality was appraised using the Mixed Methods Appraisal Tool. Data were synthesised thematically.
Thirty-two studies with a range of methodologies of mostly good quality met the inclusion criteria. Eleven interventional studies included two that evaluated the effectiveness of education interventions and nine exploratory studies with outcomes showing the impact of an intervention designed or examined to build resilience. Twenty-one non-interventional studies showed how resilience principles are put into practice. Only three studies explicitly named the concept of resilience. Resilient medication administration strategies result from five triggers.
Nurses' resilience practices were found to be responses to identified trigers that threaten safety and productivity. These were often short term, real-time proactive adaptations to preserve safety, compensating for and responding to complexities in the modern healthcare setting.
CRD42018087928.
在护理给药实践中，人们对护士如何适应给药实践以确保安全知之甚少。能够在伤害发生之前适应和做出反应的能力被称为“韧性”。目前，检查药物安全性的证据主要集中在错误和出错的地方。本综述旨在综合护理给药中应用韧性原则和实践的证据。
本综述遵循系统评价和荟萃分析的首选报告项目（PRISMA）进行，并在 PROSPERO 上进行了注册。
从 2020 年 8 月 14 日至 2021 年 1 月 1 日，使用 MEDLINE、EMBASE、PsycINFO 和 CINAHL 数据库搜索了关于住院环境中护理给药中韧性和安全性的任何设计的英文研究。
对与住院环境中护理给药中的韧性和安全性相关的实证研究进行了系统评价，研究设计包括各种方法，质量大多为良好。使用混合方法评估工具评估方法学质量。数据通过主题进行综合。
32 项研究符合纳入标准，研究方法多样，质量大多较好。11 项干预研究中有 2 项评估了教育干预的效果，9 项探索性研究的结果表明了旨在或检验建立韧性的干预措施的影响。21 项非干预性研究展示了韧性原则是如何付诸实践的。只有 3 项研究明确命名了韧性的概念。有韧性的给药策略是由五个触发因素产生的。
研究发现，护士的韧性实践是对威胁安全和生产力的识别触发因素的反应。这些通常是短期的、实时的主动适应，以确保安全，补偿和应对现代医疗保健环境的复杂性。
PROSPERO 注册号：CRD42018087928。
