儿科护士药物处方权的申请资格与处方内容分析

Analysis of eligibility and prescription content for pediatric nurse prescribing authority

目的:对儿科护士药物处方权的申请资格、处方内容及处方形式进行调查分析。方法:基于目的抽样法,选择本市4所医院62名从事儿科护理工作的护士作为试验组,同期选择57名儿科医生作为对照组。采用自行设计的调查问卷,通过线上填写形式调查医护人员对儿科护士药物处方权的申请资格、申请意愿及影响因素,并调查医护人员对护士药物处方权利弊的认知现状、对处方权内容的认知态度等。结果:儿科护士申请药物处方权资格支持率最高为学历在专科及以上、职称在中级及以上、工作年限>5年。对照组与试验组在护士申请处方权资格、处方权内容调查方面存在差异(P<0.05)。试验组在清洁消毒抗菌类药品、溶液类药品、腹泻及便秘用药、气化雾化治疗及相关用具、压力性损伤治疗及相关用具、注射及输液相关器械以及伤口、造口、导尿护理及相关医疗用品等方面的处方权赞成率较高,且与对照组比较差异有统计学意义(P<0.05)。试验组护士对于药物处方权的利弊认知排名居前2位的是:更好、更便捷地为患儿提供基础治疗服务;增加患儿就医的便利性,减轻医生工作负担。对于开放护士处方权后需解决的问题主要有:护士的培训和资质问题、病人安全和医疗错误的风险、护士处方药品的范围和限制问题等。结论:针对儿科护士药物处方权的申请资格,赞成高学历、高年资、高职称的护士申请处方权的比例更高,且儿科护士比儿科医生对于护士申请处方权持更加积极的支持态度。儿科护士申请药物处方权虽有利于护士工作开展及患儿就诊,但也存在严重弊端,必须在出台完善的法律保障体系,明确处方权限范围与职责划分后再开始进一步推行。

Objective:To investigate the eligibility,prescription content,and prescription form of pediatric nurse prescribing authority.Methods:A purposive sampling method was used to select 62 pediatric nurses working in four hospitals in the city as the experimental group and 57 pediatric doctors as the control group.A self⁃designed questionnaire was used to investigate the application qualifications and intention,as well as the influencing factors of pediatric nurse prescribing authority among medical staff through online filling,as well as the cognitive status of medical staff on the advantages and disadvantages of nurse prescribing authority,and their attitude towards the content of prescribing authority.Results:The highest support rate for eligibility of pediatric nurse prescription authority among the four hospitals in the city was as follows:education level above college degree,intermediate or higher professional title,and work experience of at least 5 years.There were differences in the investigation of the eligibility and prescription content of nurse prescribing authority between the control group and the experimental group(P<0.05).The experimental group had a higher approval rate for prescribing authority in areas such as clean disinfection antibacterial drugs,solution drugs,diarrhea and constipation drugs,gasification and atomization treatment and related equipment,pressure sore treatment and related equipment,injection and infusion related equipment,wound,stoma,catheterization care and related medical supplies,and the difference with the control group was significant(P<0.05).The top two cognitive rankings of the advantages and disadvantages of medication prescribing authority for nurses in the experimental group provided better and more convenient basic treatment services for pediatric patients;increase the convenience o medical treatment for children,reduce the workload of doctors.The main issues that need to be addressed after opening nurse prescribing authority include:nurse training and qualification issues,patient safety and medical error risks,and the scope and limitations of nurse prescribing drugs.Conclusion:For pediatric nurse prescribing authority,nurses with high education,seniority,and professional titles are more likely to apply for prescribing authority,and pediatric nurses have a more positive attitude towards nurse prescribing authority than pediatric doctors.Although the application of pediatric nurse prescribing authority is beneficial for the work of nurses and the treatment of pediatric patients,it also has serious disadvantages.It is necessary to establish a sound legal guarantee system and clarify the scope of prescription authority and the division of responsibilities before further promotion.