Black Adam, Dawood Mary
Jefferiss Wing, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
Emergency Department, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
Int Emerg Nurs. 2014 Jan;22(1):10-7. doi: 10.1016/j.ienj.2013.03.009. Epub 2013 May 4.
To explore nurse prescribing in an emergency department using patient group directions versus independent nurse prescribing.
Patient group directions allow restricted access to medication in unselected patients using pre-set criteria. Independent nurse prescribing is a flexible method of medication provision. Limited data exists on the application of either method in clinical practice.
Exploration of patient group directions and independent nurse prescribing application in an emergency department using 617 nurse practitioners' clinical notes; 235 and 382 respectively. Patient attendances from 01/07/2009 to 30/06/2010 were randomly sampled. Prescribing frequency; range of medications and diagnoses; independent episode completion and prescribing safety was explored.
Statistical difference exists in prescribing frequency between the independent nurse prescribers (51.6%, n = 197) and patient group directions (32.3%, n = 76). Appropriate medication given by 99.7% (n = 381) of independent nurse prescribers, with 1 contraindicated drug provided. The limitations of patient group directions was highlighted in 11.8% (n = 9) of cases, however all drugs given were appropriate for the diagnosis. No statistical difference in independent episode completion.
Nurses provide appropriate medication in an emergency department. Patients being managed by nurse prescribers were more likely to receive medication. Further investigation is required to justify this.
探讨在急诊科使用患者群体指导用药与独立护士处方用药的情况。
患者群体指导用药允许在未经过筛选的患者中根据预设标准有限制地获取药物。独立护士处方是一种灵活的药物供应方式。关于这两种方法在临床实践中的应用数据有限。
通过617名执业护士的临床记录（分别为235份和382份）探讨患者群体指导用药和独立护士处方用药在急诊科的应用情况。对2009年7月1日至2010年6月30日期间的患者就诊情况进行随机抽样。探讨了处方频率、药物和诊断范围、独立诊疗过程的完成情况以及处方安全性。
独立护士处方者（51.6%，n = 197）和患者群体指导用药（32.3%，n = 76）之间在处方频率上存在统计学差异。99.7%（n = 381）的独立护士处方者给予了适当的药物，仅提供了1种禁忌药物。在11.8%（n = 9）的病例中凸显了患者群体指导用药的局限性，不过所有给予的药物均与诊断相符。在独立诊疗过程的完成方面无统计学差异。
护士在急诊科提供了适当的药物。由护士处方者管理的患者更有可能接受药物治疗。需要进一步调查以证实这一点。
