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神经药理学与心理健康护士处方医生。

Neuropharmacology and mental health nurse prescribers.

作者信息

Skingsley David, Bradley Eleanor J, Nolan Peter

机构信息

Faculty of Health & Sciences, Staffordshire University, Stafford, UK.

出版信息

J Clin Nurs. 2006 Aug;15(8):989-97. doi: 10.1111/j.1365-2702.2006.01378.x.

Abstract

AIMS AND OBJECTIVES

To outline the development and content of a 'top-up' neuropharmacology module for mental health nurse prescribers and consider how much pharmacology training is required to ensure effective mental health prescribing practice.

BACKGROUND

Debate about the content of prescribing training courses has persisted within the United Kingdom since the mid-1980s. In early 2003 supplementary prescribing was introduced and gave mental health nurses the opportunity to become prescribers. The challenge of the nurse prescribing curriculum for universities is that they have only a short time to provide nurses from a range of backgrounds with enough knowledge to ensure that they meet agreed levels of competency for safe prescribing. There is growing concern within mental health care that the prescribing of medication in mental health services falls short of what would be deemed good practice. Over the past two decades, nurse training has increasingly adopted a psychosocial approach to nursing care raising concerns that, although nurses attending prescribing training may be able to communicate effectively with service users, they may lack the basic knowledge of biology and pharmacology to make effective decisions about medication.

METHODS

Following the completion of a general nurse prescribing course, mental health nurses who attended were asked to identify their specific needs during the evaluation phase. Although they had covered basic pharmacological principles in their training, they stated that they needed more specific information about drugs used in mental health; particularly how to select appropriate drug treatments for mental health conditions. This paper describes how the nurses were involved in the design of a specific module which would enable them to transfer their theoretical leaning to practice and in so doing increase their confidence in their new roles.

RESULTS

The findings of this study suggest that the understanding and confidence of mental health nurse prescribers about the drugs they prescribe coupled with the information they provide to service users can be improved as a result of specific educational support. It would appear that adopting a prescribing dimension to one's role requires nurses to revisit a number of skills that are integral to the work of the mental health nurse, e.g. good communication, establishing empathy, listening to what clients say, responding to what is required and involving clients in their own care.

CONCLUSIONS

Mental health nurses from one particular Trust in the West Midlands were provided with a 'top-up' course in neuropharmacology and, although they found this challenging, ultimately they found this to be helpful. As nurse prescribing is 'rolled out' to other nursing specialities it is important that local Trusts and Workforce Development Directorates maintain a dialogue about nurse prescriber training to ensure that nurse prescribers receive the appropriate time and support for their ongoing Continued Professional Development. As increasing numbers of nurses from different specialities qualify as nurse prescribers it is vital that they are supported by their employing organizations and given the opportunity to maintain their competency and confidence in their prescribing practice.

摘要

目的与目标

概述为心理健康护士处方医生开设的“强化”神经药理学模块的发展历程与内容,并思考需要多少药理学培训才能确保有效的心理健康处方实践。

背景

自20世纪80年代中期以来,英国国内关于处方培训课程内容的争论一直持续。2003年初引入了补充处方制度,这让心理健康护士有机会成为处方医生。大学护理处方课程面临的挑战在于,它们只有很短的时间为来自不同背景的护士提供足够的知识,以确保他们达到安全处方的既定能力水平。心理健康护理领域越来越担心,心理健康服务中的药物处方未能达到良好实践的标准。在过去二十年中,护士培训越来越多地采用心理社会护理方法,这引发了人们的担忧,即尽管参加处方培训的护士可能能够与服务使用者有效沟通,但他们可能缺乏生物学和药理学的基础知识,无法就药物治疗做出有效决策。

方法

在完成一般护士处方课程后,要求参加课程的心理健康护士在评估阶段确定他们的具体需求。尽管他们在培训中已经涵盖了基本药理学原理,但他们表示需要更多关于心理健康用药的具体信息;特别是如何为心理健康状况选择合适的药物治疗。本文描述了护士如何参与设计一个特定模块,该模块将使他们能够将理论学习转化为实践,并因此增强他们对新角色的信心。

结果

本研究结果表明,通过特定的教育支持,可以提高心理健康护士处方医生对所开药物的理解和信心,以及他们向服务使用者提供的信息。似乎在角色中加入处方维度要求护士重新审视一些对心理健康护士工作至关重要的技能,例如良好的沟通、建立同理心、倾听客户所说的话、回应所需内容以及让客户参与自身护理。

结论

西米德兰兹郡一个特定信托机构的心理健康护士参加了神经药理学“强化”课程,尽管他们发现这具有挑战性,但最终他们认为这很有帮助。随着护士处方制度“推广”到其他护理专业,当地信托机构和劳动力发展部门保持关于护士处方医生培训的对话非常重要,以确保护士处方医生在持续的专业发展中获得适当的时间和支持。随着越来越多来自不同专业的护士获得护士处方医生资格,至关重要的是他们得到雇主组织的支持,并有机会保持他们在处方实践中的能力和信心。

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