| PurposeThis study is the sub-topics of“the influencing factor and prescription content of nursingprescribe authority in China”, in order to probe into the Oncology nurse specialist can prescribewhich concrete drugs and Laboratory test under which particular situation、adopting whichprescription pattern. Looking forward to providing references for how to cultivate the Oncologynurse specialist and for drafting some relevant laws and regulations in China.ObjectFrequently-used drugs and Laboratory Examinations in Oncology fieldMethodsLiterature review: learn about the development of nursing prescribe authority in the UnitedStates、England、Australian、Canada and the current situation of Oncology nurse specialist inthe four country.Semi-structured interview: draw up the particular situation and prescription content for thefirst round questionnaire.Delphi Method: determine under which particular situation、adopting which prescriptionpattern the Oncology nurse specialist can prescribe which concrete drugs and Laboratory test.Results1 Determine which particular situation the Oncology nurse specialist can participate inprescribingThrough tow round Delphi Method questionnaire to determine which particular situation theOncology nurse specialist can participate in prescribing. In the Chronic symptoms management,there are Cancerous pain、vomiting、constipation、diarrhea、Cancerous fever、Oral CavityInfection、phlebitis 7 particular situation; In Oncology emergencies, there are Chemotherapydrug allergy、acute massive hemoptysis、acute massive hemorrhage of upper gastrointestinaltract、uncontrolled hemorrhagic Shock、cerebral hernia 5 particular situation；In Laboratory test,there are blood routine、Serum Biochemical Index、Blood coagulation inspection, the bloodculture, sputum cultures, urine culture, electrocardiogram, tumor markers, stool test 9 particularsituation.2 Determined the indicators, weights of particular situationBased on the experts’scoring for each item, using the Proportional distribution method todetermine the indicators’weights, one-grade items, rank is Laboratory test、Chronic symptomsmanagement、Oncology emergencies；In Laboratory test, the top five test items are Blood tests, electrocardiogram, blood biochemical, stool test, and clotting inspection; In Chronic symptomsmanagement, the top three particular situation are Constipation、phlebitis、cancerous pain；InOncology emergencies, the top three particular situation are Chemotherapy drug allergy,uncontrolled hemorrhagic shock, acute massive hemorrhage of upper gastrointestinal tract.3 Analysis of the differences between the doctor group and the nurse group about degree ofapprovement on particular situationThrough Wilcoxon , "Cancerous pain", "oral infections," "acute massive hemoptysis " and"acute upper gastrointestinal bleeding" these particular situations, there is Statistical differencesbetween the doctor group and the nurse group; there is no Statistical differences in otherparticular situations or any Laboratory test.4 Determined the prescription pattern and prescription content which Oncology nursespecialist can prescribe(1) tend to nurse independent prescribingConstipation：plug dew、glycerin、liquid paraffin、phenolphthalein piece、folium sennae、Maren pills、Maren capsule;Diarrhea: bifidobacterium、diphenoxylate;Cancerous fever：Naproxen Tablets、Indometacin Tablets、Indometacin Suppositories、Antongding injection、Bupleurum injection;Oral Cavity Infection：chlorhexidine, sodium chloride solution, hydrogen peroxide solutionmetronidazole solution, sodium bicarbonate solution;Phlebitis：Hirudoid and magnesium sulfate, golden scatteredacute massive hemoptysis：etamsylate、aminomethylbenzoic acid;Acute massivehemorrhage of upper gastrointestinal tract：Inj OmeprazoleHemorrhagic Shock：Sodium chloride、green fluidLaboratory test：Routine blood、blood biochemical、and clotting inspection、the blood culture,sputum cultures, urine culture, ecg, stool test(2) tend to protocol prescriptionDiarrhea: LoperamideCancerous fever：Inj DexamethasoneOral Cavity Infection：ketoconazole、fluconazole、NystatinChemotherapy drug allergy：Dexamethasone Injection、Epinephrine Inj、acute massive hemoptysis：Haemocoagulase、pituitrinAcute massive hemorrhage of upper gastrointestinal tract：somatostatinHemorrhagic Shock：dextran、hydroxyethyl starch (3) two prescription pattern similarChemotherapy drug allergy：Diphenhydramine Hydrochloride InjAcute massive hemorrhage of upper gastrointestinal tract: Haemocoagulasecerebral hernia: mannitolLaboratory test：tumor marker(4) Extended Nurse Prescribing1 tend to nurse independent prescribingCancerous pain: aspirin、ibuprofen、ibuprofen Sustained release tabletsVomiting：Domperidone Tablets、motoclopramide、Metoclopramide2 tend to protocol prescriptionCancerous pain: BucinnazineHydrochlorideInjection、Tramadol Hydrochloride Injection、Morphine Tablets、Morphine sustained release tablets、Morphine injection、DuragesicVomiting：Benzene hella sensitive injection、Inj Omeprazole、Cimetidine Inj、Dose Ondansetron3 two prescription pattern similarCancerous pain: Bucinnazine HydrochlorideTablets、Tramadol Hydrochloride Tablets5 Analysis the differences between the doctor group and the nurse group about prescriptionpatternAdopt Fisher test, In the Chronic symptoms management, there is Statistical differencesbetween the doctor group and the nurse group about prescription pattern on folium sennae、mannitol and In Laboratory test , there is Statistical differences about tumor marker,prescription pattern.ConclusionConstructed the particular situation which the Oncology nurse specialist can participate inprescribing. And determined adopting which prescription pattern the Oncology nurse specialistcan prescribe which concrete drugs and Laboratory test.suggestion1 guarantee the admittance and Appraisal System of the Oncology nurse specialist2 Establishing relevant laws and regulations3 Considering The Chinese Situations, develop the Oncology nurse specialist, prescriptionfunctionsNew point of view in this studyDetermined under what particular situation and adopting which prescription pattern, theOncology nurse specialist can prescribe which concrete drugs and Laboratory test. Conception for making further investigation1 To study different roles of the Oncology nurse specialist,prescription content2 To study different Medical Settings of the Oncology nurse specialist,prescription content... |
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