摘要
目的:评价国内外儿童用药安全相关指南的质量,为科学制定儿童用药安全相关指南和儿童用药安全临床实践提供参考。方法:系统检索国内外临床实践指南网站及中英文数据库中关于儿童用药安全指南,检索时限为2015年1月—2020年12月,由2名研究者按照纳入及排除标准独立筛选文献,使用指南研究与评价工具(AGREEⅡ)对纳入指南进行独立质量评价,采用组内相关系数(ICC)衡量评价人员内部一致性。结果:共纳入16篇儿童用药安全相关的指南,其中国内4篇,国外12篇;循证指南2篇,专家共识性指南13篇,政策性指南1篇。AGREEⅡ各个领域的标准化得分均值分别为:范围和目的82.47%、参与人员50.70%、严谨性17.97%、清晰性65.97%、应用性23.44%、编辑独立性64.58%,指南推荐级别为A级2个、B级11个、C级3个。评价人员总体一致性较好(ICC为0.798~0.964)。结论:现有证据表明,目前最新的国内外儿童用药安全相关指南总体质量一般,尤其需要在制定的严谨性和应用性方面进一步完善。建议临床医务人员基于指南,结合临床情景、专业判断和病人意愿,构建适于我国的儿童用药安全实施方案。
Objective:To evaluate the quality of children′s medication safety guidelines at home and abroad,so as to provide reference for scientific formulation of children′s medication safety guidelines and clinical practice.Methods:According to the inclusion and exclusion criteria,the domestic and international clinical practice guidelines were searched from January 2015 to December 2020 in the Chinese and English database and websites.All the guidelines were evaluated for the quality according to the Appraisal of Guidelines for Research and EvaluationⅡ(AGREEⅡ)by two researchers independently and the intra-class correlation coefficient(ICC)was used to measure the internal consistency of the researchers.Results:A total of 16 children′s medication safety guidelines were included.Among which,4 guidelines were from China,12 were from abroad,and the categories included 2 evidence-based guidelines,13 expert consensus and 1 policy.The median scores in each field were 82.47%for scope and purpose,50.70%for participants in the development of guidelines,17.97%for rigor,65.97%for clarity and presentation,23.44%for applicability and 64.58%for editorial independence.The overall quality of the guides were 2 grade A,11 grade B,and 3 grade C.The overall consistency of the evaluators in each field was good(ICC range from 0.798 to 0.964).Conclusions:Current evidences show that the quality of the latest domestic and international children′s medication safety guidelines is at the general level,especially the rigor and application need to be improved.It is suggested that,based on referring relevant foreign guidelines,clinical staff should combine with the clinical situation,professional judgment and patient′s will to establish an implementation plan for Chinese children′s medication safety.
作者
荆凤
何梦雪
胡雁
JING Feng;HE Mengxue;HU Yan(School of Nursing,Fudan University,Shanghai 200032 China)
出处
《循证护理》
2022年第6期718-725,共8页
Chinese Evidence-Based Nursing
