摘要
[目的]系统收集与评价现有的与老年住院病人用药差错相关的预防及护理管理策略的有效证据。[方法]通过构建研究团队,确定检索策略及文献的纳入和排除标准,进行系统的中英文文献检索,构建文献评阅数据库,对文献进行系统的评阅。[结果]共纳入44篇文献,对10项预防及管理策略进行了系统的分析,结果表明,现有证据支持启用计算机化医嘱输入(CPOE)和临床次策支持系统(CDSS)以减少给药差错的发生。有限的证据指出,启用计算机报警系统、病人个体化发药系统、自动发药系统、计算机生成给药记录及条形码技术,对用药流程进行重建、构建多学科的用药回顾与安全委员会及匿名的、非惩罚性的差错上报系统有利于促进用药安全。尚缺乏证据支持床旁终端系统、设置专门的发药护士、双人核对及常规的教育与培训对减少用药差错的效果。[结论]关于老年住院病人用药差错预防策略的证据是非常有限的,其研究的方法学质量有待进一步提高。
Objective：To gather and evaluate the existing and related effective evidences with prevention and nursing management strategy of medication errors in elderly inpatients.Methods：By constructing research teams and determining the retrieval strategy and literature into and out of the standards to carry out the systematic Chinese and English literature retrieval and construct literature review database for systematic review of literatures.Results：A total of 44 articles were included,10 prevention and management strategies were analyzed systematically,the results showed that the available evidence supported enable computerized orders input（CPOE） and clinical decision support system（CDSS） in order to reduce occurrence of medication errors.Limited evidence indicated that it is helpful to promote drug safety through starting using computer alarm system,patients individualized drug delivery system,automatic dispensing system,computer-generated dosing record and bar code technology,medication process reconstruction,construct a multidisciplinary medication review and security committee and the anonymous,non-punitive reporting system.And there is no evidence to support the effect of bed terminal system,setting up special dispensing nurses,double check and regular education and training for reducing medication errors.Conclusion：The evidences on prevention strategy of medication errors in elderly inpatients are very limited,and the quality of its research methodology remains to be further improved.
出处
《护理研究（中旬版）》
2013年第8期2548-2553,共6页
Chinese Nursing Researsh
基金
复旦大学校级护理科研基金
编号:FNF201008
关键词
用药差错
药物不良事件
用药安全
预防策略
系统评价
medication errors
drug adverse events
medication safety
prevention strategies
system evaluation
