应用Delphi法对临床护士特定情况下药物处方权的再探讨

Re-probe into application of Delphi method on drugs-prescription right of clinical nurses under particular situations

[目的]探讨中国临床护士特定情况下的药物处方权。[方法]采用自行设计的问卷,应用Delphi法对30名护理专家和10名医疗专家进行临床护士特定情况下药物处方权的问卷咨询。[结果]第2轮专家认同率最高的特定情况:高热时开具柴胡、对乙酰氨基酚倾向于护士独立处方形式,开具地塞米松倾向于协议处方,对高热惊厥时开具水合氯醛两种处方形式接近,开具苯巴比妥倾向于协议处方;低血糖症时开具葡萄糖溶液倾向于护士独立处方形式,开具氢化可的松倾向于协议处方;延长处方中的癌症姑息治疗时开具镇痛药两种处方形式接近、开具止吐药倾向于护士独立处方形式,高血压时开具降压药倾向于协议处方。[结论]医疗专家和护理专家对给予临床护士特定情况下一定的药物处方较认可,可以给予高热、低血糖症、高血压急症等11项特定情况时具体药物的处方权。

Objective：To probe into drugs-prescription right of Chinese clinical nurses under particular situations.Methods： By adopting self-designed questionnaire and Delphi method,a total of 30 nursing experts and 10 medical experts accepted questionnaire consultation on drugs-prescription right of clinical nurses under particular situations.Results： Experts in the second round agreed that the particular situations of the highest self-identity rates including prescribing bupleurum and acetaminophen when patients with high fever tended to independent prescribing form of nurses,prescribing dexamethasone tended to agreement prescription.For infants with febrile convulsions,to prescribe chloral hydrate was close of two prescriptions forms,while to prescribe phenobarbital tended to agreement prescription.For patients with hypoglycemia,to prescribe glucose solution tended to independent prescribing form,while to prescribe hydrocortisone tended to agreement prescription.For cancer patients accepting palliative treatment of prolonging prescription,to prescribe analgesics was close of two prescriptions forms,while to prescribe antiemetics tended to agreement prescription of nurses.For hypertension patients,to prescribe antihypertensive drugs tended to agreement prescription.Conclusions：Both nursing and medical experts were recognized that to give some drugs-prescription rights to clinical nurses under particular situations,which including 11 particular situations such as patients with high fever,hypoglycemia,hypertension and so on.