Attitudes and beliefs towards implementation of nurse prescribing among general nurses and nurse specialists in China: A cross-sectional survey study

Career Considerations in Nurse-Led Traditional Chinese Medicine Clinics: a Two-Center Qualitative Study

Background

Growing demand exists for high-quality Traditional Chinese Medicine (TCM) care, particularly through Nurse-led TCM clinics (TCM-NLCs). Nurses with extensive experience in TCM departments represent a potential workforce for this healthcare model. This qualitative study aims to investigate the willingness of these candidates to engage in TCM-NLCs, with a specific focus on their main concerns and apprehensions when facing new challenges.

Methods

Individual semi-structured face to face interviews were conducted with senior nurses from two TCM hospitals in Shanghai. Each participant had a minimum of three years of work experience in a TCM related department. Conventional qualitative content analysis was utilized.

Results

Fourteen participants were interviewed and data saturation was achieved. Nurses exhibited strong interest in practicing in TCM-NLCs. They believed that such innovative TCM nursing service model not only extends nursing role, provides greater empowerment and opportunities for professional development but also meets patients' diverse healthcare needs, reduces reliance on other healthcare providers such as doctors, and increases hospital revenue. However, challenges such as deficiencies in evidence-based TCM nursing education, the absence of standardized practice guidelines, and limited prescriptive privileges were identified as primary obstacles to engaging in TCM-NLCs practice, potentially undermining the specialization of this advanced nursing practice model.

Conclusion

Although the nurses interviewed were highly motivated, they generally lacked confidence to practice independently in TCM-NLCs. A pressing priority is to address their concerns by providing appropriate resources as well as education and policy support to enhance their competency and ensure their practice autonomy, therefore building a more qualified pool of professionals for advanced TCM nursing practice.

Construction and application of the core competence course training system for infectious disease specialist nurses

OBJECTIVES

This study aims to construct and apply a training course system which was scientific and comprehensive to foster the core competence of infectious disease specialist nurses.

DESIGN

A two-round Delphi consultation survey was carried out to collect feedback from experts on constructing the training course system of core competence for infectious disease specialist nurses. Besides, a non-randomized controlled experimental study was adopted to check the application effect of the courses.

METHODS

This study adopted a series of methods including group discussion, theoretical analysis and Delphi consultation to draft the training course content of core competence of infectious disease specialist nurses. Twenty-one Chinese experts were invited to participate in the Delphi consultation from November 2021 to December 2021. From October 2022 to January 2023, a total of 105 infectious disease specialist nurses from two training bases were selected by the convenience sampling method, of which the nurses in one training base were the control group and the nurses in the other training base were the observation group. The observation group was trained by the constructed core competence training course. Questionnaire evaluation was used to compare the core competence of infectious disease specialist nurses and the training effect.

RESULTS

The experts, regarded as the authorities on the subject, were highly motivated in this study. Besides, they reached a consensus on the results. The final training course system of core competence for infectious disease specialist nurses focused on 5 competence modules and was composed of 12 categories of courses with 66 classes and corresponding objectives. The core competence scores of the observation group were significantly higher than those in the control group after training (P < 0.05), which proved the training system can effectively enhance the core competence of infectious disease specialist nurses.

CONCLUSIONS

The research methods embodied scientific and precise properties. The course system was comprehensive in content and reliable in results. It could serve as a reference for training infectious disease specialist nurses.

[Problems and Suggested Solutions of Advanced Practice Nursing in Disaster Events]

Nurses constitute the largest component of the healthcare workforce and are often the mainstay of disaster management. The leadership, decision-making, and coordination skills that advanced practice nurses possess are of critical value for disaster precision nursing. However, previous studies mostly focused on disaster specialist nurses and emergency or critical care nurses and little attention was directed at advanced practice nurses. In this paper, we reviewed published research and summarized the current status of advanced practice nursing in disaster events. We identified through our analysis the problems in advanced practice nursing, including poor disaster education, a lack of clearly-defined rescue roles, and difficulty in the implementation of practice reform. We suggested solutions, including developing a whole-process and multi-form disaster curriculum, refining rescue tasks from a team perspective, and establishing a system of quality and safety supervision for advanced practice nursing, aiming to provide new ideas for the development of disaster nursing in China.

Nurses and Physicians' Perceptions Regarding the Role of Oncology Clinical Nurse Specialists in an Exploratory Qualitative Study

The purpose of the study was to examine the attitudes of nursing and medical teams about the role of oncology clinical nurse specialists in the healthcare system in Israel, where, unlike many countries in the world, such a role has not yet been developed or professionally defined. We conducted 24 interviews with physicians and nurses between August and October 2021. The interviews were transcribed and analyzed using a thematic analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. Five main themes emerged from the interviews: (1) contribution to the healthcare system, (2) contribution to the patient, (3) drawing professional boundaries, (4) additional responsibilities and authority for oncology clinical nurse specialists, and (5) the field's readiness for a new position of oncology clinical nurse specialists. The findings provide evidence about the need to develop the role of clinical nurse specialists in the oncology field due to its potential benefits for nurses, physicians, patients, family members, and the healthcare system. At the same time, an in-depth exploration of the boundaries of the role and its implementation, in full cooperation with the oncologists and relevant professional unions, is needed to prevent unnecessary conflicts in the oncology field. Professional development training programs in nursing must create a platform for open dialogue between key stakeholders, nurses, and physicians, in order to help all involved parties, place the benefits to the patients above any personal or status considerations.

Nurse prescription start-up in a Spanish health organization: Nurses' preparedness and 6-month results

INTRODUCTION

Nurse prescribing is well consolidated in many countries. In Spain, recent legislation has allowed nurse to prescribe under specific conditions, but the implementation process is complex.

OBJECTIVES

First, to describe nurses' knowledge and expectations of nurse prescribing in a health institution in Spain. Second, to report the nurses' prescriptions in a pilot group at 6 months.

METHODS

A descriptive, online survey design was used to identify nurses' knowledge and expectations of prescribing. The results were compared according to the nurses' professional position and training. We analyzed the number and type of prescriptions issued in the first 6 months.

RESULTS

Training needs (overall score = 4.2/5) and lack of knowledge of the law (4.25/5) were scored lower by nurses with postgraduate training. Subjective assessment of preparedness among nurses was high (>4/5), and the highest-scoring expected impact was improvement in patients' experience (4.25/5). Years of nursing experience were negatively correlated with preparedness and the expectation of an increase in patient management errors. A total of 212 prescriptions were issued (2 drugs and 200 health devices).

CONCLUSIONS

Nurses perceived good preparedness but also the need for more training in medicines and prescribing law. Expectations of prescribing were favourable. Most prescriptions were for health devices.

Is the Australian nursing workforce ready to embrace prescribing under supervision? A cross-sectional survey

AIM

The aim was to explore nurses' preparedness to expand their practice to prescribe medicines under a supervision model.

DESIGN

This was a cross-sectional study.

METHODS

A convenience sample of Australian nurses recruited from memberships of State-based Nursing and Midwifery Unions and professional bodies from diverse care settings. Nurses undertook an online researcher-constructed survey between March and July 2021 to identify current prescribing practices, motivations for undertaking education in prescribing and perceived barriers to implementation of nurse prescribing under supervision. Data related to demographics, nursing experience and barriers to becoming a prescriber were analysed descriptively. Logistic regression was used to model nursing experience variables with desire to become a prescriber.

RESULTS

A total of 4424 nurses participated with the majority (n = 3645, 82%) reporting they were highly likely to expand their practice to prescribe medicines under supervision. The main motivations to prescribe were to enhance patient care and job satisfaction. Nurses were more likely to want to prescribe if they had <10 years experience (95% CI = 0.3-0.5, p < 0.001), held a bachelor's degree (95% CI = 1.3-2.2, p < 0.001) or higher qualification (95% CI = 1.8-2.9, p < 0.001). Most reported lack of acknowledgement of increased responsibility and workloads (n = 4098, 93%), and insufficient organizational support (n = 4197, 95%) may prevent uptake of nurse prescribing.

CONCLUSIONS

Most Australian nurses demonstrated their preparedness to embrace the role of prescribing under supervision. The perceived barriers identified in this study can inform future implementation of this expanded nursing role.

IMPACT

The Nursing and Midwifery Board of Australia has proposed a standard of practice to enable nurses to prescribe under supervision. Models of nurse prescribing are being considered globally to address population needs. Successful adoption of this practice is dependent on aspects such as key personnel's acceptance of the initiative. The workforce readiness and barriers highlighted in this study can inform implementation at policy and organizational levels.

Factors Influencing Nurses’ Opinions on the Implementation of Nursing Advice in Poland

In the past five years, nursing practice has changed drastically in Poland. Nurses have received many new competencies in response to the need to provide services to patients. The purpose of the study was to analyze nurses’ opinions on the new rights to provide nursing advice and to identify factors that influence their opinions in this regard. A descriptive cross-sectional study was conducted among 798 nurses who work in various medical facilities. The influence of selected variables on nurses’ opinions on the provision of nursing advice to patients was evaluated using logistic regression. The nurses surveyed had a positive attitude towards new competencies and believed that they were able to independently provide the patient with advice within the scope provided by Polish legislation. Logistic regression showed that the factors that statistically significantly influenced nurses’ opinions on particular types of nursing advice were age (p = 0.038), education (p = 0.000), and the place of work of the respondents; that is, hospital (p = 0.016). More research is needed to demonstrate the effectiveness and quality of the implemented nursing advice and its impact on the functioning of the health system.

Attitudes and beliefs towards implementation of nurse prescribing among general nurses and nurse specialists in China: A cross-sectional survey study

Aims

To investigate the attitudes and beliefs towards the implementation of nurse prescribing among general nurses and nurse specialists.

Design

A cross‐sectional survey among general nurses and nurse specialists was conducted in seven provinces and one autonomous region in mainland China using convenience sampling method.

Methods

The attitudes and beliefs towards nurse prescribing were assessed using the Nurse Attitudes and Beliefs towards Nurse prescribing scale, of which Cronbach's coefficient was 0.902, retest reliability was 0.808. Respondents from eight hospitals across the country were employed to complete an online questionnaire.

Results

Nurse specialists (n = 399) had statistically significantly more favourable intentions towards nurse prescribing than general nurses (n = 415; 105.64 ± 12.83 vs. 96.39 ± 13.16; p < .001). The years of clinical work experience, professional title, education degree were positively correlated with general nurses' and nurse specialists' attitudes and beliefs towards nurse prescribing (p < .05). Among nurse specialists, the variety of specialties and whether they work in nurse‐led clinics on an outpatient basis have positively influence on their intentions towards nurse prescribing (p < .05).