Resilience in nursing medication administration practice: a systematic review with narrative synthesis

Area of Science:

• Nursing
• Patient Safety
• Healthcare Management

Background:

• Limited understanding of how nurses adapt medication administration to ensure safety.
• Resilience is the capacity to adapt and respond proactively to prevent harm.
• Existing research primarily focuses on medication errors rather than adaptive strategies.

Purpose of the Study:

• To synthesize evidence on resilience principles and practices in nursing medication administration.
• To explore how nurses maintain safety during medication administration.
• To identify triggers and strategies for resilient medication administration.

Main Methods:

• Systematic review guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
• Searched MEDLINE, EMBASE, PsychINFO, and CINAHL databases.
• Thematic synthesis of 32 empirical studies of varying methodologies.

Main Results:

• Thirty-two studies met inclusion criteria, with most of good quality.
• Eleven interventional studies and 21 non-interventional studies were included.
• Resilient medication administration strategies emerge from five identified triggers.

Conclusions:

• Nurses' resilience practices are responses to triggers threatening safety and productivity.
• These practices involve short-term, real-time adaptations to preserve safety.
• Resilience helps compensate for and respond to complexities in modern healthcare settings.