Association Hospitalière Sainte-Marie, Centre Hospitalier Sainte Marie Clermont-Ferrand, 33, rue G. Péri, 63037 Clermont-Ferrand cedex 1, France.
Association Hospitalière Sainte-Marie, Centre Hospitalier Sainte Marie Clermont-Ferrand, 33, rue G. Péri, 63037 Clermont-Ferrand cedex 1, France.
Encephale. 2023 Jun;49(3):268-274. doi: 10.1016/j.encep.2022.06.008. Epub 2022 Oct 14.
Pro re nata are frequent in psychiatry. The risks engendered by this treatment requires that their prescription and administration be made safer. The frequency of administration of pro re nata depends mainly on the nurse's clinical judgment.
Our first objective was to assess nurses' satisfaction about the quality of doctors' pro re nata prescriptions. Our second objective was to assess the nurses' self-reported practices for administering pro re nata treatments as written in the prescription.
Self-administered questionnaires were sent by the hospital's internal mail between November 13, 2014, and December 10, 2014 to all nurses in our psychiatric establishment in France. The questionnaire included multiple-choice questions and questions based on clinical vignettes.
The response rate was 51.9% (124/239). Overall, 75.6% considered that the quality of the prescriptions in terms of dosage was satisfactory. However, regardless of the quality of the doctor's pro re nata prescription, nurses did not contact the doctor even when the prescription quality was poor. Unexpectedly, we found that 88.7% have administered medication "as needed" without a doctor's prescription and sometimes acted without consulting doctors.
The nurses appeared globally satisfied with doctors' prescriptions of pro re nata medications. On the other hand, most administered some medications without any prescription, that is, illegally. Physicians must be rigorous in the quality of their PRN prescriptions. At the same time, nurses must comply with the medical prescription or contact the physician if the quality of the PRN prescription appears poor.
在精神病学中，按需治疗（pro re nata）很常见。这种治疗方式带来的风险要求其开具和管理更加安全。按需治疗的给药频率主要取决于护士的临床判断。
我们的首要目标是评估护士对医生开具的按需治疗处方质量的满意度。我们的第二个目标是评估护士根据处方实际执行按需治疗的情况。
我们于 2014 年 11 月 13 日至 12 月 10 日通过医院内部邮件向法国某精神科机构的所有护士发送了自填式问卷。问卷包含多项选择题和基于临床情景的问答题。
应答率为 51.9%（124/239）。总体而言，75.6%的护士认为按需治疗处方的剂量方面的质量令人满意。然而，无论处方质量如何，护士都不会联系医生，即使处方质量较差。出乎意料的是，我们发现 88.7%的护士在没有医生处方的情况下按需给药，有时甚至在没有咨询医生的情况下自行给药。
护士对医生开具的按需治疗处方总体上表示满意。另一方面，大多数护士在没有处方的情况下给药，即非法用药。医生必须严格控制按需治疗处方的质量。同时，如果按需治疗处方的质量较差，护士必须遵守医嘱或联系医生。
