Kabiri Neda, Hajebrahimi Sakineh, Rahmani Parvin, Tavani Fatemeh Molaei, Saghaleini Seied Hadi, Soofiyani Saiedeh Razi, Talebpour Amin
Research Center for Evidence-Based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran.
Medical Philosophy and History Research Center Tabriz University of Medical Sciences Tabriz Iran.
Health Sci Rep. 2024 Dec 17;7(12):e70277. doi: 10.1002/hsr2.70277. eCollection 2024 Dec.
According to the World Health Organization (WHO), an Adverse Drug Reaction (ADR) is defined as "a response to a drug which is noxious and unintended, and which occurs at doses normally used in humans for the prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function." The aim of this research was to evaluate the current practice and implement the best practices for detecting and reporting ADR in a tertiary hospital in Tabriz, Iran.
We used a mixed-methods sequential explanatory design in the current study. The research was conceptually informed by the Joanna Briggs Institute model of Evidence-Based Healthcare (JBI EBHC). A three-phase implementation process, outlined by this model, was used in this study. The first and third phases comprised the quantitaive phase of the study, in which we evaluated the current practice and conducted a final evaluation to measure changes in compliance with the best practice. The qualitative phase, the second phase of the JBI EBHC model, was conducted to identify barriers and develop implementation strategies. There were seven evidence-based audit criteria for evaluating the practice, with a sample size of 23 nurses for the quantitative phase and 10 participants for the qualitative phase.
The quantitative findings revealed an improvement in compliance rates for all criteria following the follow-up audit. From the qualitative analysis, four themes of barriers were identified: time and workload, lack of a proper reporting system for ADR, lack of belief and readiness for change among nurses, and lack of awareness about the importance of documenting ADR.
The results of this implementation study demonstrated enhanced ADR reporting. It can be inferred that implementing educational strategies, such as holding conferences, informal meetings, workshops, and educational pamphlets, can facilitate the implementation of evidence into practice.
Findings will help nurses across sectors of primary, secondary, and tertiary care use the implemented strategies to improve the quality of care and reduce ADR.
根据世界卫生组织(WHO)的定义,药物不良反应(ADR)是指“在正常用于人类疾病预防、诊断或治疗,或用于改变生理功能的剂量下,出现的有害且非预期的药物反应”。本研究的目的是评估伊朗大不里士一家三级医院在检测和报告药物不良反应方面的当前做法,并实施最佳实践。
在本研究中,我们采用了混合方法序列解释性设计。该研究在概念上以乔安娜·布里格斯循证医疗保健研究所(JBI EBHC)模型为依据。本研究采用了该模型概述的三阶段实施过程。第一阶段和第三阶段构成了研究的定量阶段,在此阶段我们评估了当前做法,并进行了最终评估以衡量与最佳实践的依从性变化。定性阶段是JBI EBHC模型的第二阶段,旨在识别障碍并制定实施策略。有七个基于证据的审核标准来评估实践,定量阶段的样本量为23名护士,定性阶段的样本量为10名参与者。
定量研究结果显示,在后续审核后,所有标准的依从率均有所提高。通过定性分析,确定了四个障碍主题:时间和工作量、缺乏适当的药物不良反应报告系统、护士缺乏改变的信念和准备、以及对记录药物不良反应重要性的认识不足。
这项实施研究的结果表明药物不良反应报告有所增加。可以推断,实施教育策略,如举办会议、非正式会议、研讨会和发放教育手册等,有助于将证据转化为实践。
研究结果将帮助初级、中级和三级护理部门的护士采用所实施的策略来提高护理质量并减少药物不良反应。