护士抗肿瘤药物和免疫抑制剂与免疫调节剂处方权内容的研究

Research on content of prescription rights for nurses′anti-tumor drugs,immunosuppressants and immunomodulators

[目的]探讨我国三级甲等医院符合处方权申请者资质的肿瘤科护士可开具抗肿瘤药物、风湿免疫科护士可开具免疫抑制剂与免疫调节剂的处方内容。[方法]通过查阅国内外护士处方权文献,初步筛选抗肿瘤药物7个类别80种药物,免疫抑制剂与免疫调节剂10个类别38种药物,制作咨询问卷,应用改良式德尔菲法对24名肿瘤科专家、22名风湿免疫科专家进行2轮专家咨询,对咨询结果进行整理分析,通过计算专家积极系数和权威程度评估咨询结果的可靠性。[结果]专家不建议护士开出抗肿瘤药物,建议风湿免疫科护士以协议处方形式开出白芍总苷。肿瘤科、风湿免疫科2轮咨询专家积极系数分别为93.33%、100.00%和92.31%、100.00%,2轮权威系数分别为0.84、0.87和0.82、0.87。[结论]本次咨询专家权威程度较高,结果可靠。确定了肿瘤科护士可开具抗肿瘤药物、免疫抑制剂与免疫调节剂的处方内容与处方形式。

Objective:To explore the content of prescriptions for antineoplastic drugs and immunosuppressants and immunomodulators that can be issued by nurses in oncology department and rheumatology and immunology department who are qualified as prescription right applicants in Third Grade A Hospitals in China.Methods:By consulting the literature of nurses′prescription rights at home and abroad,a total of 80 drugs in seven categories of antitumor drugs,38 drugs in ten categories of immunosuppressants and immunomodulators were preliminarily screened,and a questionnaire was made.The modified Delphi method applied two rounds of expert consultations were conducted with 24 oncology experts and 22 rheumatology immunology experts,and the results of the consultation were analyzed.The reliability of the consultation results was evaluated by calculating the expert′s positive coefficient and authority.Results:Experts did not recommend that nurses prescribed antineoplastic drugs,and recommended that nurses in rheumatism and immunology department prescribed total glucosides of paeony in the form of protocol prescription.The positive coefficients of two rounds of consulting experts in the Oncology and Rheumatology Departments were 93.33%,100.00%and 92.31%,100.00%,and the authoritative coefficients of two rounds were 0.84,0.87and0.82,0.87.Conclusion:The level of authority of the consulting experts was relatively high,and the results were reliable.The content and form of prescription of antineoplastic drugs,immunosuppressants and immunomodulators were determined.