Understanding pharmaceutical care and nurse prescribing in Spain: A grounded theory approach through healthcare professionals’ views and expectations

Understanding the Impact of the Nurse Manager's Vocation for Leadership on the Healthcare Workplace Environments in Mexico: A Grounded Theory Approach

BACKGROUND

Leadership in any managerial position that a nurse may hold appears to be closely connected to fostering positive and productive work environments within healthcare settings. However, not all nurse managers are characterized by leadership, and not all nurse leaders are nurse managers. In countries, such as Mexico, those who occupy these roles have barely sufficient training in management, are mainly characterized by their experience in one clinical specialty and their vocation for leadership is not a requirement. Our study aims to understand how the leadership vocation that some nurse managers have in their daily practice could impact the work environments of healthcare organizations in Mexico.

METHODS

A qualitative design was carried out through a grounded theory approach based on Corbin & Strauss, interviewing individually 13 nurse managers with representative experience in Mexican public sector hospitals.

RESULTS

According to the interviewees, the meaning of vocation is based mainly on the love for their profession, on the vocation of being a nurse and caring for people, as well as on the development of their own natural leadership potential for decision-making in practice. This situation produces positive feedback on themselves by generating productive effects in the work environment, consequently strengthening them to better organize professional resources and therefore producing improvements.

CONCLUSIONS

The nurse manager's vocation of leadership derives from both the vocation of being a practicing nurse and the vocation for being a leader, positively impacting and productively contributing to the improvement of the work environment. Consequently, nurse managers with vocation for leadership should be the gold standard role in any healthcare organization. This study was retrospectively registered with the (registros-OSF-bmyvz-v1) on the (26 July 2023) registration number (10.17605/OSF.IO/BMYVZ).

Attitudes of the public and medical professionals toward nurse prescribing: A text-mining study based on social medias

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.

Identifying the Enablers and Barriers to Advance Nurse Prescribing of Medication in Spain According to Experts' Views: A Delphi Study

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.

Antecedents and Consequences of Online Healthcare Community Usage: A Grounded Theory Approach

The online healthcare community has grown rapidly in recent years. However, the antecedents and consequences of the use of online healthcare community platforms have not been systematized. Using grounded theory, this study collects first-hand data on the use of online healthcare communities through in-depth interviews and analyzes the interview data using a three-level coding approach including open coding, axial coding, and selective coding. The results showed the following. (1) Doctors, hospitals, and the online platforms themselves, along with the impact of healthcare environmental factors, affect patients using the online healthcare community. (2) The use of an online healthcare platform affects patient-related factors, such as emotional dependence and patient satisfaction, as well as factors related to doctor–patient interactions, such as the perception of healthcare quality and the doctor–patient relationship, through mediating factors, including doctor–patient communication, treatment processes, and healthcare costs. (3) Improving patients’ healthcare experience and the doctor–patient relationship may feed back into operation quality and the operating environment of the online healthcare community, thus promoting the promotion and use of an online healthcare community platform.