Study On The Content Of Nurse's Respiratory System And Antimicrobial Drug Prescription

Purpose:The purpose of this study is to learn from the experience of foreign countries in the development of the right of nurse prescription on the basis of the research on the right of nurse prescription in China,To explore the content and form of prescriptions for respiratory drugs and antimicrobial drugs that can be issued by nurses in the department of respiratory medicine in China's third-level first-class hospitals,In order to provide some reference for the formulation of the laws and regulations of nurse prescription right in our country.Object:In this study,20 clinical nursing experts and 18 medical experts were consulted in the department of respiratory medicine of 14 grade a hospitals in Shanxi,Beijing,Guangdong and other provinces.The selection criteria for experts are:1)10 years or more of work experience in this field,2)the title of deputy director or above or the clinical working years equivalent to the deputy director of the title of intermediate and above titles,3)bachelor degree or above,4)have a rigorous and realistic attitude and volunteered to participate in this study.Two items was required among the former three items.The content and form of prescriptions for respiratory and antimicrobial drugs were determined by an expert nurse.Methods:1.Literature analysisSearch domestic and foreign databases and browse official foreign websites(PubMed,Science Direct)and official foreign websites(mainly including European respiratory association,American thoracic association and international nurses network),Throughliterature research,relevant materials of foreign nurse prescription rights and nurse prescription list were consulted,and combined with relevant respiratory drugs and antimicrobial drugs in China's 'clinical drug manual'(the fifth edition),the expert consultation questionnaire was preliminarily prepared.2.Semi-structured interviewOn the basis of literature review,semi-structured interviews were conducted with 3doctors and 2 nurses in the respiratory department.According to the interview results,the preliminary expert questionnaire was revised to form the formal first-round expert consultation questionnaire.3.Delphi methodWe invited 20 nursing experts and 18 medical experts from 14 first-class hospitals in Shanxi,Beijing,Guangdong,etc.Two rounds of 'expert consultation questionnaire on the content of nurses' respiratory system and antimicrobial drugs' were conducted,and the final results were obtained through statistical analysis of the consultation results.Results:1.Determination of the content and form of respiratory drug prescriptionEight drugs including Salbutamol,Terbutaline,Ipratropium Bromide,Tiotropium Bromide,Budesonide,Diphenhydramine,Cetirizine and Loratadine were prescribed by Independent prescription form.A total of 16 drugs,including Carbocisteine,Beclomethasone,Fluticasone,Hydrocortisone,Prednisone,Methylprednisolone,Triamcinolone,Sodium Cromoglycate,Nedocromil,Zafirluast,Sratrodast,Promethazine,Cyproheptadine,Terfenadine,Mizolasllne and Acrivastine,were prescribed by Protocol prescription form.A total of 7 drugs,including Bromhexine,Ambroxol,Bambuterol,Shametrol,Formoterol,Montelukast and chlorphenamine,were prescribed by Independent prescription form or Protocol prescription form.2.Determination of the content and form of the prescription of antimicrobial drugsThe recognition rate of all drugs in the antimicrobial drugs was lower than 80%,including Benzypenicillin(60.6%),Amoxycillin(69.7%),Amoxycillin/Clavulanic Acid(63.6%),Cefalexin(60.6%),Cefazolin(60.6%),Cefuroxime(63.6%),Cefaclor(63.6%),Cefotxi me(51.5%),Ceftazidime(60.6%),Ceftriaxone(60.6%),Cefixime(60.6%),Gentamicin(54.6%),Erythromycin(66.7%),Roxithromycin(72.7%),Clarithromycin(66.7%),Azithromycin(75.8%),Tetracycline(63.6%),Clindamycin(60.6%),Norfloxacin(72.7%),Ofloxacin(69.7%),Cipro floxacin(69.7%),Levofloxacin(72.7%),Moxifloxacin(60.6%),Metronidazole(72.7%),Tinida zole(72.7%),Ornidazole(66.7%),Amantadine(66.7%),Rimantadine(60.6%),Zanamivir(69.7%),Oseltamivir Phosphate(66.7%),Aciclovir(75.8%),Ganciclovir(69.7%),valaciclovir(63.6%),Famciclovir(66.7%),Ribavirim(57.6%),Adefovir(63.6%),Entecavir(63.6%),Tiread(63.6%),Zidovudine(60.6%),Nevirapine(60.6%),Ritonavir(60.6%),Atazanavir(60.6%),Boc eprevir(60.6%),Miconazole(54.6%),Econazole(57.6%),Kotoconazole(60.6%),Fluconazole(66.7%).Conclusion:1.Among the drugs for respiratory system,it is suggested that nurses in respiratory medicine department can prescribe 31 drugs in 3 categories of drugs for respiratory system.Drug prescription form: 8 drugs are recommended to be prescribed independently,16 drug experts recommend to prescribe in the form of agreement,and 7drugs can be prescribed in the form of independent prescription or agreement.2.Nurses in the respiratory department are not advised to prescribe all the drugs in the Antimicrobials.