Enabling legislation in diagnosis and prescribing of medicine by nurses/health practitioners

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.

Dermatology nurse prescribing in China: a Delphi method

Objectives: To identify the dermatological system drugs that may be prescribed by Chinese dermatological nurses through expert consensus.

Methods: A 2-round study, consisting of 32 medical and nursing experts, was conducted using the Delphi method from September 2019 to June 2020. Microsoft Excel 2019 and IBM SPSS Ver. 22 were used to analyze the results of the consultations.

Results: A total of 63 drugs across 13 categories were identified as relevant to Chinese nurses working in dermatological departments. Among these drugs, 1 drug was generally prescribed independently, 17 drugs tended to be prescribed collaboratively, and 45 were prescribed either independently or in collaboration with others.

Conclusions: This expert consensus determines the prescription drugs that may be prescribed by dermatology nurses in China, which can be used as the key content of prescription drug training for dermatology nurses in future. The results of the study could provide a basis for the implementation of nurses’ prescription rights in China in future and provide a reference for the formulation of relevant legislation on nurses’ prescription rights.

The case of pharmacist prescribing policy in Israel

Pharmacy prescribing policy in Israel has been negotiated and changed in recent years in order to improve patient treatment and access to medicines, and reduce national health insurance costs by allowing pharmacists to prescribe medications. Various stakeholders and institutions were involved in the formulation process, affecting the process while representing different motives. The complexity of pharmacy prescribing policy formulation is universal - any policy project needs, for strategic and tactical reasons, to acquire an inventory of institutions involved, identify the key players and explore potential support or opposition among them. This article uses the field (theory) of new institutional economics to explain the process of pharmaceutical institutional change and identifies the stakeholders who are involved in the reform.

In the framework of pharmaceutical policies, seven models of prescribing practices are outlined, and the Canadian and British prescribing models are presented. The paper then focuses on the Israeli case and the main issues that concern decision-makers in the Israeli health system, such as inequality in access to health services and the erosion of the notion of universal health services. These concerns and the involvement of different stakeholders, such as The Israeli Medical Association (IMA) and health funds, influenced and directed the final Pharmacist Prescribing Law. After several rejections and amendments the law was passed, enabling experienced pharmacists to prescribe only to patients with a previous prescription given by a physician in the hope it would improve services to patients and reduce physicians’ workloads. Here, the topic of the new prescribing policy is introduced, using tools from the new institutional school in political economy.

Nurse prescribing in low-resource settings: professional considerations

AIM

This paper reviews the professional issues relating to nurse prescribing in low-resource countries.

BACKGROUND

In order to meet community healthcare need, nurses in low-resource settings often perform roles such as prescribing medication, for which they may not have had adequate training, often in the absence of supervision, legislation and regulation. In general, however, there is a paucity of published evidence relating to nurse prescribing in low-resource settings. Several studies have demonstrated improved health and social outcomes resulting from nurse-prescribing interventions. Alternatively, other studies have shown unsatisfactory nurse-prescribing patterns, such as overuse of antibiotics and poor adherence to national treatment guidelines. There are several examples of how nurse prescribing in low-resource countries has been recognized and addressed at national level; these are discussed in detail. However, given that it is widely acknowledged how crucial nurses are for the delivery of health care in regions where there are no medical personnel, international policy and guidance relating to this issue is only just beginning to acknowledge and address the relevant issues.

CONCLUSION

Where there is a need for nurses to extend their role in the ordering of medicines and other treatments, the responsibilities, training, rights and roles of these nurses need to be clearly defined and recognized at all levels of the health service. There is a need for rigorous evaluations incorporating health, social and economic outcomes of nurse-prescribing interventions, in addition to close monitoring of legislative and regulatory changes related to nursing roles.

The biological sciences in nursing: a developing country perspective

AIM

This paper reports a study to inform curriculum development by exploring the contribution of bioscience education programmes to nurses' clinical practice, their understanding of the rationale for practice, and their perceptions of their continuing professional development needs.

BACKGROUND

The future of the health services worldwide depends on nurse education programmes equipping practitioners to deliver safe and effective patient care. In the developed world, the structure and indicative content of nursing curricula have been debated extensively. However, despite the rapid expansion in nursing roles brought about by social change, there is little information on the educational needs of nurses in developing countries.

METHODS

This study was undertaken in government teaching hospitals in Cape Town, South Africa in 2003. A purposive sample of 54 nurses from a range of clinical settings completed questionnaires and described critical incidents where bioscience knowledge had directed practice. Questionnaires were analysed descriptively, in the main. Analysis of critical incident reports was based on Akinsanya's bionursing model.

FINDINGS

Most nurses felt that their understanding of the biological, but not the physical sciences, was adequate or better: all felt confident with their knowledge of anatomy, compared with 57.4% (31/54) for microbiology. Respondents attributed the successes and failures of their education programmes to their teachers' delivery of content, ability to relate to practice and management of the process of learning. The biological, but not the physical, sciences were universally (96-100%) regarded as relevant to nursing. However, the critical incidents and nurses' own reports indicated a need for further education in pharmacology (40/54, 74.1%) and microbiology (29/54, 53.7%).

CONCLUSION

To meet the needs of nurses in developing countries, and empower them to meet the increasingly complex demands of their expanding roles, nurse educators need to consider increasing the curriculum content in certain key areas, including pharmacology and microbiology.