Abstract:

Objective The purpose of this study was to systematically review the experience of nurses who made medication errors at work place,to provide theoretical basis to develop a medication errors management system and to construct nurse support programs in adverse events of medical safety. Methods A systematic search strategy identified qualitative studies exploring the experience of nurses who made medication errors. Articles from databases,including CBM,CNKI,VIP,Wanfang data,Joanna Briggs Institute Library,the Cochrane Library,PubMed,EMbase,Web of Science,EBSCO,PsycINFO,CINAHL Complete,and opengrey,were retrieved from inception to June 30th 2019. The quality of included studies was evaluated based on the Critical Appraisal Skills Programme for qualitative studies. The results were integrated by thematic synthesis. Results A total of 11 studies were included. A thematic synthesis identified three core themes:①Emotional experience. Most nurses had negative emotional experience,and they were eager for support and understanding from others,including patients,family members and colleagues. Strong and effective help and support can reduce the negative impact of nurses.②Medical response. Nurses have taken measures to avoid or reduce injuries timely,but their willingness to inform patients or their families and to report errors is low. ③Career impact and concerns. Medication errors had a positive or negative impact on nurses’ career. Conclusion The administrators and authorities of health institutes should pay more attention to the negative impact of nurses who made medication errors and give necessary help and support,assist them to better cope with errors as soon as possible and promote medication safety.

Key words: Nurses, Medication Errors, Qualitative Research, Systematic Review, Thematic Synthesis

摘要：

目的 系统评价护士发生用药错误的体验,为管理者制订完善的用药错误管理体系,构建医疗安全不良事件护士支持项目提供理论依据。 方法 计算机检索中国生物医学文献数据库、中国知网、维普、万方、乔安娜布里格斯研究所（Joanna Briggs Institute,JBI）循证卫生保健中心图书馆、考克兰循证医学图书馆、PubMed、EMbase、Web of Science、EBSCO、CINAHL Complete、PsycINFO及opengrey数据库,检索时限均为从建库至2019年6月30日,收集护士发生用药错误体验的质性研究,采用英国牛津循证医学中心文献质量评价项目进行文章质量评价,采用主题综合法对结果进行整合。 结果 共纳入11项研究,提炼31个研究结果,归纳形成10个新类别,整合形成3大核心主题。①情绪情感体验:多数护士表现消极情感体验,渴望得到他人包括患者、家属及同事的支持和理解,有力的帮助和支持可减少护士负面情绪;②医疗应对体验:护士能及时采取相应措施避免或降低伤害,但向患者或家属的告知意愿和主动上报事件的意愿较低;③职业影响体验:用药错误事件对护士职业产生正性或负性影响。 结论 用药错误给护士带来较大的心理应激,患方的理解以及同事、家属的支持会帮助其积极应对错误事件,促进患者用药安全。

关键词: 护士, 用药错误, 质性研究, 系统评价, 主题综合法