The Study On Contents Of Nurse Prescription For Antineoplastic Drugs,Immunosuppressants And Immunomodulators,Blood And Hematopoietic System Drugs

Objective:The purpose of this study is to research the prescription right of nurses in the early stage of the research group,consult the relevant materials of the prescription right of foreign nurses,and combine the antineoplastic drugs,immunosuppressants and immunomodulators,blood and hematopoietic system drugs in the clinical drug Manual of China,Based on the national conditions of our country,this paper discusses the three first-class hospitals in China:1.The content and form of prescription of antineoplastic drugs that can be prescribed by nurses in oncology department;2.The contents and forms of immunosuppressants and immunomodulator prescriptions that can be prescribed by nurses in rheumatology and immunology department;3.The contents and forms of prescription of blood and hematopoiesis system drugs that can be prescribed by nurses in the department of hematology.The purpose of this study is to provide some reference for the implementation of the content of prescription right of nurses in the future.Objects:Clinical experts and nursing experts working in the oncology department,rheumatology and immunology department and hematology department of the provincial and foreign third-class hospital.The premise of expert selection is to agree to give the nurses prescription rights in principle.The inclusion criteria of experts are:(1)deputy senior title and above.(2)working in corresponding clinical departments for 10 years or above.(3)bachelor degree or above.(4)strict and realistic attitude and voluntaryparticipation.The first three standards meet two requirements.Methods:1.Literature research method: Search domestic and foreign databases and browse foreign official websites,consult and understand the current situation of prescription right of foreign nurses and the contents related to antineoplastic drugs,immunosuppressants and immunomodulators,blood and hematopoiesis system nurses' drug prescriptions in the list of drug prescriptions,and initially formulate expert consultation questionnaire.2.Semi structured interview method: According to the preliminary design of the questionnaire to develop an interview outline,respectively,three medical experts and two nursing experts in the oncology department,two medical experts and two nursing experts in the rheumatology and immunology department and hematology department were interviewed semi structured in Shanxi Province.According to the interview opinions and group discussion,the first round of expert consultation questionnaire was preliminarily formulated.3.Modified Delphi method: invite clinical experts and nursing experts working in the oncology department,rheumatology and immunology department and hematology department at inside and outside the province to carry out two rounds of expert consultation on the content of prescription right of antineoplastic drugs,immunosuppressants and immunomodulators,blood and hematopoiesis system nurses,and carry out statistical analysis on the consultation results to get the final research results.Among them,there are twelve nursing experts and twelve medical experts in oncology department,twelve nursing experts and ten medical experts in rheumatology and Immunology Department,thirteen nursing experts and ten medical experts in hematology department.Results:1.The positive coefficient of expert consultation in the two rounds of nurse prescription right research of antineoplastic drugs were 93.33%,100%,and the authoritative coefficient were 0.84,0.87.The positive coefficient of expert consultation in the two rounds of nurse prescription right research of immunosuppressants and immunomodulator were 92.31%,100%,and the authoritative coefficient was 0.82,0.87.The positive coefficient of expert consultation in the two rounds of nurse prescription right research of blood and hematopoietic system drug were 92.86%,100%,and the authority coefficient were 0.85 and 0.88.2.Determine the content and form of the prescription of antineoplastic drugs.Finally,experts do not recommend that nurses in oncology department prescribe antineoplastic drugs in any form,and the identification rate of all anti-tumor drugs is less than 80%.3.Determine the content and form of the prescription immunosuppressants and immunomodulators.Finally,Experts suggest that nurses in rheumatology and immunology department can only issue one immunosuppressant and immunomodulator,which is the total glucosides of paeony in the form of immunosuppressant botanical drugs,and the prescription form is the protocol prescription.Experts do not recommend that nurses issue immunomodulator in any form.4.To determine the content and form of prescription of blood and hematopoietic system drugs.Finally,Experts suggest that nurses in hematology department can prescribe sixteen kinds of blood and hematopoietic system drugs in two categories.Anti anemia drugs include iron and vitamin preparations,anticoagulant and antithrombotic drugs include antiplatelet drugs.Among them,it is suggested that there are four drugs in the form of agreement prescription,one drug in the form of extended prescription and eleven drugs in the form of two prescriptions.Tendency to protocol prescription drugs(4 types): iron preparation ferrous gluconate,vitamin preparation mecobalamin,antiplatelet drugs ticlopidine and clopidogrel.Tendency to extended prescription drugs(1 type): vitamin preparation calcium folinate.Tendency to independent/extended prescription drugs(7 types):iron preparations ferrous sulfate,ferrous fumarate,vitamine controlled release tablets,ferrous succinate,vitamin preparations vitamin B12,adenosylcobalamin,folate.Tendency to protocol/extended prescription drugs(4 types):Iron preparation polysaccharide iron complex,iron dextran,iron sucrose,antiplatelet aspirin enteric-coated tablets.Conclusion:1.Nurses in oncology department are not recommended to prescribe antineoplastic drugs in any form.2.It is suggested that the nurses of rheumatology and immunology department can issue one drug for immunosuppressant and immunomodulator in the form of protocol prescription.3.It is suggested that the nurses of hematology department can prescribe sixteen kinds of blood and hematopoiesis system drugs in two categories.Among them,four drugs are prescribed by protocol,one drug is prescribed by extension,eleven drugs in the form of two prescriptions.