从国外护士处方权的发展看我国的护士处方权

护士处方权是指针对病人的心理、饮食、用药以及护理级别和疾病的发展所做出的判断和决策。这一概念是伴随着社区护理的发展而提出的。     

关于护士的处方权

英国的护理处方权由来已久 ,但得到长足发展却是在过去的一年里 ,这可能成为护理发展史上最重要的变革之一。许多年来 ,开处方一直是诊断医生的特权 ,人们认为让护士开处方风险很大 ,整个护理行业经过 14年才赢得了处方权 ,就象护理处方权协会秘书Stuttle所说的那样 ,争取护理处方权是一个漫长而曲折的过程。而现在学习开处方将成为护士注册培训的一个正式部分 ,所有护士在取得资格时必须掌握开处方的技能。在此过程中 ,英国政府起了重要作用 ,把护士拥有处方权列为现代化议事日程中的一项重要议题。去年英国卫生部部长 Millburn在皇家护理…     

授予护士处方权的新动向

本文阐述国外授予护士处方权的现状,对开处方护士进行的教育及开处方的注意事项,从而展示国外护理工作发展的动向。     

护理门诊护士处方权的实施展望

文章从护理门诊发展及护士处方权立法、准入资格、实施及其效果的角度归纳了国内外护理门诊及护士处方权的研究现状,在此基础上对我国未来护理门诊护士处方权的实施进行了展望,提出加强对护理门诊护士处方权实施者的法律保护、明确护理门诊护士处方权的权限、明确护理门诊护士处方权的准入资格、开展社区门诊护士处方权的试点工作等建议。     

英国社区及其护士处方权现状

综述英国社区在国家医疗体系中的位置、英国社区护士发展现状及其先进的护士处方权管理办法,为我国社区护理健康快速的发展提供参考。     

护士处方权研究现状及策略探索

为有效解决人口老龄化、慢性病高发、医生短缺等全球化重大卫生挑战,护士处方已成为国外医疗机构优化卫生资源配置、提高医疗效率和满足患者需求的有效手段。而随着我国专科护士队伍的不断壮大,授予其护士处方权已成为中国护理事业发展的迫切需求之一。本文对护士处方权的职责范围、应用场景、积极意义以及制约因素等方面进行综述,并提出相对应的策略和建议,为后续促进处方权在我国本土化推行提供理论依据和参考。     

从国外护士处方权的发展到我国护士处方权的实施

正由于护士工作中需要直接与病人接触,所以,通常护士是患者病情的第一掌握者。而当遇到急危重的患者时,往往需要护士第一时间做出相应的治疗和护理,这种情况下,护士为了患者的最大利益,需要为病人进行紧急用药,所以从某种意义上说,护士已拥有了一定的处方权。然而从我国法律而言,《护士条例》只明确了护士对医生开具的处方有监督和报告的权利,却没有开具处方的权利。单从这一种情况来     

国际护士理事会2021年《护士处方权指南》解读

处方权是传统护理执业范畴扩展的标志,也是高级实践护士有别于一般注册护士的特征性权限,目前全球已有70余个国家及地区发展高级实践护士角色,44个国家或地区立法规定护士处方权。各国护士被授予处方权均经历了复杂和逐步过渡的过程,一些关键因素和策略在其中发挥了重要作用。2021年国际护士理事会（ICN）就护士处方权制定了专门指南,总结归纳了护士处方权的全球立法监管现状、护士处方模式、实现护士处方权的实施框架、支持策略及发展建议。现对该指南进行解读,旨在促进我国卫生领域决策者、教育者、监管者、护理人员和其他医疗保健专业人员对护士处方权的理解,促进我国护士处方权规范的形成,推动护理事业的高质量发展。     

澳大利亚护士处方权的研究进展

回顾国际上有关护士处方的开展情况,并以澳大利亚护士处方权为例,对执业护士的引进、法律、申请与注册、处方模式和教育与培训等方面进行了综述,旨在借鉴澳大利亚护士处方权的发展经验,为我国护士处方权的发展提供一定的借鉴。     

护士处方权申请者资格的专家论证研究

[目的]探讨护士处方权申请者的资格,为相关决策提供理论参考。[方法]运用Delphi法对49名医护专家进行两轮问卷咨询,对咨询结果进行统计、分析。[结果]两轮专家咨询问卷的有效回收率分别为88.3%和92.5%;选择的专家涉及临床护理、护理教育及医疗3个领域,具有较好的学科代表性和地区代表性,专家对指标的权威系数均在0.80以上;建议对护士处方权申请者的准入资格从学历、职称资格、工作年限和医院级别4个方面做出具体要求。[结论]护士处方权申请者的准入资格为在三级医院工作,具有主管护师职称资格,同时具备护理本科学历和5年的临床工作经验。满足上述条件的护士在经过相关培训后才可能胜任护士处方工作。     

Visiting rights only: the diplomas in nursing in the UK in the interwar period

The aim of this article is to explore the institution and organisation of the diplomas in nursing at the universities of Leeds and London, which were established in 1921 and 1926, respectively. It will be argued that the success of these courses for the individuals who undertook them, and the profession as a whole was ultimately limited. It is accepted that the purpose of the diplomas was at least in part for the nursing elite to maintain their grip on the leadership. Nevertheless, the institution of the courses, when few women in general attended university, identifies a 'radicalness' within the profession, which has rarely been considered. Moreover, that there was a body of nurses capable of university level education challenges previous assumptions.     

Pitfalls in the Care of the Psychiatric Patient in the Emergency Department

Background

Care of the psychiatric patient in the Emergency Department (ED) is evolving. As with other disease states, there are a number of pitfalls that complicate the care of the psychiatric patient.

Objective

The purpose of this article is to update Emergency Physicians concerning the pitfalls in caring for the psychiatric patient, and possible solutions to deal with these pitfalls.

Discussion

The article will address the burden of the psychiatric patient, staff attitudes, medical clearance process, treatment of the agitated patient, suicidal patients, and admission decisions.

Conclusions

Alternative care resources, collaboration with Psychiatry, staff education, improvement in the medical clearance process, proper use of restraint and seclusion, and appropriate choice of medication for agitated patients can help avoid some of the top pitfalls in the care of the psychiatric patient in the ED.     

Changes in the parameters of the rhythms of the electrolyte-excreting function of the kidneys in women in relation to the seasons of the year

The characteristics (period, mesor, amplitude) of the rhythms of urinary excretion of sodium, potassium, chlorine, calcium, magnesium, and phosphorus were examined in normal women during various seasons. The urine was collected for 5 days with 4-hour intervals. The rhythms were detected and their parameters established with the use of mathematical methods for the assessment of the tested curve fragments repetitions and by the least squares nonlinear method. The rhythms of renal urinary and electrolyte excretion were found very smooth, particularly so in the fall and winter. The circadian rhythms have been found the most stable during all the seasons. Examinations of individual electrolyte excretion have shown that Na and K excretion is more stable all the year round and therefore this parameter is the most informative for the detection of disorders in renal electrolyte excretion.     

Choosing the choices in the USA: examples in the maternity area

The concept of choice has featured prominently in both the recent united Kingdom (UK) health care reforms and in the debate relating to the care of childbearing women. An invitation to the USA facilitated contemplation of the health care system on which the recent UK reforms have been modeled. The impact of the health system on mother's choices was a source of particular interest. The implications for midwives, their practice and their relationships with their clients and colleagues emerge clearly. It may be that the United States' model of health care does not answer the needs of the UK.     

Change in the drug-metabolizing function of the liver in patients in the postoperative period in relation to the type of anesthesia]

Anesthesia-dependent changes in pharmaco-metabolic liver function have been studied in patients operated on for cosmetic facial defects. It has been established that the postoperative period in patients subjected intraoperatively to general combined anesthesia and controlled lung ventilation was characterized by inhibited drug metabolism in the liver, which required correction of the drug doses to reduce the risk of side and toxic effects of pharmacotherapy. Patients operated on under local procaine anesthesia had no considerable changes in pharmaco-metabolic liver function in the postoperative period.