The Study Of Qualifications And Contents Of Nurse Prescribing Of Cardiovascular Medications

Objective:On the basis of searching a large number of literature,referring to the lists of drug prescription rights of nurses in cardiovascular system abroad and combining with the specific situation of our country,this paper aims to explore the qualification,prescription contents and prescription forms of drug prescription rights of nurses in cardiology department of third-level hospitals in China,with a view to providing scientific reference and theoretical basis for formulating relevant laws and policies in the future.Methods:1.Literature research methodBy searching database and browsing search engine,we searched and translated the lists of foreign nurses' drug prescriptions for cardiovascular system drugs,then made expert consultation questionnaire.2.Semi-structured interview methodFive deputy chief nurses,three chief physicians and two deputy chief physicians working in cardiology department of three third-class A hospitals in the province were selected by objective sampling.Ten medical staff working in cardiology department were interviewed with the preliminary questionnaire "Qualification and content of application for drug prescription right of Cardiology nurses".The interview opinions were collected and collated.The preliminary questionnaire was revised to form the first round of expert consultation.3.Delphi methodAccording to the expert questionnaire "Qualification and content of drug prescriptionright application for nurses in cardiology department",two rounds of forecasting consultation were conducted among medical and nursing specialists working in cardiology department in third-class hospitals of many provinces and municipalities in China.Twenty-three nursing experts participated in the whole study,including two in Shaanxi,one in Gansu,one in Anhui,one in Shanghai,one in Hebei and 13 in Shanxi.Thirteen medical experts participated in the whole study,including two in Guangzhou,one in Gansu,two in Beijing and six in Shanxi.4.Statistical methodMicrosoft Excel database and SPSS22.0 statistical software were used to analyze the consulting results.The average and standard deviation of the indicators were obtained,and the identification rate,positive coefficient and authoritative coefficient of experts were calculated.Results:1.The qualifications of nurses who could be authorized to prescribe cardiovascular medications included more than 10 years of work experience in cardiovascular department of tertiary hospital,with bachelor's degree in nursing education and with intermediate professional title.2.Medications that could be prescribed by nurse for a single cardiovascular disease were classified into 7categories,totaling to 93 types,of which 64 were within protocols,22 were independent or within protocols and 7 were independent.The 7 categories of cardiovascular drugs that nurses in the Department of Cardiology of the third-class A hospital can prescribe were:anti-hypertensive drugs,anti-angina drugs,,anti-shock and acute heart failure drugs,anti-arrhythmic drugs,chronic heart failure drugs,thrombolytic drugs,anti-thrombotic drugs,lipid-lowering drugs.Tend to the form of independent prescription drugs:Compound Amiloride Hydrochloride/Hydrochlorothiazide,Perindopril/Indapamide,Aspirin,Simvastatin,Pravastati n,Fenofibrate.Tend to the form of independent/protocol prescription drugs:Nifedipine,Captopril,Cnalapril,Benazepril,Perindopril,Ramipril,Lisinopril,Quinapril,Losartan,Valsartan,Irbesarta n,Telmisartan,Propranolol;Nitroglycerin;Norepinephrine;Perindopril,Captopril,Propranolol,Metoprolol;Rosuvastatin,Gemfibrozil,Ezetimibe.Tend to the form of protocol prescription drugs:Felodipine,Nimodipine,Nitrendipi ne,Amlodipine,Lekadipine,Verapamil,Diltiazem,Cilazepril,Candesartan,Omesartan,Acetyl butyrol,Atenolol,Labetalol,Metoprolol,Bisoprolol,Nebulol,Hydrochlorothiazide,Benfluthia zide,Furosemide,Spironolactone,ErpeneBesartan/Hydrochlorothiazide,Telmisartan/Hydroc hlorothiazide,Olmesartan/Hydrochlorothiazide,Lisinopril/Hydrochlorothiazide,Amlodipine/Telmisartan,Amlodipine/Valsartan,Amlodipine/Atorvastatin,Doxazosin,Piperazosin,Teraz osin,Methyldopa,Moxonidine and Clonidine;anti-angina drug Lsosorbide nitrate,Isosor bide mononitrate;Milrinone;Lidocaine and Flucarnil;Benfluthiazide,Cilazepril,Enalapril,Lisinopril,Quinapril,Ramipril,Benazepril,Valsartan,Losartan,Telmisartan,Candesartan,Irbes artan,Vinedinol,Atenolol,Labelol and Metoprolol for chronic heart failure Bisoprolol,Nabilol,Carvedilol,Spironolactone;Thrombolytic drugs and antithrombotic drugs Ticlop idine,Clopidogrel,Ticagrel,Prague,Fondaparinum;Lipid-regulating drugs Colenemide.3.When cardiology patients were complicated with other diseases in the case of non-single disease,any prescribing form of drugs were not prescribed according to 53.4%experts(16 people).4.The response rates of two rounds of expert consultation were 83.33% and 100%respectively,and the authority coefficients of expert were 0.85 and 0.90.Conclusion:The experts who participated in the Delphi study are active and authoritative.The results of this study are as follows: qualifications(bachelor's degree,competent nurse's title,working in cardiology department for more than 10 years)and 93 prescription contents(64protocol prescriptions,22 independent/protocol prescriptions and 7 independent prescriptions)of 7 categories are reliable.