中医护理门诊护士处方权准入资质与内容的构建

Study on the qualifications and contents of the prescription authority of nurses in traditional Chinese medicine outpatient care based on Delphi method

目的探讨中医护理门诊护士处方权的准入资质与处方内容及形式,为中医护理门诊出诊护士处方权相关政策制定与培训教学等工作的开展提供参考。方法通过文献回顾、理论分析、临床访谈等方法初步构建专家函询问卷。共纳入31名中医护理专家,基于Delphi法进行2轮问卷函询,对函询结果进行统计、分析。结果2轮专家函询问卷的有效回收率分别为90.3%和100%;专家的权威系数为0.909。中医护理门诊护士处方权准入资质要求为:本科学历,从事中医临床护理工作至少5年,具备主管护师职称;共确定了5大类36条处方:中医护理技术处方10条、护理干预处方13条、治疗材料处方8条、检查处方4条,药物处方1条;常见中医护理技术处方除了针刺法为协议处方外,其余均为独立处方;护理干预和治疗处方均为独立处方;常见检查均为独立/协议处方。结论基于Delphi法构建的中医护理门诊护士处方权准入资质与内容具有科学性、实用性,有利于中医护理门诊的进一步发展,但还需进一步深入细致探究护士处方权的具体内容和形式,为制定和完善护士处方权相关政策提供依据。

Objective To investigate the qualification requirements for nurses in traditional Chinese medicine(TCM)nursing clinics,as well as the content and forms of prescriptions,and to provide reference for the formulation of policies and training of the prescription authority of nurses in TCM nursing clinics.Methods The primary consultation questionnaires were developed through li-terature review,theoritical analysis and clinical interviews.Two rounds of consultation were conducted with 31 experts by Delphi method,and the results of the questionnaires were counted and analyzed.Results The response rates of experts in the two rounds were 90.3%and 100%,respectively.The authority of the consultation was 0.909.The qualification requirements for nurse prescribing authority in TCM outpatient care included a bachelor′s degree,a minimum of five years of clinical nursing experience in TCM,and holding the title of charge nurse.A total of 36 prescription categories were established,divided into five main types:10 for TCM nursing techniques,13 for nursing interventions,8 for treatment materials,4 for examinations,and 1 for medication.Among the commonly used TCM nursing technique prescriptions,acupuncture was designated as an agreed prescription,while the others were classified as independent prescriptions.Both nursing intervention and treatment prescriptions were recognized as independent prescriptions,and all common examinations were categorized as either independent or agreed prescriptions.Conclusion The qualification and content of nurse prescribing authority in TCM outpatient care,developed based on the Delphi method,demonstrate scientific rigor and practicality.This framework is conducive to the further development of TCM nursing outpatient services.However,there is a need for more in-depth and detailed exploration of the specific content and forms of nurse prescribing authority.Such investigations will provide a basis for formulating and refining policies related to nurse prescribing authority.