Tatterton Michael J
Nurse Consultant in Children's Palliative Care, Martin House Children's Hospice Lecturer in non-medical prescribing and medicines management, University of York England.
Int J Palliat Nurs. 2017 Aug 2;23(8):386-392. doi: 10.12968/ijpn.2017.23.8.386.
Non-medical prescribing is well established within the British health service, with increasing numbers of nurses practicing within children's hospices.
To identify the context of non-medical prescribing in children's hospices in the UK, focusing on the perceived benefits and challenges.
Internet-based questionnaires were sent to 55 UK children's hospices, exploring the practice and context of prescribing.
Of the 55 invited, 20 children's hospices responded to the questionnaire, 14 of which employed a total of 39 non-medical prescribers (NMPs). Sixteen individual NMPs responded, of which half (50%) prescribed to enable the continuation of existing medicines, 37.5% prescribed independently surrounding symptom management and control and 31.3% in end-of-life care. Perceived benefits of prescribing included timely access to medicines, increased efficiency and accuracy in the admissions process and medicine reconciliation and the increased ability to offer choice in the place of palliative and hospice care. Perceived barriers to prescribing surrounded opportunities to develop confidence, defining the scope of practice and the time required to assess, diagnose and treat.
NMPs are making a significant contribution to the prescribing workforce within hospices; however, a number of challenges need to be addressed to enable hospices to realise the benefits.
非医疗处方在英国医疗服务体系中已得到广泛认可,在儿童临终关怀机构执业的护士数量也在不断增加。
确定英国儿童临终关怀机构中非医疗处方的情况,重点关注其感知到的益处和挑战。
向55家英国儿童临终关怀机构发送了基于互联网的问卷,以探究处方的实践和情况。
在受邀的55家机构中,有20家儿童临终关怀机构回复了问卷,其中14家共雇佣了39名非医疗处方者(NMPs)。16名NMPs个人进行了回复,其中一半(50%)开处方是为了使现有药物得以持续使用,37.5%围绕症状管理和控制独立开处方,31.3%在临终关怀中开处方。开处方的感知益处包括能及时获取药物、在入院流程和药物核对方面提高效率和准确性,以及在姑息治疗和临终关怀场所提供选择的能力增强。开处方的感知障碍包括培养信心的机会、界定执业范围以及评估、诊断和治疗所需的时间。
NMPs对临终关怀机构的处方工作队伍做出了重大贡献;然而,需要应对一些挑战,以使临终关怀机构能够实现其益处。