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Zhou Q, Xu Y, Yang L, Menhas R. Attitudes of the public and medical professionals toward nurse prescribing: A text-mining study based on social medias. Int J Nurs Sci 2024; 11:99-105. [PMID: 38352288 PMCID: PMC10859581 DOI: 10.1016/j.ijnss.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 02/16/2024] Open
Abstract
Objectives This study aimed to explore the public and medical professionals' concerns and attitudes toward nurse prescribing using text-mining method to analyze social media data. Methods Python was used to automatically mine data related to the keywords "nurse prescribing" and "prescription" that were posted on four Chinese internet platforms between January 1, 2017, and November 1, 2022. The four Chinese internet platforms included social media sites such as Zhihu and Weibo, as well as medical forums like Aiaiyi Medical Hotspot and Dingxiangyuan Medicine. We conducted personnel, topic, and sentiment analysis techniques using SnowNLP, Bayesian Latent Dirichlet Allocation (LDA), and BosonNLP. Finally, we conducted content analysis using Nvivo 11 based on the results of the topic and sentiment analysis to obtain comprehensive and insightful results. Results We acquired 2,823 comments totaling 92,859 words on the four Internet platforms to conduct analysis. The analyze result showed that many public and medical professionals held a negative attitude toward nurse prescribing, and few had a prudent positive attitude. The public is concerned about the impact of nurse prescribing on medical professionals and the competency requirements for nurses. Medical professionals are concerned about the current and future status of nurse prescribing in China and the difficulties in implementing nurse prescribing. Conclusion Nurses should gradually gain recognition for their expertise and win the acceptance of the public and medical professionals on their ability of nursing prescribing by striving to enhance their professional capacity and self-authorization capabilities. Nurse administrators and educators need to recognize the advantages of nurse prescribing and address the challenges and issues in its implementation through promoting legislation, education, and heightening public awareness of its benefits.
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Affiliation(s)
- Qi Zhou
- The Fourth Affiliated Hospital of School of Medicine, Zhejiang University, Yiwu, Zhejiang, China
| | - Yiqing Xu
- Cardiopulmonary Sciences, School of Allied Health Professions, Loma Linda University, Loma Linda, USA
| | - Lili Yang
- The Fourth Affiliated Hospital of School of Medicine, Zhejiang University, Yiwu, Zhejiang, China
| | - Rashid Menhas
- The Fourth Affiliated Hospital of School of Medicine, Zhejiang University, Yiwu, Zhejiang, China
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Vara-Ortiz MÁ, Marcos-Alonso S, Fabrellas-Padrés N. Experience of primary care nurses applying nurse-led management of patients with acute minor illnesses. Int J Nurs Pract 2023:e13216. [PMID: 37964496 DOI: 10.1111/ijn.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/25/2022] [Accepted: 10/23/2023] [Indexed: 11/16/2023]
Abstract
AIM The aim of this study is to determine the experience of primary health care nurses regarding the application of nurse-led management in patients with acute minor illnesses. BACKGROUND Nursing leadership of care for acute minor illnesses is a new challenge faced by nurses in Spain. DESIGN Qualitative, hermeneutical, interpretive phenomenological approach is used. The Consolidated criteria for reporting qualitative research guidelines were applied. METHODS Twenty primary care nurses participated; three focus group discussions and nine semi-structured interviews were conducted between November 2019 and October 2020. All the focus group discussions and interviews were recorded, transcribed verbatim and analysed using content analysis. RESULTS Seven main themes emerged from the focus group discussions and interviews: concept, perception of the other actors, practice, history and social context, competencies, training, and legality. CONCLUSION The study shows the diversity and complexity of nurses' experience when applying nurse-led management in acute minor illnesses. This work has helped to show the gaps perceived by nurses, including the lack of training in the treatment of conditions historically attended by physicians, the lack of definition of the legal framework and the limitations on nurse prescribing. It also highlighted the power of the nursing profession in terms of autonomy, competencies and role expansion.
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Leslie K, Bourgeault IL, Carlton AL, Balasubramanian M, Mirshahi R, Short SD, Carè J, Cometto G, Lin V. Design, delivery and effectiveness of health practitioner regulation systems: an integrative review. HUMAN RESOURCES FOR HEALTH 2023; 21:72. [PMID: 37667368 PMCID: PMC10478314 DOI: 10.1186/s12960-023-00848-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 07/23/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions. METHODS We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework. FINDINGS This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures-processes-outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners. CONCLUSION We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
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Affiliation(s)
- Kathleen Leslie
- Athabasca University, Athabasca, Canada.
- Canadian Health Workforce Network, Ottawa, Canada.
| | - Ivy Lynn Bourgeault
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | - Anne-Louise Carlton
- Royal Melbourne Institute of Technology (RMIT) University, Melbourne, Australia
| | - Madhan Balasubramanian
- College of Business, Government and Law, Flinders University, Adelaide, Australia
- Menzies Centre for Health Policy and Economics, The University of Sydney, Sydney, Australia
| | - Raha Mirshahi
- University of Ottawa, Ottawa, Canada
- Canadian Health Workforce Network, Ottawa, Canada
| | | | - Jenny Carè
- University of Technology Sydney, Sydney, Australia
| | | | - Vivian Lin
- University of Hong Kong, Hong Kong, China
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Almotairy MM, Alghamdi AT, Alzahrani AM, Alqarni MS, Alghamdi SA, Alshahrani MA. Nurses' readiness to prescribe under supervision in Saudi Arabia: A cross-sectional study. Saudi Pharm J 2023; 31:1294-1305. [PMID: 37333020 PMCID: PMC10275749 DOI: 10.1016/j.jsps.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/20/2023] [Indexed: 06/20/2023] Open
Abstract
Aim To explore nurses' readiness to prescribe medications under supervision and identify associations between prescribing practices under supervision and demographic characteristics in Saudi Arabia. Design A cross-sectional study. Methods Using convenience sampling, this study used a 32-item survey to collect data on nurses prescribing medications under supervision between December 2022 and March 2023. Results A total of 379 nurses were recruited from different regions in Saudi Arabia. Approximately 7% (n = 30) of the participants were prescribing medications independently, and 70% (n = 267) expressed their likelihood of becoming prescribers. The highest motivating factors to become prescribers were improvement of patient care (52.2%) and contribution to the multidisciplinary team (52.0%). Most participants (60%-81%) agreed that prescribing medications under supervision would improve potential outcomes at the system, nurse, and patient levels. Availability of appropriate mentors or supervisors (72.9%) was the highest rated facilitating factor, followed by support of nursing colleagues (72%). Based on demographic characteristics, findings revealed significant differences in the: a) likelihood and motivators of becoming prescribers; b) required minimum qualification, years of experience, and continuing professional education hours to become prescribers; and c) type of organizations delivering educational programs for nurse prescribing. Conclusion Majority of nurses in Saudi Arabia favored becoming prescribers, and motivating factors were mostly relevant to optimizing patient care outcomes. Having the proper supervision was rated as the most facilitating factor for nurse prescribing. Nurses' views on potential outcomes, facilitating factors, and possible motivators varied based on nurses' demographical characteristics. Implications for the professional and/or patient care Nurses favored prescribing under supervision to improve patient care outcomes, which is an opportunity to expand the benefits of health services, including easy access to healthcare. Impact Results revealed that nurses support the implementation of prescribing practice under supervision. Thus, the findings may inform practice change in Saudi Arabia to allow prescribing under supervision, which was perceived to have a positive impact on patient care outcomes. Reporting Method This study adhered to STROBE guidelines.
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Affiliation(s)
- Monir M. Almotairy
- Department of Nursing Administration and Education, College of Nursing, King Saud University, P.O. Box 642, Riyadh 11421, Saudi Arabia
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Jodar-Solà G, Brugués-Brugués A, Serra-Sutton V, Espallargues-Carreras M, Trejo-Omeñaca A, Monguet-Fierro JM. Opinion on the benefits of nurse prescribing in Catalonia. Consensus of health professionals and managers. GACETA SANITARIA 2023; 37:102310. [PMID: 37267891 DOI: 10.1016/j.gaceta.2023.102310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To study the level of agreement among health professionals and managers in Catalonia on the benefits of nurse prescribing (NP). METHOD An online Real Time Delphi was conducted to collect the level of agreement of health professionals and managers. Participants voted in a 6-point scale (1 low benefit and 6 high benefit) for 12 items describing benefits of NP. A total of 1332 professionals participated. The level of consensus was calculated applying interquartile ranges of scores and standardized mean differences among subgroups using effect sizes (ES) and their corresponding 95% confidence intervals. RESULTS The scores indicate a general agreement on the perceived benefits of NP among participants. Standardized differences among scores on the perceived benefits among professionals were small to high (ES range between 0.2 and 1.2) between nurses and medical doctors and high between nurses and pharmacists (ES range: 1.2 and 2.4). Differences between scores of nurses and those of managers or other professionals in the present study were smaller for most voted benefits. CONCLUSIONS The study shows an agreement on the benefits of NP. Nevertheless, when standardized scores are taken into consideration, differences among professionals' perceptions emerged, and aligned with documented barriers identified in the literature such as corporative aspects, cultural limitations, institutional and organisational inertia, beliefs and unawareness of what NP implies.
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Affiliation(s)
- Glòria Jodar-Solà
- Equip d'Atenció Primària Sant Andreu Pallejà, Pallejà, Catalonia, Spain; Col·legi Oficial d'Infermeres i Infermers de Barcelona (COIB), Barcelona, Catalonia, Spain
| | - Alba Brugués-Brugués
- Consorci Castelldefels Agents de Salut (CASAP), Castelldefels (Barcelona), Catalonia, Spain; Associació d'Infermeria Familiar i Comunitària de Catalunya (AIFiCC), Barcelona, Catalonia, Spain
| | - Vicky Serra-Sutton
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Catalonia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.
| | - Mireia Espallargues-Carreras
- Agència de Qualitat i Avaluació Sanitàries de Catalunya (AQuAS), Barcelona, Catalonia, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Barcelona, Spain
| | - Alex Trejo-Omeñaca
- Onsanity Solutions S.L., Barcelona, Catalonia, Spain; Universitat Politècnica de Catalunya, Escola Superior d'Enginyeria de Barcelona. Departament de Disseny, Barcelona, Catalonia, Spain
| | - Josep M Monguet-Fierro
- Universitat Politècnica de Catalunya, Escola Superior d'Enginyeria de Barcelona. Departament de Disseny, Barcelona, Catalonia, Spain
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Gomis-Jimeno FJ, Lillo-Crespo M. Identifying the Enablers and Barriers to Advance Nurse Prescribing of Medication in Spain According to Experts' Views: A Delphi Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4681. [PMID: 36981590 PMCID: PMC10048874 DOI: 10.3390/ijerph20064681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
Nurses play an important role in pharmaceutical care worldwide in detecting clinical changes, communicating and discussing pharmacotherapy with patients, their families, and other healthcare professionals, proposing and implementing drug-related interventions, and ensuring the monitoring of patients and their medication regimens, among others. However, there is no global consensus across countries regarding the prescribing of medication by nurses. In Spain, for example, this topic is currently in transition since the approval of the Royal Decree 1302/2018 of October 22nd, which regulates the indication, use, and authorization for dispensing human-use medication by nurses. Our study aims to identify the enablers and barriers to advancing the nurse prescribing of medication in Spain through the views of experts in the field and according to the latest Royal Decree approved and the steps taken by the different Spanish autonomous communities. A modified qualitative Delphi study with three iterations was performed online through the perspectives of experts from the field of healthcare education, research, practice, management, and policy. Data extracted from the literature review were used to formulate the open-ended questions utilized in the three rounds. The experts involved (n = 15) belonged to different Spanish regions where the Royal Decree is being implemented with different speeds, and had distinct backgrounds and experiences. Our results highlight the importance of prospectively developing additional protocols based on chronic diseases as well as scaling up towards independent nursing prescription, the inclusion of a joint multidisciplinary pharmaceutical care model, the controversial role played by national nursing councils and boards, the variability in the speed of implementation among the autonomous communities, and the lack of nursing training in the field of medication prescription.
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Affiliation(s)
- Francisco Javier Gomis-Jimeno
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
- HLA Vistahermosa Hospital, 03015 Alicante, Spain
| | - Manuel Lillo-Crespo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, 03690 Alicante, Spain
- HLA Vistahermosa Hospital, 03015 Alicante, Spain
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Pantaleo F, D'Angelo D, Stievano A, Albanesi B, Petrizzo A, Notarnicola I, De Marinis MG, Marchetti A. An example of evaluation of tuning nursing competences in the licensure exam: An observational study. Heliyon 2023; 9:e13412. [PMID: 36814610 PMCID: PMC9939617 DOI: 10.1016/j.heliyon.2023.e13412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/06/2023] Open
Abstract
Introduction The licensure exam in nursing has always focused on the curricula used in universities. 'Tuning' was the first project that sought to harmonize training purposes regarding competences and learning outcomes in Europe. The Tuning educational structures have been offered in various disciplines, including nursing with the development of the Tuning Nursing Project. The study describes which of 47 Tuning Nursing Competences were evaluated during the licensure exam in nursing degree courses, and what types of trials were used for their assessment. Methods A multicentric observational study was conducted in 4 universities in Italy. Data were collected in academic years 2017-2019, using two grids: one for cognitive and one for psychomotor tests. Results The Tuning competences were requested 7522 times. The most frequently demanded were those associated with domain number two, "Nursing practice and clinical decision making". The level of performance most required in cognitive tests was the autonomy of judgement, and both tests concerned the fields of non-communicable diseases and the hospitalized adult patient. Conclusions The competences most often assessed coincided with those deemed core for the first cycle of studies at the European level. Unfortunately, it has been detected a high degree of discrepancy in the types of tests used in different schools.
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Affiliation(s)
- Flavia Pantaleo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Daniela D'Angelo
- National Center for Clinical Excellence, Healthcare Quality and Safety, Higher Institute of Health, Rome, Italy
| | - Alessandro Stievano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy,Corresponding author.
| | - Beatrice Albanesi
- Department of Biomedicine and Prevention, University Department of Public Health and Paediatrics, University of Turin, Turin, Italy
| | - Antonello Petrizzo
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | | | - Anna Marchetti
- Research Unit Nursing Science, Campus Bio Medico University, Rome, Italy
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Franco-Rodríguez A, Domínguez-Martís EM, Mosteiro-Miguéns DG, López-Ares D, Cotón-Sánchez B, Domínguez-Varela M, Novío S. Translation, Cross-Cultural Adaptation, and Validation of the Galician Version of the Nurse Prescribing Self-Efficacy Scale. Healthcare (Basel) 2022; 10:healthcare10122563. [PMID: 36554086 PMCID: PMC9778594 DOI: 10.3390/healthcare10122563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Low self-efficacy has been identified as one of the factors that could hinder the prescribing competence of nurses. No valid and reliable existing instruments assess Galician nurses' confidence to prescribe. The aim of this study was to determine the reliability and validity of the Galician version of the Nurse Prescribing Self-Efficacy Scale (G-NP-SES, 19 items). The study was conducted in two phases: the translation and adaptation to the Galician version of the NP-SES, and the assessment of its psychometric properties. G-NP-SES was sent to nurses working in primary healthcare centers in Galicia (Spain) between March and June of 2022. Its content, construct and discriminant validity, and internal consistency reliability were examined. A total of 193 people participated in the study. As the original scale, G-NP-SES also had three dimensions (% of cumulative variance = 80.82%). It showed good internal consistency (Cronbach's alpha coefficient (α) = 0.90, with each factor ranging from 0.86 to 0.89), high content validity (scale's content validity index = 0.92, with item-content validity index ranged from 0.87 to 1), and good discriminant validity. G-NP-SES is an instrument with good psychometric properties which could be used to accurately assess Galician nurses' self-efficacy to prescribe and consequently to improve their job performance.
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Affiliation(s)
| | - Eva María Domínguez-Martís
- Galician Public Healthcare Service, Healthcare Centre of Concepción Arenal, C/Santiago León de Caracas 12, 15701 A Coruña, Spain
| | - Diego Gabriel Mosteiro-Miguéns
- Galician Public Healthcare Service, Healthcare Centre of Concepción Arenal, C/Santiago León de Caracas 12, 15701 A Coruña, Spain
| | - David López-Ares
- Galician Public Healthcare Service, University Hospital Complex of A Coruña (CHUAC), 15006 A Coruña, Spain
| | | | | | - Silvia Novío
- Department of Psiquiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, C/ San Francisco s/n, 15782 A Coruña, Spain
- Correspondence:
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Vara-Ortiz MÁ, Fabrellas Padrés N. [Impact of training and legal aspects on the application of nurse demand management by primary care nurses in Catalonia]. Aten Primaria 2022; 54:102491. [PMID: 36272398 PMCID: PMC9586855 DOI: 10.1016/j.aprim.2022.102491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/16/2022] [Accepted: 09/28/2022] [Indexed: 12/02/2022] Open
Abstract
Objetivo Conocer la experiencia de las enfermeras de atención primaria en la aplicación de la gestión enfermera de la demanda (GED). Diseño Estudio observacional, descriptivo y transversal. Emplazamiento Atención primaria de Cataluña. Participantes Enfermeras de atención primaria de Cataluña. Se estimó una muestra de 394 participantes alcanzando 405. La obtención de datos fue desde octubre de 2021 hasta enero de 2022. Mediciones principales Se realizó un cuestionario ad hoc, el cual exploraba aspectos referentes a la experiencia de aplicación de la GED: definición y manejo del programa, formación y aspectos legales del programa. Resultados Las enfermeras entienden la GED como un triaje. Además, consideran que la implantación de la prescripción enfermera no mejora la aplicación de la GED. Manifiestan una falta de formación especialmente las enfermeras más noveles. La formación ideal en GED, consideran, debería incluir fisiopatología y supuestos prácticos. Siete de cada 10 enfermeras desconocen el marco legal que ampara la GED y les provoca inseguridad no conocerlo. Seis de cada 10 han dejado de ser resolutivas por miedo a las repercusiones legales. Las enfermeras que sí conocen el marco legal son las que han dejado de resolver en menor proporción. Conclusiones Se constata la necesidad de formación general en la GED y en los aspectos legales que dan cobertura al programa especialmente en las enfermeras más jóvenes y con menos experiencia en atención primaria. De esta manera se mejorará la aplicación y aceptación del rol autónomo enfermero en la gestión de enfermedades agudas leves.
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Affiliation(s)
- María Ángeles Vara-Ortiz
- Escola d'Infermeria, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, España; Centro de Atención Primaria Barri Llatí, Santa Coloma de Gramenet, Barcelona, España.
| | - Núria Fabrellas Padrés
- Escola d'Infermeria, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, España
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Lillo-Crespo M, Riquelme-Galindo J, De Baetselier E, Van Rompaey B, Dilles T. Understanding pharmaceutical care and nurse prescribing in Spain: A grounded theory approach through healthcare professionals’ views and expectations. PLoS One 2022; 17:e0260445. [PMID: 35073326 PMCID: PMC8786147 DOI: 10.1371/journal.pone.0260445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022] Open
Abstract
Background Pharmaceutical care has been implemented and regulated differently across Europe with no consensus among countries in relation with professional competencies and especially on nurse prescribing. Demophac Project funded by the European Commission aims to develop a Pan-European Pharmaceutical Care Model with collaboration of 14 partner teams across Europe including Spain where nurse prescribing is starting its implementation at regional level. The aim of the study was to increase understanding of the role of nurses in Pharmaceutical care in Spain after the Nurse Prescribing Regulation approved in 2018 throughout exploring the views and expectations of health professionals involved in the representative settings. Methods and findings In depth interviews were conducted in a structure previously agreed by the European Demophac partnership around four topics associated with the Nursing ideal role in pharmaceutical care and the ideal interaction with other healthcare professionals. A grounded-theory approach based on Corbin & Strauss was conducted to interpret collected data from the Spanish most representative settings (primary care, specialized care and residential care for older population). Participants were health professionals involved in pharmaceutical care that accepted to participate (nurses (n = 7), physicians (n = 8) and pharmacists (n = 9)). A pharmaceutical care comprehensive model for the Spanish context considering the recently approved Nurse Prescribing role and the interprofessional collaboration and communication was developed towards facilitating the understanding in such context and the contribution to the unified European Demophac Framework. Conclusions Nurses are primarily responsible for population’s Pharmaceutical Care while other professionals pivot on them to provide quality healthcare on a multidisciplinary level. Nurse prescribing may contribute efficiently to the Spanish Health System though more consensus in terms of nurses’ training nationwide and enhancement in communication among different professionals within healthcare organizations is required to achieve adequate integrated care into practice.
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Affiliation(s)
- Manuel Lillo-Crespo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Jorge Riquelme-Galindo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Elyne De Baetselier
- Department of Nursing and Pharmaceutical Care, University of Antwerp, Antwerp, Belgium
| | - Bart Van Rompaey
- Department of Nursing and Pharmaceutical Care, University of Antwerp, Antwerp, Belgium
| | - Tinne Dilles
- Department of Nursing and Pharmaceutical Care, University of Antwerp, Antwerp, Belgium
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Velasco-González V, Loya-Pérez L, Navarro-García E, Sáinz-Gil M. Reporting of suspected adverse drug reactions by nursing in Spain. An observational-descriptive retrospective study. ENFERMERIA CLINICA (ENGLISH EDITION) 2021; 31:363-370. [PMID: 34756240 DOI: 10.1016/j.enfcle.2020.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/25/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.
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Affiliation(s)
- Verónica Velasco-González
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain; Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, Spain; Grupo de Investigación en Cuidados Enfermeros (GICE), Universidad de Valladolid, Valladolid, Spain; Grupo de investigación «Farmacogenética, Genética del Cáncer, Polimorfismos Genéticos y Farmacoepidemiología», Universidad de Valladolid, Valladolid, Spain
| | - Laura Loya-Pérez
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, Spain
| | - Ester Navarro-García
- Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain.
| | - María Sáinz-Gil
- Centro de estudios Sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; Centro de Farmacovigilancia de Castilla y León, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Velasco-González V, Loya-Pérez L, Navarro-García E, Sainz-Gil M. Reporting of suspected adverse drug reactions by nursing in Spain. An observational-descriptive retrospective study. ENFERMERIA CLINICA 2021; 31:S1130-8621(20)30534-9. [PMID: 33531221 DOI: 10.1016/j.enfcli.2020.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 09/22/2020] [Accepted: 10/25/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study aimed to gain knowledge of the nurses' involvement in the spontaneous report of suspected adverse drug reactions (ADR) in the Spanish Pharmacovigilance System for Medicinal Products for Human Use (SEFV-H), describing the principal characteristics of the reported cases, identifying points of improvement. METHODS A descriptive observational retrospective study was based on the data from FEDRA, the database created by the SEFV-H. The sample taken was the spontaneous adverse drug reactions reported to SEFV-H by nurses during the first 6 months of the 2018. RESULTS Complete data was provided by 6,370 suspicions of ADR reported to SEFV-H by all healthcare professionals. Only 4,8% of the samples were taken by nurses, 62,7% came from medical centers. The majority of the ADR were not considered a serious disease (78%). The most frequently adverse drug reactions reported by nurses were local reactions. The patients most involved were children and vaccines were the most reported drugs (58,3%), followed by the intravenous contrast agents used in diagnostic tests. CONCLUSIONS Nurses report very few cases to SEFV-H and are mostly related to the administration of vaccines and are sent by nurses working in the out-of-hospital setting. Most cases are not serious and usually report known adverse reactions to the suspected drug. This observed under-notification raises the need to promote increased pharmacovigilance training among these notifying nurses so that they can continue to report, and also for those who do not do so in their daily practice, so that they can begin to do so.
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Affiliation(s)
- Verónica Velasco-González
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España; Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Instituto de Oftalmobiología Aplicada, Universidad de Valladolid, Valladolid, España; Grupo de Investigación en Cuidados Enfermeros (GICE), Universidad de Valladolid, Valladolid, España; Grupo de investigación «Farmacogenética, Genética del Cáncer, Polimorfismos Genéticos y Farmacoepidemiología», Universidad de Valladolid, Valladolid, España
| | - Laura Loya-Pérez
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Valladolid, Valladolid, España
| | - Ester Navarro-García
- Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España.
| | - María Sainz-Gil
- Centro de Estudios sobre la Seguridad de los Medicamentos, Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Centro de Farmacovigilancia de Castilla y León, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
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13
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Newly Qualified Nurses' Perception of Their Competency Achievement on Leaving University: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214284. [PMID: 31690034 PMCID: PMC6862868 DOI: 10.3390/ijerph16214284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/01/2019] [Accepted: 11/03/2019] [Indexed: 01/06/2023]
Abstract
Background: After implementing the Tuning Educational Structures in Europe Project, numerous efforts have been made to define, establish, and evaluate nursing competences. The European Federation of Nurses Association played a key role in enacting the nursing competences included in Directive 2013/55/EU. Nevertheless, assessing competences remains elusive, and there is little research into nurses’ perceptions of the competency training provided by their universities. The purpose of the study was to explore the perceptions and experiences of newly qualified nurses about the competences they acquired during their university education. Methods: A qualitative research study was developed in a Spanish university. Twelve semi-structured interviews with newly qualified nurses were conducted, and two focus groups made up of twelve students were carried out in order to triangulate the results. Participants were recruited through email contact. Interviews focused on clinical training, theoretical content, and the reality of healthcare. Data was analyzed thematically. Results: Two main themes emerged: (1) improving theoretical content and (2) rethinking practical lessons and clinical training. A lack of knowledge about mental health, pharmacology, or critical care has been found; in addition, it was highlighted, among others, the need to improve communication skills in difficult and conflictive situations. Conclusions: Considering the participants’ perception of deficiency in some aspects of most of the competences established by the European Federation of Nurses Association, further research has been suggested to include other stakeholders’ views.
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Hämel K, Toso BRGDO, Casanova A, Giovanella L. Advanced Practice Nursing in Primary Health Care in the Spanish National Health System. CIENCIA & SAUDE COLETIVA 2019; 25:303-314. [PMID: 31859878 DOI: 10.1590/1413-81232020251.28332019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 08/20/2019] [Indexed: 11/21/2022] Open
Abstract
The primary health care in the Spanish National Health System is organised in health centres with multi-professional teams, composed of doctors and nurses specialised in family and community health, in addition to other professionals. This article analyses the role of primary health care nurses in the Spanish National Health System. In the last decade, new concepts of task sharing between doctors and nurses as well as advanced nursing roles have been evolved in the health centres that focus on improving care for chronically ill patients and access to primary care. With shared responsibility, nurses are responsible for chronic patients in stable conditions, health prevention and promotion. The scaling up of advanced nursing tasks is limited by uncertainties of roles, disparities between states, and legislations that do not cover the full extent of advanced nursing tasks. The case study of Spain indicates that a strong multi-professional model of primary health care teams is a crucial basis for the evolvement of advanced nursing practice and its acceptance in daily routines. However, advantageous education structures and legislations are needed to allow nurses to develop their contribution in the full potential.
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Affiliation(s)
- Kerstin Hämel
- School of Public Health, Bielefeld University. Universitätsstraße 25, D-33615 Bielefeld. Alemanha.
| | | | - Angela Casanova
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
| | - Ligia Giovanella
- Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Prydderch S. Preparing pre-registration nurses to be 'prescriber ready': Aspirational or an achievable reality? NURSE EDUCATION TODAY 2019; 78:1-4. [PMID: 30959409 DOI: 10.1016/j.nedt.2019.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 02/11/2019] [Accepted: 03/27/2019] [Indexed: 06/09/2023]
Abstract
The Nursing and Midwifery Council (NMC), the professional body for U.K. registered nurses, midwives and nursing associates has recently proposed future nurses should be 'prescriber ready', in a move to ensure the nursing workforce can prescribe medicines soon after registration (NMC, 2018a). Considering this, the educational preparation requirements for future nurses requires consideration, particularly where it is incumbent on the University, or NMC Approved Educational Institution (AEI), to prepare nurses with sufficient knowledge and skills to enter an NMC approved non-medical prescribing programme from the point of registration. This paper explores the new NMC educational and practice standards for nurses and the potential infrastructures required of the AEI where there is a responsibility under the NMC to develop a new, more progressive generation of 'prescriber ready' nurse. Excitingly, Universities and nurse educators are now tasked with ensuring future nurses can safely demonstrate an amalgam of nursing care, fusing traditional nursing expertise with skills which once remained the exclusive responsibility of the doctor, thus creating a new generation of hybrid practitioners.
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Policy proposals for a new welfare: the development of the family and community nurse in Italy as the key to promote social capital and social innovation. Prim Health Care Res Dev 2019; 20:e109. [PMID: 32799972 PMCID: PMC6609921 DOI: 10.1017/s146342361800083x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: To discuss the development of the family and community health nurse (FCHN) in Italy by focusing on three levels: organisational, political and theoretical. Background: The role of the FCHN in Italy is not yet embedded evenly across the Italian National Health System (INHS) and does not have formal recognition, either contractually or organisationally. Although complementary post-basic training has been available for over a decade, the FCHN’s role in Italy currently exists only in pilot form. In some regions, the FCHN has operated for longer, thanks to which a clearer understanding of the functions and responsibilities required by the FCHN has emerged. Proposals for professional and social policies have emerged, as the FCHN’s role may be an answer to health problems and a contributor to the construction of social capital, capable of influencing both individual and collective well-being. Methods: A mixed method investigation via a parallel concurrent design to identify the organisational models for the FCHN was conducted across Italy. In this paper, two profiles are discussed – family and community health nursing and FCHN – but each with its different connotations. The former refers to the practice of nursing and the latter to the nursing practitioners working with family and the community. Conclusion: We describe the expected future outcomes for FCHNs as elements of social innovation for the development of a new welfare system.
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Ortega-Marlasca MM. Nurses prescribing in Spain: The reality. Nurs Health Sci 2018; 20:271-272. [DOI: 10.1111/nhs.12421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Manuel-María Ortega-Marlasca
- Department of Medicine, School of Medicine; University of Cadiz; Cadiz Spain
- Vocalía de Atención Primaria; Colegio Oficial de Médicos de Cadiz; Cadiz Spain
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