Centre for Advanced Studies in Nursing, Division of Applied Health Sciences, University of Aberdeen, UK.
J Psychiatr Ment Health Nurs. 2012 Dec;19(10):916-32. doi: 10.1111/j.1365-2850.2011.01872.x. Epub 2012 Feb 1.
This paper reports a pilot study exploring mental health nurse prescribers' perceptions of barriers to prescribing independently but also includes perceptions of barriers to supplementary prescribing. Current prescribing practice as experienced by mental health nurses suggests a need to identify and highlight these barriers. A mixed methodology explanatory sequential study was carried out over 3 months in Scotland in 2008 as part of a Master's degree. A questionnaire was completed by 33 mental health nurse prescribers. A focus group was conducted with 12 mental health nurse prescribers. Participants' views exposed a number of barriers to prescribing previously unidentified in a review of the relevant literature, and concurred with some previously documented barriers. Sixty per cent of mental health nurse prescribers in the study were not prescribing. Barriers identified in the study included concern about how prescribing impacts on the therapeutic relationship, role conflict, lack of support, inappropriateness of prescriber training, remuneration, qualifying to prescribing time, supervision, prescribing policies, clinical governance and nurse management. Nurse prescribing involves increased accountability and responsibility which is not currently recognized in job status or pay banding. Mental health nurse prescribing has the potential to enhance service provision, but until barriers to prescribing have been identified and addressed as part of the process of organizational change, nurse prescribing cannot achieve its maximum potential.
本文报告了一项探索精神科护士从业者独立处方障碍的初步研究，同时也包括了对补充处方障碍的看法。精神科护士目前的处方实践表明，有必要识别和强调这些障碍。2008 年，在苏格兰进行了为期 3 个月的混合方法解释性顺序研究，作为硕士学位的一部分。33 名精神科护士从业者完成了一份问卷。对 12 名精神科护士从业者进行了焦点小组讨论。参与者的观点揭示了一些在对相关文献进行回顾时未被识别的处方障碍，并与一些之前记录的障碍达成了一致。研究中有 60%的精神科护士从业者没有开处方。研究中发现的障碍包括担心处方对治疗关系的影响、角色冲突、缺乏支持、处方培训不当、薪酬、获得处方时间、监督、处方政策、临床治理和护士管理。护士处方需要承担更多的责任和义务，但目前在工作地位或薪酬级别上并没有得到认可。精神科护士处方有可能提高服务提供，但在处方障碍被确定并作为组织变革过程的一部分得到解决之前，护士处方无法发挥其最大潜力。
