Glasgow Caledonian University, Glasgow, UK.
Glasgow Caledonian University, Glasgow, UK.
J Hosp Infect. 2021 Jul;113:22-29. doi: 10.1016/j.jhin.2021.04.008. Epub 2021 Apr 15.
The number of nurse prescribers is increasing, yet little evidence exists about their antibiotic prescribing behaviour.
To measure nurse independent prescribers' (NIPs) intention to manage patients, presenting with an upper respiratory tract infection (URTI) for the first time, without prescribing an antibiotic and to examine the determinants of this behaviour.
This was a mixed-method study using the Reasoned Action Approach (RAA). Content analysis of data from 27 telephone interviews with NIPs informed the development of a questionnaire which was tested for validity and reliability and used in a national survey of NIPs across Scotland. Descriptive and inferential statistical analysis was carried out to determine intention to manage patients without prescribing an antibiotic and the significant influences on this intention.
From 184 participants it was found that NIPs intended to manage patients, presenting with a URTI for the first time, without prescribing an antibiotic. Key determinants were perceived norm, perceived behavioural control, and moral norm. Significant beliefs were positive social influence from other non-medical prescribers (P = 0.007) and nurse prescribers (P = 0.045), the enablers of prescriber experience and confidence (P ≤ 0.001), and the barrier of pressure from patients/carers (P = 0.010).
The findings provide reassurance that NIPs intend to prescribe appropriately. The identification of nurse-specific barriers and enablers to this intention should be acknowledged and targeted in future interventions to manage this behaviour.
护士从业者的数量正在增加，但关于他们开抗生素处方行为的证据很少。
测量首次出现上呼吸道感染（URTI）的患者的独立护士从业者（NIP）不开具抗生素治疗的管理意愿，并研究该行为的决定因素。
这是一项使用理性行为理论（RAA）的混合方法研究。对 27 名 NIP 电话访谈数据的内容分析为问卷的开发提供了信息，该问卷经过了有效性和可靠性测试，并在苏格兰全国范围内对 NIP 进行了调查。进行描述性和推断性统计分析，以确定不开具抗生素治疗患者的管理意愿以及对这种意愿有重要影响的因素。
从 184 名参与者中发现，NIP 打算对首次出现 URTI 的患者进行管理，而不开具抗生素。主要决定因素是感知规范、感知行为控制和道德规范。重要的信念是来自其他非医疗从业者（P=0.007）和护士从业者（P=0.045）的积极社会影响、促进者经验和信心（P≤0.001）以及来自患者/照顾者的压力的障碍（P=0.010）。
这些发现让人放心，NIP 打算适当地开具处方。应该承认并针对这种意图的特定护士障碍和促进因素进行干预，以管理这种行为。
