Iranian nurses’ attitudes towards the necessity and barriers to developing nurse prescribing roles

Abstract Background Prescribing medication by nurses as an approach to rational drug prescription has been proposed in many countries. Nursing prescribing is an effective measure in the management of critically ill patients admitted to intensive care units (ICU). This study investigated the attitude of ICU nurses towards the necessity and the barriers to developing nursing prescribing. Materials and methods In this cross-sectional study, 136 ICU nurses were included by stratified random sampling. The data collection tool was the researcher-made questionnaire. Cronbach’s alpha method was used to evaluate the reliability of the instrument. The validity of the instrument was also verified by the content validity method. To collect the data, the researcher referred to the nurses’ workplace and provided them with a questionnaire and collected it after completion.The collected data were analyzed by IBM SPSS 16 using descriptive and inferential statistics. Results It was revealed that 58.8 % of nurses were familiar with the term ‘nursing prescribing’; a majority (92.1 %) of whom considered it vital to develop this role in the ICU. Moreover, 86 % (n = 98) of the nurses assumed that it is possible to implement this role in ICU. The most potential barriers to its implementation were lack of legitimacy, disapproval of physicians, and the reluctance of nursing managers. Conclusions Most nurses maintained a positive attitude towards nursing prescribing; hence, its legitimacy seems vital in ICUs. For the development of the ‘nurse prescribing’ role, the Nursing System Organization may be helpful.

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Assessment of Risks Related to Medicine Dispensing by Nonprofessionals in Colombia: Clinical Case Simulations

Annals of Pharmacotherapy ◽

10.1345/aph.1e420 ◽

2005 ◽

Vol 39 (3) ◽

pp. 527-532 ◽

Cited By ~ 5

Author(s):

Claudia Vacca ◽

José Orozco ◽

Albert Figueras ◽

Dolors Capellà

Keyword(s):

Drug Use ◽

Drug Prescription ◽

Educational Background ◽

Cross Sectional Study ◽

Cross Sectional ◽

Essential Information ◽

Rational Drug Use ◽

Rational Drug ◽

Public Health Institutions ◽

Therapeutic Problem

BACKGROUND: Appropriate dispensing is one of the steps for rational drug use, so it is generally advised that the dispenser should have relevant and updated knowledge, skills, and attitudes. OBJECTIVE: To assess pharmacies and nonprofessional employees' (NEs) skills and knowledge, as well as their response to several specific case simulations in Bogotá, Colombia. METHODS: A descriptive cross-sectional study was performed on a random sample of 371 pharmacies in Bogotá. Information from each pharmacy was obtained using 2 approaches: (1) direct interview to collect data on organizational aspects of the store and characteristics of NEs, and (2) simulation (both by direct interview and by telephone) to assess dispensing responses in 6 simulated clinical cases. RESULTS: More than half of the simulated clinical situations resulted in inappropriate dispensing (direct simulations 57%; telephone simulations 55%). The proportion of correct answers to theoretical questions regarding a specific therapeutic problem during interviews was higher than the response when a simulation presented that same case and a dispensing act was expected. The educational background of the NEs included in the study points to a specific problem: two-thirds of the individuals selling medicines had completed only secondary-level education and only 2% of the sample had a pharmacist as technical director. Continuing education courses were either directly organized by drug manufacturers (one-third of the courses attended by pharmacists) or sponsored by them (more than an additional one-third). CONCLUSIONS: NEs should be considered part of the therapeutic chain and, if appropriately updated or instructed, could play a very important role in the always difficult promotion of rational drug use. Public health institutions and universities should be more actively involved in the provision of independent, unbiased, and essential information on common therapeutic problems, safety concerns, and new drug prescription restrictions.

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Healthcare utilisation, cancer screening and potential barriers to accessing cancer care in rural South West Nigeria: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-040352 ◽

2021 ◽

Vol 11 (7) ◽

pp. e040352

Author(s):

Avinash Sharma ◽

Olusegun Isaac Alatise ◽

Kelli O'Connell ◽

Samson Gbenga Ogunleye ◽

Adewale Abdulwasiu Aderounmu ◽

...

Keyword(s):

Cancer Screening ◽

Cancer Care ◽

Healthcare Utilisation ◽

Cross Sectional Study ◽

Personal Income ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Potential Barriers ◽

South West

Background/aimsCancer burden is predicted to double by 2030 in sub-Saharan Africa; access to healthcare services for cancer management is a priority in the region. In Nigeria, National Cancer Control Plan aims to ensure >50% cancer screening of eligible populations by 2022 for all Nigerians. We describe healthcare utilisation, cancer screening activities and potential barriers to accessing cancer care within an understudied rural community-based adult population in South West Nigeria.MethodsIn April 2018, we conducted a cross-sectional study of community-based adults (>18 years) ~130 km east of Ibadan, 250 km from Lagos in Osun State, South West Nigeria. Participants completed a face-to-face survey in local dialect. We used a questionnaire to assess demographics, health status, income, medical expenditures, doctor visits and cancer screening history.ResultsWe enrolled 346 individuals: with median age of 52 years and 75% women. Of the entire cohort, 4% had medical insurance. 46% reported a major medical cost in the last year. Cancer screening activities were infrequent in eligible participants: 1.5% reported having had cervical cancer screening, 3.3% mammogram and 5% colonoscopy screening. Cancer screening assessment was less frequent in those with less income and lower education levels. Using a multivariable logistic regression model including personal income, insurance status and education, higher personal income was associated with more cancer screening activity (OR 2.7, 95% CI 1.3 to 5.7, p<0.01). Despite this, most individuals had contact with a primary healthcare doctor (52% in the last year), and over 70% access to radio and TV suggesting the opportunity to expand community-based screening interventions and awareness exists.ConclusionsDespite national increases in cancer cases, we highlight a deficiency in cancer screening and universal healthcare coverage within a community-based adult Nigerian population. Subject to availability of governmental resources, increasing financial risk protection, awareness and targeted resource allocation may help expand access in Nigeria.

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Drug utilization pattern of antimicrobials in intensive care unit of a tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20204103 ◽

2020 ◽

Vol 9 (10) ◽

pp. 1594

Author(s):

Saswat Satapathy ◽

Yajnesh P. Sahu ◽

Ashok K. Panigrahi ◽

Bhabagrahi Rath ◽

Ananta N. Patra

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Drug Utilization ◽

Drug Prescription ◽

Tertiary Care ◽

Quality Of Healthcare ◽

Cross Sectional Study ◽

Utilization Pattern ◽

Prescribing Practices ◽

Cross Sectional

Background: The intensive care unit is a setting where the multiple medications are prescribed to patients. Antimicrobials are heavily prescribed in the ICUs, which in turn enhance the risk of antimicrobial resistance, increase the side effects and increases the cost of treatment. Drug utilization study is a component of medical auditing that aims to monitor and evaluate the drug prescription patterns and to suggest necessary modifications in the prescribing practices to achieve rational therapeutic practice.Methods: A cross-sectional study was conducted in which data of patients admitted to ICU during the period from June 2019 to August 2019 was collected from the Medical Record Section of the hospital. Drug utilization pattern of antimicrobials in ICU was analyzed.Results: Out of 90 patients, 60 were males and 30 were females. The average duration of stay in ICU was 7.53 days. The most common antibiotic prescribed was ceftriaxone followed by piperacillin and tazobactam with DDD/100 bed days of 24.2 and 17.3 respectively.Conclusions: In this study, the results appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of antimicrobials in the ICU setting. Therefore, it is necessary to conduct drug utilization research to understand the drug consumption and for implementation of protocols to improve the quality of healthcare.

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LOW BIRTH WEIGHT BABIES;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.08.1003 ◽

2017 ◽

Vol 24 (08) ◽

pp. 1176-1180

Author(s):

Brig® Khalid Mehmood ◽

Ijaz Ali ◽

Syed Hyder Raza

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Gestational Age ◽

Sampling Technique ◽

Cross Sectional Study ◽

Data Collection Tool ◽

Cross Sectional ◽

Normal Birth ◽

Low Birth Weight Babies ◽

Study Setting

Objectives: To determine the proportion of LBW Babies among those deliveredat DHQ Hospital Mirpur. Study design: Descriptive cross sectional study. Setting: DHQ hospitalMirpur AJK. Duration of study: January 2013-May 2013. Sample size: 459 deliveries. Studypopulation: women reporting in Peads OPD of DHQ hospital Mirpur AJ&K with their babiesduring study period. Sampling technique: Convenience method. Data collection tool: Datacollection Performa. Data analysis: SPSS version 14.0.Results: Out of 459 deliveriesconducted at Divisional Head Quarter hospital Mirpur, 149 cases of low birth weight babies(<2500gms) whereas the rest 310 had normal birth weight. Frequency of Low Birth Weight inmale new born babies was high, i.e ratio of male babies were 55% (82) out of 149 individualswhile females were 45% (67). Less than 37 weeks of gestational age, 37% (55) were pretermbabies and 37 – 42 weeks of gestational age, 63% (94) were full term babies.

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Can we reduce psychosomatic symptoms and work presenteeism with physical activity?

Human Systems Management ◽

10.3233/hsm-211213 ◽

2021 ◽

pp. 1-11

Author(s):

Andreja Petrovčič ◽

Vanja Erčulj ◽

Eva Boštjančič

Keyword(s):

Physical Activity ◽

Cost Effective ◽

Cross Sectional Study ◽

Lower Percentage ◽

Cross Sectional ◽

Effective Measure ◽

Psychosomatic Symptoms ◽

General Evaluation ◽

Patient Health ◽

The Relationship

BACKGROUND: Past studies have tended to consider the relationships between presenteeism, physical activity and psychosomatic symptoms in a partial manner and not as a whole. OBJECTIVE: This cross-sectional study investigated the relationship between physical activity, psychosomatic symptoms and presenteeism, in order to increase the visibility of presenteeism and promote workplace health. METHODS: Two questionnaires (Patient Health Questionnaire and Work Limitations Questionnaire) and a set of physical activity questions were administered on the sample of 514 employees. RESULTS: The results showed a statistically significant relationship between presenteeism and some variables of physical activity, as well as between presenteeism and psychosomatic symptoms. Further results showed a statistically significant association between psychosomatic symptoms and some variables of physical activity. General evaluation (adequacy) of physical activity, and general, aerobic physical activity proved to be important predictors of presenteeism, while general, aerobic physical activity also predicted psychosomatic symptoms. Analysis of the results revealed that psychosomatic symptoms moderate the relationship between physical activity and presenteeism. CONCLUSIONS: The article points out that employees with health problems have a lower percentage of productive time than healthy employees. However, developing an active lifestyle can be a cost-effective measure to cope with presenteeism and promote psychophysical health among employees.

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Pharmacists’ interventions on 2 years of drug monitoring in an oncology pediatric inpatient ward

Journal of Oncology Pharmacy Practice ◽

10.1177/10781552211041037 ◽

2021 ◽

pp. 107815522110410

Author(s):

Rafaela Dall Agnol ◽

Maitê T dos Santos ◽

Mariana B Michalowski ◽

Lídia Einsfeld

Keyword(s):

Drug Prescription ◽

Cross Sectional Study ◽

Lymphocytic Leukemia ◽

High Rate ◽

Drug Related Problems ◽

Cross Sectional ◽

Inpatient Ward ◽

Leukemia Treatment ◽

Pediatric Inpatient ◽

Male Sex

Background In oncology, pharmacists contribute to safety and effectiveness of drug treatment, identifying, preventing and forwarding solutions to drug-related problems (DRPs). However, it is still necessary to elucidate the profile of drug-related problems in pediatric cancer treatment to contribute to guide clinical pharmacy activities. Methods A retrospective cross-sectional study was conducted. Records on Excel® spreadsheets of 2 years of pharmaceutical assistance were analyzed regarding the prescriptions of chemotherapy for hospitalized patients aged 0–19 years. Data on age, sex, cancer diagnosis, protocol and drugs prescribed were collected. Causes and types of DRPs and pharmacists’ interventions as their rate of acceptance were measured according to PCNE V 9.0. Results Drug-related problems were identified for 84 patients, in 5.3% of analyzed prescriptions. Leukemias, patients aged 0–4 years and male sex were associated with higher rates of drug-related problems. The BFM 2009 protocol for acute lymphocytic leukemia treatment had the highest frequency of prescriptions with drug-related problems. Main drug-related problems were related to effectiveness (49.2%) and safety (33.2%), with most of them due to drug selection and dose. Rate of acceptance of interventions was 92.2% and 90.6% of drug-related problems were fully resolved. Mercaptopurine and filgrastim were the drugs most associated with drug-related problems. Oral antineoplastic agents represented 36% of the prescriptions with drug-related problems. Conclusion The high rate of acceptance of pharmacist interventions demonstrates the relevance of the pharmacist participation in the care of hospitalized pediatric patients undergoing chemotherapy. Pharmacists need to take attention to cases of necessity of drug prescription, intervening with other health professionals. Special attention to oral chemotherapy is required.

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Acceptance of evidence-based nursing databases by educational nurses using Rogers’ model

Journal of Librarianship and Information Science ◽

10.1177/0961000620948569 ◽

2020 ◽

pp. 096100062094856

Author(s):

Najme Dehghan Salmasi ◽

Maryam Kazerani ◽

Maryam Shekofteh ◽

Sara Jambarsang

Keyword(s):

Nursing Education ◽

Cross Sectional Study ◽

Evidence Based ◽

Persuasion Knowledge ◽

Sectional Study ◽

Data Collection Tool ◽

Validity And Reliability ◽

Cross Sectional ◽

Implementation Rate ◽

Evidence Based Nursing

Nurses always need accurate, up-to-date and reliable information. Evidence-based resources can be an appropriate approach to this need. The first step in utilizing these resources is to acknowledge them and use them in clinical practice. This descriptive cross-sectional study was designed to determine the acceptance rate of evidence-based databases by nurses based on Rogers’ innovation-diffusion model. A total of 214 nurses working in educational hospitals participated in the study in 2019. The data collection tool was a questionnaire, with confirmed validity and reliability, which was designed based on five components of Rogers’ model: knowledge, persuasion, decision, implementation and confirmation. The data analysis was performed using SPPS Version 23 to compute descriptive and analytical statistics indices. Based on the categories in Rogers’ model, the nurses had moderate views on the rate of acceptance of evidence-based databases, limited (low) knowledge and awareness of the databases, a favorable persuasion level and a low implementation rate. Well-educated, senior educational supervisors and nurses were more in line with persuasion, knowledge and implementation of evidence-based resources. According to the regression analysis ( p < 0.001), persuasion and confirmation components had the greatest effect on the acceptance of databases, indicating the significance of providing evidence-based nursing education, both formal and informal, using the related databases.

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Off-label drug prescriptions in French general practice: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-026076 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026076 ◽

Cited By ~ 1

Author(s):

François Drogou ◽

Allison Netboute ◽

Joris Giai ◽

Xavier Dode ◽

David Darmon ◽

...

Keyword(s):

General Practice ◽

Drug Prescription ◽

Low Frequency ◽

Cross Sectional Study ◽

Drug Prescriptions ◽

Off Label Use ◽

Sectional Study ◽

Cross Sectional ◽

Off Label ◽

Label Use

ObjectivesOff-label drug prescribing is a public health and economic issue. The aim of this study was to describe off-label prescription in general practice in France, in terms of frequency and nature, and to identify its main determining factors.DesignMulticentre cross-sectional studySettingTwenty-three training general practice officesParticipantsAll the voluntary patients coming for a medical consultation or visited at home over a cumulative period of 5 days per office between November 2015 and January 2016.MethodsEleven interns, acting as observers, collected data. Two reviewers analysed the drugs prescribed by the trainers, in order to identify those prescribed off-label in terms of their indication or the age of the patient. We used a univariate, then a multivariate model, based on hierarchical mixed-effects logistic regression.ResultsAmong the 4932 drug prescriptions registered, 911 (18.5%[95% CI17.4% to 19.6%]) were off-label, of which 865 (17.6%) due to the indication of the drug and 58 (1.2%) due to the age of the patient. The prescription never mentioned the off-label use, neither was the patient informed of it, as required by the French law. With the multivariate analysis, variables contributing to off-label prescription were the number of drugs (OR=1.05 for each additional drug), the initiation of new drug therapy (OR=1.26) and the non-specific goal of the prescription (OR=1.43); the age of the patient ≤14 years (OR=1.42); the rural location of the physician’s practice (OR=1.38) and the low frequency of the visits of national health insurance representatives (OR=0.93).ConclusionAlmost one out of five drugs prescribed in French general practice was off-label. It seems necessary to better train physicians in clinical pharmacology, to provide them with more effective drug prescription software, to reinforce postmarketing surveillance and to clearly define off-label use by consensus.

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Utilization of Insecticide Treated Bed Nets (ITNs) among Caregivers of Children under Five Years in the Ho Municipality

Interdisciplinary Perspectives on Infectious Diseases ◽

10.1155/2019/3693450 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Kennedy Diema Konlan ◽

Milipaak Japiong ◽

Kennedy Dodam Konlan ◽

Agani Afaya ◽

Solomon Mohammed Salia ◽

...

Keyword(s):

Continuous Distribution ◽

Cross Sectional Study ◽

Bed Nets ◽

Cross Sectional ◽

Effective Measure ◽

Children Under Five ◽

Under Five ◽

The Difference ◽

Multistage Sampling ◽

Insecticide Treated Bed Nets

Background. In Ghana, attempts to control malaria through antimalarial medications are currently threatened by the emergence and spread of drug resistant malaria parasites. This, together with the increasing incidence of malaria, has heightened the need for a more effective method of controlling the spread. The use of Insecticide Treated Bed Net (ITN) has been recognised as an effective measure in the prevention of malaria. Objective/Purpose. In this study, we examined the utilisation of ITN among caregivers of children under five years in Ho municipality of Ghana. Methods. This descriptive cross-sectional study recruited 283 household representatives through a multistage sampling method. A questionnaire was used to collect the data and was analyzed using STATA version 14. Descriptive and inferential statistics were adopted in presenting the data. Results. Ownership of ITN was higher (80.7%) than its utilisation (41.7%). The age of caregiver was strongly associated with the utilisation of ITN (AOR=2.00, 95% CI=0.00, 0.02, p<0.001) among children less than five years. Caregivers aged 26-35 were 49% times less likely to use an ITN as compared to those aged between 17 and 25 and the difference was statistically significant. Conclusion. In order to ensure a high ITN coverage and utilisation, there is the need for continuous distribution of ITNs to households. Households should be sensitized to use the nets to prevent the continuous spread of malaria.

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