Manchester Pharmacy School, M13 9PL, UK.
Manchester Pharmacy School, M13 9PL, UK.
Res Social Adm Pharm. 2020 Feb;16(2):249-256. doi: 10.1016/j.sapharm.2019.05.013. Epub 2019 May 22.
In the UK, non-medical prescribers (NMPs) are a significant part of the healthcare workforce. Little is known about their self-efficacy when prescribing, and their willingness to take responsibility for prescribing decisions.
To explore the perceptions of NMPs regarding their self-efficacy in prescribing and responsibility for prescribing decisions.
Cross-sectional survey of a purposive sample of NMPs on acute medical units (AMUs) across the UK. Bandura's Social Cognitive Theory informed the self-efficacy aspect of the questionnaire. Participants' views were also sought on responsibility for prescribing decisions. For quantitative data descriptive statistics were calculated. Hierarchical multiple linear regressions determined whether five independent variables improved the prediction of self-efficacy in aspects of prescribing: NMP's profession; length of time qualified as a healthcare professional and as an NMP; the number of items prescribed and hours worked per week on an AMU. Framework analysis was used to analyse the qualitative data.
Ninety-nine valid responses were obtained. Self-efficacy overall was high. The longer the participant had been qualified as an NMP was associated with increased self-efficacy in certain aspects of prescribing. All physiotherapists, and more nurses than pharmacists were responsible for prescribing decisions. Where participants were not fully responsible, the responsibility was partial or shared.
Self-efficacy of NMPs when prescribing is influenced by several factors. The variables within this study appear to account for only a small part of this self-efficacy. Self-efficacy in prescribing appears to contribute to NMPs' willingness to take responsibility for prescribing decisions; further influenced by their job role and the prescribing this entails. Stakeholders need to appreciate the full range of factors that influence the self-efficacy of NMPs when prescribing, and the association of this to take responsibility for prescribing decisions. This knowledge will assist in maximising the benefits of non-medical prescribing within the healthcare system.
在英国，非医疗从业者（NMP）是医疗保健工作队伍的重要组成部分。对于他们在开处方方面的自我效能感以及对处方决策承担责任的意愿，人们知之甚少。
探讨 NMP 对自己在处方方面的自我效能感和对处方决策承担责任的看法。
对英国各地急症医疗单位（AMU）的 NMP 进行了一项基于目的的横断面调查。班杜拉的社会认知理论为问卷的自我效能感部分提供了依据。还征求了参与者对处方决策责任的看法。对于定量数据，计算了描述性统计数据。分层多元线性回归确定了五个独立变量是否可以改善对处方五个方面的自我效能感的预测：NMP 的职业；作为医疗保健专业人员和 NMP 的合格时间；开处的项目数和每周在 AMU 工作的小时数。使用框架分析对定性数据进行了分析。
共获得 99 份有效回复。总体而言，自我效能感很高。参与者作为 NMP 的合格时间越长，在某些方面的处方自我效能感就越高。所有的物理治疗师，比药剂师更多的护士都对处方决策负责。在参与者没有完全负责的情况下，责任是部分或共享的。
NMP 开处方时的自我效能感受多种因素的影响。本研究中的变量似乎只占这种自我效能感的一小部分。在处方方面的自我效能感似乎有助于 NMP 愿意对处方决策负责；进一步受到其工作角色和相关处方的影响。利益相关者需要了解影响 NMP 开处方自我效能感的所有因素，以及与承担处方决策责任的关联。这方面的知识将有助于在医疗保健系统中最大限度地发挥非医疗处方的优势。
