NHS London, UK.
J Adv Nurs. 2011 Jan;67(1):117-26. doi: 10.1111/j.1365-2648.2010.05490.x. Epub 2010 Nov 15.
This paper is a report of an evaluation of the implementation of nurse prescribing in an acute care hospital in England.
At the time of the study, evaluation of nurse prescribing had taken place in community settings, but little was known about its impact and effectiveness in acute care. Although nurse prescribing has permitted doctor-nurse substitution in acute episodic care, some doctors have expressed concerns about patient safety in relation to nurse prescribing.
A mixed methods single-case study was conducted in 2005-06, using purposive sampling. Semi-structured interviews were carried out with 18 hospital staff, non-participant observation of two nurses and two doctors undertaking 52 patient-prescriber consultations with 47 patients, and a questionnaire survey with 122 patients (response rate 61%: n=74).
Nurse prescribing was found to benefit patients through service delivery improvement and using staff skills differently. Nurse prescribers and their colleagues were positive about role and service changes and their impact on patient care. No differences were found between the ways in which nurses and doctors performed prescribing roles, but there was a statistically significant difference between the medication-related information satisfaction ratings of patients who had seen a nurse prescriber, compared to those seen by a doctor.
Nurses and doctors were found to provide equivalent care. Shared vision, local champions, action learning and peer support were the enabling factors that helped to embed the new prescribing roles within the study site.
本文报告了对英格兰一家急症护理医院护士处方执行情况的评估。
在研究时，社区环境下已经进行了护士处方评估，但对于在急症护理中的影响和效果知之甚少。尽管护士处方允许在急性发作性护理中替代医生-护士，但一些医生对与护士处方相关的患者安全表示担忧。
2005-06 年采用目的抽样进行了一项混合方法单案例研究。对 18 名医院工作人员进行了半结构式访谈，对两名护士和两名医生进行了非参与式观察，他们与 47 名患者进行了 52 次患者-处方者咨询，对 122 名患者进行了问卷调查（回应率 61%：n=74）。
护士处方通过改善服务交付和以不同方式利用员工技能被发现有利于患者。护士处方者及其同事对角色和服务变化及其对患者护理的影响持积极态度。护士和医生执行处方角色的方式没有差异，但与看过护士处方者相比，看过医生处方者的患者对药物相关信息满意度评分存在统计学显著差异。
发现护士和医生提供的护理等效。共同愿景、当地拥护者、行动学习和同行支持是帮助在研究现场嵌入新处方角色的促成因素。
