Courtenay Molly, Carey Nicola, Burke Joanna
School of Health and Social Care, University of Reading, Reading, UK.
J Adv Nurs. 2006 Sep;55(6):698-707. doi: 10.1111/j.1365-2648.2006.03960.x.
From Spring 2006, independent extended nurse prescribers in the United Kingdom will be able to prescribe any licensed medicines except controlled drugs. Supplementary nurse prescribers are currently able to prescribe any medication. No other country in the world has such extended prescribing rights for nurses. Aspects of prescribing viewed positively by nurses include continuity of care, increased satisfaction, and the belief that patients receive improved information about prescriptions. There is some evidence, however, that nurses feel ill-prepared to prescribe due to poor understanding of pharmacology, physical assessment and diagnosis.
This paper reports a study assessing the extent to which independent extended supplementary nurse prescribers feel prepared to prescribe medicines for patients with dermatological conditions.
A convenience sample of 1187 qualified independent extended supplementary nurse prescribers was sent a postal questionnaire. A total of 868 completed questionnaires was returned, and 638 of these nurses prescribed medicines for skin conditions. The data were collected in 2005.
A total of 605 (94.8%) participants used independent extended prescribing and 234 (36.7%) supplementary prescribing. The majority were highly experienced and worked in primary care. In general, their prescribing programme had met their needs when prescribing medicines for patients with dermatological conditions. However, the needs of those who had undertaken a diploma-level module in dermatology and/or dermatology study days, and those working in both primary and secondary care, were met to a statistically significantly greater extent during the programme than for those nurses without this preparation, or those working in either primary or secondary care.
Independent extended supplementary prescribing has extended the role that nurses in the United Kingdom are able to play in the management of skin disease. Specialist dermatology training is a prerequisite for nurses adopting this role. Further evaluative work on patient-focused outcomes, i.e. accessibility and convenience of care, and satisfaction with quality of care, is required.
自2006年春季起，英国的独立扩展护士处方医生将能够开具除管制药品外的任何已获许可的药品。补充护士处方医生目前能够开具任何药物。世界上没有其他国家赋予护士如此广泛的处方权。护士对处方的积极看法包括护理的连续性、满意度提高，以及认为患者能获得更多关于处方的信息。然而，有证据表明，由于对药理学、体格检查和诊断的理解不足，护士觉得自己没有做好开处方的准备。
本文报告一项研究，评估独立扩展补充护士处方医生为皮肤病患者开处方时的准备程度。
向1187名合格的独立扩展补充护士处方医生发放了邮寄问卷，这是一个便利样本。共收到868份完整问卷，其中638名护士为皮肤病患者开处方。数据于2005年收集。
共有605名（94.8%）参与者使用独立扩展处方，234名（36.7%）使用补充处方。大多数参与者经验丰富，在初级保健机构工作。总体而言，他们的处方计划在为皮肤病患者开处方时满足了他们的需求。然而，在该计划中，参加过皮肤科文凭课程模块和/或皮肤科学习日的护士，以及在初级和二级保健机构工作的护士的需求，在统计学上比没有这种准备的护士或仅在初级或二级保健机构工作的护士得到了更大程度的满足。
独立扩展补充处方扩大了英国护士在皮肤病管理中所能发挥的作用。专科皮肤科培训是护士承担这一角色的先决条件。需要进一步开展以患者为中心的结果评估工作，即护理的可及性和便利性以及对护理质量的满意度。
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