Miles K, Seitio O, McGilvray M
Camden Primary Care Trust/Centre for Sexual Health and HIV Research, Royal Free and University College Medical School, University College London, London, UK.
Int Nurs Rev. 2006 Dec;53(4):290-6. doi: 10.1111/j.1466-7657.2006.00491.x.
This paper reviews the professional issues relating to nurse prescribing in low-resource countries.
In order to meet community healthcare need, nurses in low-resource settings often perform roles such as prescribing medication, for which they may not have had adequate training, often in the absence of supervision, legislation and regulation. In general, however, there is a paucity of published evidence relating to nurse prescribing in low-resource settings. Several studies have demonstrated improved health and social outcomes resulting from nurse-prescribing interventions. Alternatively, other studies have shown unsatisfactory nurse-prescribing patterns, such as overuse of antibiotics and poor adherence to national treatment guidelines. There are several examples of how nurse prescribing in low-resource countries has been recognized and addressed at national level; these are discussed in detail. However, given that it is widely acknowledged how crucial nurses are for the delivery of health care in regions where there are no medical personnel, international policy and guidance relating to this issue is only just beginning to acknowledge and address the relevant issues.
Where there is a need for nurses to extend their role in the ordering of medicines and other treatments, the responsibilities, training, rights and roles of these nurses need to be clearly defined and recognized at all levels of the health service. There is a need for rigorous evaluations incorporating health, social and economic outcomes of nurse-prescribing interventions, in addition to close monitoring of legislative and regulatory changes related to nursing roles.
本文综述了资源匮乏国家与护士开处方相关的专业问题。
为满足社区医疗需求,资源匮乏地区的护士常常履行诸如开处方等职责,而他们可能未接受过充分培训,且往往缺乏监督、立法和监管。然而总体而言,关于资源匮乏地区护士开处方的已发表证据很少。多项研究表明,护士开处方干预带来了更好的健康和社会结果。另一方面,其他研究显示护士的开处方模式不尽人意,如抗生素过度使用以及对国家治疗指南的依从性差。有几个关于资源匮乏国家护士开处方如何在国家层面得到认可和解决的例子,将详细讨论这些例子。然而,鉴于人们普遍认识到在没有医务人员的地区护士对提供医疗保健至关重要,有关这一问题的国际政策和指导才刚刚开始承认并解决相关问题。
在需要护士扩大其在药品和其他治疗开单方面作用的地方,这些护士的责任、培训、权利和作用需要在卫生服务的各级得到明确界定和认可。除了密切监测与护理角色相关的立法和监管变化外,还需要对护士开处方干预的健康、社会和经济结果进行严格评估。