Wilkinson Jill
School of Nursing, Massey University, Wellington, New Zealand.
J Prim Health Care. 2015 Mar 1;7(1):34-41.
The Medicines (Standing Order) Amendment Regulations 2011 allow medicines to be supplied or administered to a patient by a nurse in the absence of a medical practitioner and without a prescription. Regulations have been in place since 2002, but no substantive research has occurred in New Zealand concerning their use.
This paper reports a survey of registered nurses (RNs) who work in primary health care (PHC) settings and explores aspects of their practice relating to their use of standing orders.
A self-reported survey using a non-probability sample of RNs working in PHC who use standing orders in their practice (n=231). Data were analysed descriptively.
The sample were experienced RNs (mean 24 years since registration) and 53% have a postgraduate qualification. Some nurses' understanding of a standing order included provision of a prescription to a patient. Standing orders were used frequently (42% reported use 1 to >5 times/day) for a wide variety of conditions. There is a significant relationship between undertaking the stated professional development requirements and confidence in the clinical decisions made (p=0.025). Over half (52%) would like to use standing orders more often.
Standing orders are used extensively in PHC settings. The conditions nurses are involved in treating are usually already differentiated or have a high degree of diagnostic certainty. Nurses can effectively provide medicines under standing orders when doctors support their use, issue evidence-based orders, and have confidence in nurses with advanced skills. Doctors need to meet their responsibilities under the Regulations.
《2011年药品（长期处方）修订条例》允许护士在没有执业医生在场且无处方的情况下为患者提供或使用药品。自2002年起已有相关条例，但新西兰尚未针对其使用情况开展实质性研究。
本文报告了一项针对在初级卫生保健（PHC）机构工作的注册护士（RN）的调查，并探讨了他们在使用长期处方方面的实践情况。
采用自我报告式调查，样本为在PHC机构工作且在实践中使用长期处方的非概率抽样RN（n = 231）。对数据进行描述性分析。
样本为经验丰富的RN（注册后平均工作24年），53%拥有研究生学历。一些护士对长期处方的理解包括为患者提供处方。长期处方在多种病症中被频繁使用（42%报告每天使用1至超过5次）。完成规定的专业发展要求与对临床决策的信心之间存在显著关联（p = 0.025）。超过半数（52%）的人希望更频繁地使用长期处方。
长期处方在PHC机构中被广泛使用。护士所参与治疗的病症通常已经明确或具有较高的诊断确定性。当医生支持其使用、发布循证医嘱并信任具备高级技能的护士时，护士可以依据长期处方有效地提供药品。医生需要履行条例规定的职责。
