Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of ...Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.展开更多
目的:对重症病人再喂养综合征(RFS)的诊断标准、发生现状及RFS的影响因素进行范围综述,为RFS的预防及早期发现提供参考依据。方法:采用ARKSEY提出的范围综述的研究框架,检索PubMed、Web of Science、EMbase、the Cochrane Library、中...目的:对重症病人再喂养综合征(RFS)的诊断标准、发生现状及RFS的影响因素进行范围综述,为RFS的预防及早期发现提供参考依据。方法:采用ARKSEY提出的范围综述的研究框架,检索PubMed、Web of Science、EMbase、the Cochrane Library、中国生物医学文献数据库、中国知网、维普数据库和万方数据库关于重症病人再喂养综合征的研究,检索时限为建库至2022年12月。由2名研究人员根据纳入与排除标准独立进行文献筛选、数据提取,收集并总结数据,报告研究结果。结果:共纳入16篇文献,未发现RFS统一的诊断标准,采用NICE提出的RFS诊断标准的研究居多;重症病人RFS的发生率为6.5%~73.5%,在不同研究和不同患病群体之间存在一定差异;重症病人RFS的主要影响因素包括人口学、营养、疾病、再喂养、生化指标及治疗。结论:应进一步探讨RFS的国际标准化定义、制定严格的筛查工具、标准化防治策略、开展个体化干预措施,为重症病人的RFS早期筛查及干预提供支持。展开更多
基金project was supported by the Shanxi Province Soft Science Research Program in China(No.2017041041-1)
文摘Objective:To investigate the necessary eligibility criteria for prescriptive authority for midwives,gather suggestions from experts on training content for prescriptive authority for midwives,and explore the scope of practice of their prescriptive authority in certain circumstances.The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives.Methods:Based on a literature search and semistructured interviews,a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives.This stage included nursing experts(20)and medical experts(16)engaged in midwifery in many tertiary Grade A hospitals in China.Subsequently,consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts(18)and medical experts(14)engaged in midwifery in many tertiary Grade A hospitals in China.The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority,training content,circumstances,scope of practice for prescriptive authority,and the prescription forms.Results:Among the consulted experts,70.59%(the highest acceptance rate)considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority,85.29%(the highest acceptance rate)considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority,and 50%(the highest acceptance rate)considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority.The applicants should at least be practicing at Grade C hospitals,which was the consensus among 91.18%of the consulted experts.Among the consulted experts,100%,100%,97.06%,94.12%,and 94.12%agreed that the applicants should have knowledge in pharmacology,laws and ethics,nursing,diagnostics,and midwifery,respectively.The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority,including uterine atony,excessive uterine contraction,postpartum hemorrhage,premature rupture of fetal membranes,normal labor,and neonatal asphyxia.Under these 6 circumstances,the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives.Of these prescriptions,51.5%were independent prescriptions,30.3%were protocol prescriptions,and the remaining 18.2%were both independent and protocol prescriptions.Conclusions:Midwives who have an undergraduate degree,supervisor nurse position,and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority.Partial prescriptive authority could be granted after regulated training in fundamental theories and practices,which could improve the independence and professionalism of midwifery.
文摘目的:对重症病人再喂养综合征(RFS)的诊断标准、发生现状及RFS的影响因素进行范围综述,为RFS的预防及早期发现提供参考依据。方法:采用ARKSEY提出的范围综述的研究框架,检索PubMed、Web of Science、EMbase、the Cochrane Library、中国生物医学文献数据库、中国知网、维普数据库和万方数据库关于重症病人再喂养综合征的研究,检索时限为建库至2022年12月。由2名研究人员根据纳入与排除标准独立进行文献筛选、数据提取,收集并总结数据,报告研究结果。结果:共纳入16篇文献,未发现RFS统一的诊断标准,采用NICE提出的RFS诊断标准的研究居多;重症病人RFS的发生率为6.5%~73.5%,在不同研究和不同患病群体之间存在一定差异;重症病人RFS的主要影响因素包括人口学、营养、疾病、再喂养、生化指标及治疗。结论:应进一步探讨RFS的国际标准化定义、制定严格的筛查工具、标准化防治策略、开展个体化干预措施,为重症病人的RFS早期筛查及干预提供支持。
