成人用药错误预防及管理的系统评价再评价  

Overview of systematic reviews of prevention and management of medication errors in adult patients

作　　者：麦智德 伊默 李珂[1] 张建霞[1] 王志稳[2] Mai Zhide;Yi Mo;Li Ke;Zhang Jianxia;Wang Zhiwen(Emergency Department,Peking University First Hospital,Beijing 100034,China;School of Nursing,Peking University,Beijing 100191,China)

机构地区：[1]北京大学第一医院急诊科,北京100034 [2]北京大学护理学院,北京100191

出　　处：《中华现代护理杂志》2024年第20期2716-2723,共8页Chinese Journal of Modern Nursing

基　　金：北京大学循证护理专项研究基金(XZJJ-2023-08)。

摘　　要：目的:对用药错误预防及管理措施的系统评价进行再评价,为医护人员临床决策提供证据支持。方法:计算机检索Cochrane Library、澳大利亚乔安娜布里格斯研究所循证卫生保健中心数据库、CINAHL、PubMed、Embase、中国知网、中国生物医学文献服务系统、万方数据库和维普网,检索用药错误预防及管理措施的系统评价,检索时限均为建库至2023年6月30日。由2名经过系统循证培训的研究员应用系统评价方法学质量评价工具(AMSTAR 2)对文献质量进行评价,采用推荐分级的评估、制订与评价(GRADE)对结局指标质量评价。结果:最终纳入19篇系统评价。采用AMSTAR 2方法学质量评价整体偏低,评价为高质量的1篇、低质量1篇、极低质量17篇。采用GRADE系统对19篇系统评价的55条结局指标的证据质量评价结果显示,3条证据质量为中等、27条证据质量为低等、25条证据质量为极低,证据质量整体偏低。结论:用药错误预防及管理措施的相关研究已经较为广泛地开展,计算机系统是降低用药错误较为有效的措施之一。给药流程修正、医生/护士教育与培训、双人核对、药剂师干预、智能药柜/智能泵、药物显示等措施有效性尚不明确,仍需大样本量、高质量的研究进一步证实。ObjectiveTo overview the systematic reviews of prevention and management measures of medication errors,so as to provide evidence support for clinical decision-making for medical staff.MethodsCochrane Library,Australia Joanna Briggs Institute Evidence-based Healthcare Center database,CINAHL,PubMed,Embase,CNKI,SinoMed,Wanfang database and VIP database were searched by computer to search for systematic reviews of prevention and management measures of medication errors,and the search period was from establishment of the databases to June 30,2023.Two researchers with systematic evidence-based training applied A Measure Tool to Assess Systematic Reviews 2(AMSTAR 2)to evaluate the literature quality,and Grades of Recommendations Assessment,Development and Evaluation(GRADE)was used to evaluate the quality of outcome indicators.ResultsFinally,a total of 19 systematic reviews were included.The overall quality evaluation using AMSTAR 2 was relatively low,with one article rated as high-quality,one article rated as low-quality and 17 articles rated as extremely low-quality.According to the evidence quality evaluation results of GRADE system for 55 outcome indicators of 19 systematic reviews,3 pieces of evidence were medium,27 pieces of evidence were low and 25 pieces of evidence were extremely low,indicating an overall low quality of evidence.ConclusionsThe related researches on prevention and management of medication errors have been carried out extensively,and the computer system is one of the effective measures to reduce medication errors.The effectiveness of measures such as administration process modification,doctor/nurse education and training,double check,pharmacist intervention,automated dispensing cabinet/automated pump and drug display is still unclear and needs to be further confirmed by large sample size and high-quality studies.

关 键 词：用药错误 系统评价 META分析 循证护理学 系统评价再评价 

分 类 号：R473[医药卫生—护理学]