Resilience in nursing medication administration practice: a systematic review with narrative synthesis.

IF 1.3 Q4 HEALTH CARE SCIENCES & SERVICES
Pollyanna Lr Kellett, Bryony Dean Franklin, Susie Pearce, Jonathan Benn
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Abstract

Resilience in nursing medication administration practice: a systematic review with narrative synthesis.

Objective: 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.

Design: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided the review, which was registered with PROSPERO.

Data sources: MEDLINE, EMBASE, PsychINFO and CINAHL databases were searched from 14 August 2020 to 1 January 2021 for English-language studies.

Methods: 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.

Results: 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.

Conclusions: 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.

Prospero registration number: CRD42018087928.

护理用药管理实践中的应变能力:叙事综合系统综述。
护理用药管理实践中的应变能力:系统综述与叙事综合:人们对护士如何调整用药管理实践以维护用药安全知之甚少。在伤害发生前进行调整和应对的能力被称为 "应变能力"。目前研究用药安全的证据主要集中在错误和出错的原因上。本综述旨在综合有关在护理用药管理中应用应变原则和实践的证据:数据来源:MEDLINE、EMBASE、Psychology and Psychology、Medical Review and Meta-Analyses:从 2020 年 8 月 14 日至 2021 年 1 月 1 日,在 MEDLINE、EMBASE、PsychINFO 和 CINAHL 数据库中检索英语研究:对住院环境中护理用药的适应性和安全性相关的任何设计的实证研究进行了系统性回顾。采用混合方法评估工具对方法质量进行评估。结果:符合纳入标准的研究有 32 项,研究方法各异,大部分质量良好。11 项干预性研究包括 2 项评估教育干预有效性的研究和 9 项探索性研究,其结果显示了旨在培养抗逆力的干预措施的影响。21 项非干预性研究显示了如何将抗逆力原则付诸实践。只有三项研究明确提出了抗逆力的概念。抗逆性用药策略源于五个触发因素:研究发现,护士的抗逆力实践是对已识别的威胁安全和工作效率的触发因素的反应。这些通常是短期的、实时的主动调整,以维护安全、补偿和应对现代医疗环境中的复杂性:CRD42018087928。
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来源期刊
BMJ Open Quality
BMJ Open Quality Nursing-Leadership and Management
CiteScore
2.20
自引率
0.00%
发文量
226
审稿时长
20 weeks
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