Nursing journals and medication management: identification and categorization of publications from 1987 to 2008

Abstracts

Este estudio objetivó identificar y categorizar los artículos de periódicos nacionales de enfermería que abordan temas referentes a la administración de medicamentos en el período de 1987 a 2008. A partir de la búsqueda realizada en las principales bases de datos de la salud, se utilizó la revisión de literatura acerca de la temática en seis periódicos nacionales, categorizando los artículos en lo referente a: asistencia; enseñanza; investigación; técnica y errores de medicación; comunicación; y, medicamentos específicos. Fueron identificados 108 artículos, destacándose la Revista Latino-Americana de Enfermería y la Revista Brasileña de Enfermería y el autor Casiani y la categoría medicamentos específicos, como aquellos responsables por la cantidad más expresiva de artículos publicados. Es necesario sumar esfuerzos para realizar una producción más expresiva de artículos relacionados a la administración de medicamentos.

sistemas de medicación; vehículos homeopáticos; enfermería

Este estudo objetivou identificar e categorizar os artigos de periódicos nacionais de enfermagem que abordam temas referentes à administração de medicamentos no período de 1987 a 2008. A partir da busca realizada nas principais bases de dados da saúde, utilizou-se a revisão de literatura acerca da temática em seis periódicos nacionais, categorizando os artigos em assistência, ensino, pesquisa, técnica e erros de medicação, comunicação e medicamentos específicos. Foram identificados 108 artigos, destacando-se a Revista Latino-Americana de Enfermagem e a Revista Brasileira de Enfermagem e o autor Cassiani e a categoria medicamentos específicos, como aqueles responsáveis pelo mais expressivo quantitativo de artigos publicados. É necessária a soma de esforços para uma mais expressiva produção de artigos relacionados à administração de medicamentos.

sistemas de medicação; veículos homeopáticos; enfermagem

ARTIGO DE REVISÃO

Nursing journals and medication management: identification and categorization of publications from 1987 to 2008

Paulo Celso Prado Telles Filho^I; Marcus Fernando da Silva Praxedes^II

^IUniversidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil: RN, Ph.D. in Nursing, Adjunct Professor, e-mail: [e-mail]

^IIUniversidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil: Undergraduate Student in Nursing, e-mail: [e-mail]

ABSTRACT

This study aimed to identify and categorize publications about themes related to medication administration in Brazilian nursing journals between 1987 and 2008. From a survey in the main health databases, we reviewed literature about the theme in six Brazilian journals, classifying the articles into care, teaching, research, technique, medication errors, communication and specific drugs. One hundred eight articles were identified, particularly in the Revista Latino-Americana de Enfermagem and the Revista Brasileira de Enfermagem. The author Cassiani and the category specific drugs stand out as responsible for the largest number of articles published. Efforts need to be added up with a view to a more expressive production of articles on medication administration.

Descriptors: medication systems; homeopathic vehicles; nursing

INTRODUCTION

Medication administration is one of the activities with the highest burden of responsibility for the nursing team. Hence, scientific production in this area is extremely important, as it maximizes the use of different evidence-based principles, permitting the existence of a safe medication process.

The number and complexity of medication administration techniques is increasing, entailing increasing demands by the job market. It is a consensus among researchers and professionals involved in this practice that knowledge plays an important role nowadays⁽¹⁾.

Thus, the use of work methods with solid theoretical foundations is considered fundamental, permitting nursing professionals' intellectual and practical growth, with a view to evidence-based and high-quality care delivery. This evidences the importance of research on themes related to medication administration.

Hence, this study is justified by the fact that identifying and categorizing articles on themes related to medication administration makes it possible to understand the current situation of scientific production on this theme, making it easier to locate the produced articles and appointing the need for scientific production on important themes on which little research has been done, thus benefitting nursing knowledge.

AIM

This study aimed to identify and categorize articles about themes related to medication administration, published in Brazilian nursing journals between 1987 and 2008.

METHODS

This study describes a literature review on medication administration, covering the period from 1987 to 2008. This period was used as, before 1987, literature contains a small number of articles about this theme, besides the fact that it was not considered convenient to work with outdated references. The bibliographic survey was carried out on the internet, through BIREME, searching the LILACS (Latin American and Caribbean Health Science Literature) and BDENF (Brazilian Bibliographic Database Specialized in Nursing) databases, as these are considered the main health databases in Brazil.

To survey the articles, the keywords used were "enfermagem", "sistema de medicação", "veículos homeopáticos" and "medicamentos", according to the descriptors the databases adopted.

The following criteria were used to selected the sample: articles published in Brazilian journals; articles on medication administration, covering all areas of interest to nursing; journals indexed in LILACS and BDENF and articles published between 1987 and 2008.

The full versions of all articles were obtained from the libraries at Universidade Federal de Minas Gerais, Pontifícia Universidade Católica in Belo Horizonte and Universidade de São Paulo.

The review was based on the journals: Revista Gaúcha de Enfermagem, Revista Brasileira de Enfermagem, Revista da Escola de Enfermagem da USP, Revista Nursing (Brazilian edition), Revista Latino-Americana de Enfermagem and Revista Baiana de Enfermagem. These journals were listed based on the search in the abovementioned databases.

A data collection form was elaborated and filled out for each article, including information like title, journal, year, authors and category (care, teaching, research, technique and medication errors, communication and specific drugs).

RESULTS

Before presenting the tables, it should be explained that the articles were distributed among the following categories: care, teaching, research, technique and medication errors, communication and specific drugs, respectively. To achieve this distribution, the full version of each article was read.

The authors considered it important to cite the article titles in the tables, as these facilitate the reader's reference as to the theme addressed in each article.

Next, Table 1 is presented, categorizing articles related to care according to journal, year and authors.

Table 1 reveals nine publications in Revista Brasileira de Enfermagem, the journals that published most articles on care. The second journal is Revista Latino-Americana de Enfermagem, with five publications.

Among the authors, Cassiani stood out with four publications. She was the main author in two of these, the single author in one and a co-author in yet another article.

The largest number of articles, i.e. four, was published in 2007, followed by 2003 with three publications and 1987, 1993, 1994, 1998 and 2005 with two publications each year. Next, Table 2 presents publications in the teaching category.

It is observed in Table 2 that six of the ten articles published on this theme came from Revista Brasileira de Enfermagem. A publication gap was observed between 2005 and 2008.

As to the authors, Cassiani stood out with five publications, one as the first author and four as a co-author, followed by Mendes with three publications, one as the first author and two as a co-author. Next are Nogueira, Zanetti and Zem-Mascarenhas with two publications each. Next, Table 3 shows publications in the research category.

In Table 3, Revista Latino-Americana de Enfermagem stands out with eight publications and Revista da Escola de Enfermagem da USP with five. The largest number of articles on medication administration research was published in 2000, totaling four articles. Four publications appeared in 2008 and two in 2007, both of which included Cassiani as one of the authors.

In this respect, like in Table 1, that author was responsible for seven publications, and also stood out in medication administration research. Table 4 shows articles about technique and medication errors.

In the technique category, Revista Latino-Americana de Enfermagem and Revista Nursing (Brazilian edition) stood out by the number of publications about technique, with five and four articles, respectively.

Zanetti and Grossi were the authors responsible for the largest number of articles about technique. Only two articles were published in the 1990's, and the highest number of publications was found in 2001.

In the medication errors category, Revista Brasileira de Enfermagem and Revista Latino-Americana stand out as the main knowledge producers on medication errors and 2006 as the year with the highest number of publications, i.e. four articles.

As to authorship, Cassiani strongly stands out with a production of nine articles, one as the single author and eight as a co-author. The second most frequent author is Miasso with four publications, three as the main author and one as a co-author. Bohomol, Oliveira, Pedreira and Ramos published two articles each. Table 5 shows articles on communication and specific drugs.

Only three journals published on communication, with two articles each: Revista da Escola de Enfermagem-USP, Revista Nursing (Brazilian edition) and Revista Latino-Americana de Enfermagem. Again, Cassiani appears as the main knowledge producer with two articles.

2007 displayed the highest number of publications. Scientific production gaps were found between 1990 and 1996, between 1998 and 2004 and in 2008.

The specific drugs category includes 23 articles about drugs with uncommon characteristics. All journals under analysis published on the theme. Revista Latino-Americana de Enfermagem stood out with nine articles.

Only one article was published in the 1990's, with a knowledge gap between 1990 and 1992 and between 1994 and 1999. The year 2007 stood out with the largest number of publications, totaling eight articles. As to authorship, Bechelli and Secoli stood out with two publications each.

DISCUSSION

After reading the full versions and categorizing the articles, as described in the methods section, a literature search was performed to find research to support the discussion of results.

Hence, it should be asserted that the support for nursing care, based on the production shown in Table 1, helps the nursing team to carefully assess the risks patients are exposed to, permits information on the existence of these risks and the care proposed to prevent them, with a view to achieving patient safety⁽²⁾.

Another important category is teaching, as scientific production offers relevant contributions to teaching and, consequently, to nursing practice⁽³⁾.

In view of the above, nursing research on medication administration teaching is essential for professional development, as it guarantees the passage from a state of relative ignorance to one of knowledge capable of transforming reality⁽⁴⁾.

With respect to Table 3, it is known that nursing research's main task is to contribute to evidence-based practice, demanding studies to determine the efficacy of nursing prescriptions and care. Hence, through these efforts, nursing science will grow and produce evidence-based justifications to propose changes in practice and patient care⁽⁵⁾.

It is also important to consider that theoretical foundations in terms of technique need to take into account transformations in the increasingly competitive job market. This foundation should guarantee constant training to the nursing team, permitting learning and research, with a view to getting to know new techniques and identifying their concepts and foundations.

Hence, nursing practice needs to follow evidence-based principles. Research is needed to identify and prevent medication errors, a theme present in the nursing theme's daily reality. Medication administration errors are real and severe risks to patient integrity amount to 11%⁽⁶⁾.

Hence, in view of nursing team members' different doubts during the medication preparation and administration process⁽⁷⁾, scientific research on this theme is needed. Professionals need knowledge and skills with a view to a safe and high-quality process, permitting the identification of errors before they occur.

Communication also plays a fundamental role in the medication administration process. Many errors occur when the team communicates inadequately. Research is needed to help and review medication processes and create proactive actions and strategies aimed at a better communication⁽⁸⁾.

Of all categories in this research, communication stands out as the least developed category in quantitative terms. This theme needs to be prioritized, as it is fundamental for nursing team activities, including medication administration.

The fact that the number of articles about communication is small may be related to the fact that researchers in the area are not attentive to the importance of communication in the medication administration process. Hence, they should join efforts to perform research in this knowledge area.

As for specific drugs, the need for research development is evident, considering these drugs' peculiarities in terms of pre-administration assessment, dose, administration, therapeutic effects, reduction of adverse effects, medication interactions and toxicity control. Therefore, specific knowledge needs to be mastered and a solid information base needs to be created, responsible for high-quality and safe patient care delivery⁽⁹⁾.

It should be highlighted that medication administration approaches in nursing research have been characterized by constant changes, with a view to overcoming the knowledge fragmentation present until then⁽¹⁰⁾.

CONCLUSIONS

It was considered important to identify and categorize nursing publications on medication administration in nursing journals, in view of the importance of studying scientific production with a view to high-quality evidence-based care.

One hundred eight publications on the theme were found between 1987 and 2008. Revista Latino-Americana de Enfermagem was responsible for 34 articles, followed by Revista Brasileira de Enfermagem with 29 articles. These were the journals that most published on medication administration in the study period.

The articles evidenced different authors, some of which stood out, however, especially Cassiani with 28 articles. With regard to the articles' classification, the largest number of publications addressed specific drugs, with 23 articles, followed by care and research with 21 and 20 articles, respectively. Medication errors, technique, teaching and communication were less privileged categories in quantitative terms, with 14, 14, 10 and 6 articles, respectively.

The large variety of approaches in the publications, as revealed in this study, gives some idea about the range of this theme for nursing and signals the need for researchers to invest in further research, so as to contribute to new knowledge production on medication administration, mainly on medication administration-communication, contributing to the advancement of research on this theme.

Recebido em: 1º.10.2008

Aprovado em: 8.7.2009

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Publication Dates

• Publication in this collection
  30 Nov 2009
• Date of issue
  Oct 2009

History

• Received
  01 Oct 2008
• Accepted
  08 July 2009