Ryan-Woolley Bernadette M, McHugh Gretl A, Luker Karen A
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
Palliat Med. 2007 Jun;21(4):273-7. doi: 10.1177/0269216307079047.
This study investigates Macmillan nurses' views on nurse prescribing in cancer and palliative care and explores perceived motivators and barriers to training for and the implementation of this extended nursing role.
National postal survey of 2252 Macmillan nurses in the UK.
A response rate of 70% (1575) was achieved. Eleven percent (168 of 1575) of Macmillan nurses surveyed were trained as extended formulary independent nurse prescribers. Half (88 of 168) of the Macmillan nurses who could prescribe from the extended formulary were prescribing, representing just 6% (88 of 1575) of the sample. Training deficits highlighted included poor organization and insufficient length, depth and specificity of courses (to meet the needs of nurses working in palliative care) and a lack of medical mentorship. Among Macmillan nurses who had not undergone extended formulary independent nurse prescribing training, 25% (335) perceived that prescribing was not part of their specialist nursing role. A further 40% (538) expressed reluctance to undergo training.
A clear lack of enthusiasm amongst specialist nurses in cancer and palliative care to undertake prescribing training was identified. It is noteworthy that half of the Macmillan nurses trained as extended formulary independent nurse prescribers were not prescribing. Since government targets for nurse prescribing are not yet being met, these findings raise important questions concerning whether extended nurse prescribing is likely to be a successful initiative in cancer and palliative care.
本研究调查了麦克米伦护士对癌症及姑息治疗中护士处方权的看法，并探讨了她们对这种扩展护理角色培训及实施的感知动机和障碍。
对英国2252名麦克米伦护士进行全国邮政调查。
回复率为70%（1575人）。接受调查的麦克米伦护士中有11%（1575人中的168人）接受了扩展处方集独立护士处方权培训。能够依据扩展处方集进行处方的麦克米伦护士中有一半（168人中的88人）正在进行处方开具，这仅占样本的6%（1575人中的88人）。突出的培训不足包括组织不善、课程长度、深度和针对性不足（无法满足姑息治疗护士的需求）以及缺乏医学指导。在未接受扩展处方集独立护士处方权培训的麦克米伦护士中，25%（335人）认为处方开具不属于其专科护理角色的一部分。另有40%（538人）表示不愿接受培训。
研究发现，癌症及姑息治疗专科护士对接受处方权培训明显缺乏热情。值得注意的是，接受扩展处方集独立护士处方权培训中的麦克米伦护士有一半未进行处方开具。鉴于尚未达到政府关于护士处方权的目标，这些发现引发了关于扩展护士处方权在癌症及姑息治疗中是否可能成为一项成功举措的重要问题。
