title: Factors that condition the spontaneous reporting of adverse drug reactions among nurses: an integrative review.
abstract: OBJECTIVE
  To describe and synthesise previous research on factors conditioning the spontaneous reporting of adverse drug reactions among nurses.
  
  
  BACKGROUND
  Spontaneous reports of adverse drug reactions by health-care providers, are a main instrument for the continuous evaluation of the risk-benefit ratio of every drug. Under-reporting of adverse drug reactions by all health-care providers, in particular by nurses, is a major limitation to this system.
  
  
  RESULTS
  An integrated review of the literature was conducted using MEDLINE, CINAHL, Embase, Scopus databases and Google Scholar. After evaluation for appropriateness related to inclusion/exclusion criteria, 16 studies were included in the final analysis and synthesis.
  
  
  RESULTS
  Two factors emerged from the study: (1) intrinsic factors related to nurses' knowledge and attitudes; (2) extrinsic factors related to nurses' interaction with health-care organisations and to the relationship between nurses and physicians. Nurses' attitudes that hinder reporting include ignorance, insecurity, fear and lethargy.
  
  
  CONCLUSIONS
  Nurses are not fully aware of their role in adverse drug reaction reporting. Nurses must acquire greater knowledge to implement specific skills into their daily clinical practice.
  
  
  CONCLUSIONS
  To improve nurses' reporting of adverse drug reactions, it is necessary to develop management approaches that modify both intrinsic and extrinsic factors.
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: De Angelis
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Sofia
authors.initials: S
authors.lastname: Colaceci
authors.affiliation: National Centre of Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Giusti
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D006801:Humans; D024802:Nurse's Role; D019555:Physician-Nurse Relations; D057184:Practice Patterns, Nurses'
keywords: adverse drug reaction reporting systems; attitudes; nurses; pharmacovigilance