Learning to Become a Nurse Prescriber in New Zealand Using a Constructivist Approach: A Narrative Case Study

Anecita Gigi Lim, M. Honey, N. North, J. Shaw
{"title":"Learning to Become a Nurse Prescriber in New Zealand Using a Constructivist Approach: A Narrative Case Study","authors":"Anecita Gigi Lim, M. Honey, N. North, J. Shaw","doi":"10.36951/ngpxnz.2015.009","DOIUrl":null,"url":null,"abstract":"IntroductionMedical prescribing, in terms of both education and practice, has been extensively researched but this has not been the case with nurse prescribing (Coombes, Mitchell, & Stowasser, 2008; Franson, Dubois, de Kam, Burggraaf, & Cohen, 2009; Garbutt et al., 2006; Gwee, 2009). One reason for this is that internationally, prescriptive authority differs between countries, and hence the educational preparation for nurses to prescribe also varies. This has detracted from consistent research into the educational preparation and practice of nurse prescribing despite the fact that registered nurse prescribing is well established in some countries, notably the United Kingdom and is generally regarded positively (Latter et al., 2010).This article describes the pedagogical underpinnings of one of the first postgraduate programmes developed for nurse practitioners to gain prescriptive authority. Nurses intending to become nurse practitioner prescribers were interviewed to gain an understanding of their experiences of undertaking these postgraduate prescribing programmes.BackgroundNurse prescribing in New Zealand: A brief historyIn New Zealand, the nurse practitioner role was introLim, duced to improve patient access to health care services (National Health Committee, 2000). The introduction of the nurse practitioner role also represented a significant advance for professional nursing and positioned nurses to practice autonomously. Autonomous practice for nurse practitioners includes performing comprehensive health assessments, clinical diagnosis and prescribing treatments. The introduction of nurse prescribing in New Zealand has developed concurrently with the role of the nurse practitioner (Nursing Council of New Zealand, 2005). Since 1999, nurse practitioners in New Zealand can prescribe as long as they have completed the necessary educational preparation (Lim, Honey, & Kilpatrick, 2007).Prescriptive authority in New Zealand is outlined in the Medicines Act of 1981 and in the Medicines Regulation of 1984. Under the Act, health professionals with prescriptive authority (authorised prescribers) can prescribe all medicines from Part 1A or Part 1B of the Schedule 1 of the Medicines Regulations. Three health professional groups were authorised prescribers (doctors, dentists and midwives) until 1999 (Medicines Amendment Act 1999) when prescriptive authority for nurses was considered by the New Zealand government and the legislation was amended.Educational preparation for prescribing was included in the undergraduate programme for doctors, dentists and midwives, which was not the case for nurses. Therefore the term, designated prescribers, was added in the amendments to the Act. Unlike authorised prescribers, designated prescribers are required to undergo additional education in pharmacology and therapeutics to become prescribers. Since 1999, further amendments to the Act (in 2011) extended prescriptive authority to pharmacists and diabetes nurse specialists, so that pharmacists, diabetes nurse specialists and nurse practitioners could become designated prescribers. The extension was further refined in 2013 (Medicines Amendment Act 2013), when nurse practitioner prescribers gained the same prescriptive authority as doctors, dentists and midwives as authorised prescribers, and a new category of prescribers called delegated prescribers was added to the Act. There are now three levels of prescriptive authority in New Zealand: authorised, designated and delegated. These legislative changes bring challenges and potential for confusion to nurse prescribing roles.Educational preparation of nurses for prescribing has always been considered in the changes to the legislation. Educational preparation includes knowledge of applied biological sciences, advanced assessment and diagnoses, pharmacology and therapeutics, alongside a prescribing practicum where the knowledge is applied within a clinical context. …","PeriodicalId":77298,"journal":{"name":"Nursing praxis in New Zealand inc","volume":"25 1","pages":"27"},"PeriodicalIF":0.0000,"publicationDate":"2015-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"6","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nursing praxis in New Zealand inc","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36951/ngpxnz.2015.009","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 6

Abstract

IntroductionMedical prescribing, in terms of both education and practice, has been extensively researched but this has not been the case with nurse prescribing (Coombes, Mitchell, & Stowasser, 2008; Franson, Dubois, de Kam, Burggraaf, & Cohen, 2009; Garbutt et al., 2006; Gwee, 2009). One reason for this is that internationally, prescriptive authority differs between countries, and hence the educational preparation for nurses to prescribe also varies. This has detracted from consistent research into the educational preparation and practice of nurse prescribing despite the fact that registered nurse prescribing is well established in some countries, notably the United Kingdom and is generally regarded positively (Latter et al., 2010).This article describes the pedagogical underpinnings of one of the first postgraduate programmes developed for nurse practitioners to gain prescriptive authority. Nurses intending to become nurse practitioner prescribers were interviewed to gain an understanding of their experiences of undertaking these postgraduate prescribing programmes.BackgroundNurse prescribing in New Zealand: A brief historyIn New Zealand, the nurse practitioner role was introLim, duced to improve patient access to health care services (National Health Committee, 2000). The introduction of the nurse practitioner role also represented a significant advance for professional nursing and positioned nurses to practice autonomously. Autonomous practice for nurse practitioners includes performing comprehensive health assessments, clinical diagnosis and prescribing treatments. The introduction of nurse prescribing in New Zealand has developed concurrently with the role of the nurse practitioner (Nursing Council of New Zealand, 2005). Since 1999, nurse practitioners in New Zealand can prescribe as long as they have completed the necessary educational preparation (Lim, Honey, & Kilpatrick, 2007).Prescriptive authority in New Zealand is outlined in the Medicines Act of 1981 and in the Medicines Regulation of 1984. Under the Act, health professionals with prescriptive authority (authorised prescribers) can prescribe all medicines from Part 1A or Part 1B of the Schedule 1 of the Medicines Regulations. Three health professional groups were authorised prescribers (doctors, dentists and midwives) until 1999 (Medicines Amendment Act 1999) when prescriptive authority for nurses was considered by the New Zealand government and the legislation was amended.Educational preparation for prescribing was included in the undergraduate programme for doctors, dentists and midwives, which was not the case for nurses. Therefore the term, designated prescribers, was added in the amendments to the Act. Unlike authorised prescribers, designated prescribers are required to undergo additional education in pharmacology and therapeutics to become prescribers. Since 1999, further amendments to the Act (in 2011) extended prescriptive authority to pharmacists and diabetes nurse specialists, so that pharmacists, diabetes nurse specialists and nurse practitioners could become designated prescribers. The extension was further refined in 2013 (Medicines Amendment Act 2013), when nurse practitioner prescribers gained the same prescriptive authority as doctors, dentists and midwives as authorised prescribers, and a new category of prescribers called delegated prescribers was added to the Act. There are now three levels of prescriptive authority in New Zealand: authorised, designated and delegated. These legislative changes bring challenges and potential for confusion to nurse prescribing roles.Educational preparation of nurses for prescribing has always been considered in the changes to the legislation. Educational preparation includes knowledge of applied biological sciences, advanced assessment and diagnoses, pharmacology and therapeutics, alongside a prescribing practicum where the knowledge is applied within a clinical context. …
用建构主义方法学习成为新西兰的护士处方医师:一个叙事案例研究
医学处方,在教育和实践方面,已经被广泛研究,但这并不是护士处方的情况(Coombes, Mitchell, & Stowasser, 2008;弗朗森、杜布瓦、德卡姆、伯格格拉夫和科恩,2009;Garbutt et al., 2006;Gwee, 2009)。其中一个原因是,在国际上,各国之间的规定权威不同,因此护士开处方的教育准备也各不相同。这削弱了对护士开处方的教育准备和实践的一致研究,尽管注册护士开处方在一些国家,特别是英国已经建立起来,并且通常被认为是积极的(Latter等人,2010)。本文描述了为护士从业人员开发的第一个研究生课程之一的教学基础,以获得规范性权威。有意成为执业护士开处方者的护士接受了访谈,以了解她们参加这些研究生开处方课程的经验。背景:新西兰护士开处方:简史在新西兰,执业护士的作用是为了改善病人获得医疗保健服务的机会(国家卫生委员会,2000年)。护士执业角色的引入也代表了专业护理和定位护士自主实践的重大进步。护士从业人员的自主实践包括进行全面的健康评估,临床诊断和处方治疗。在新西兰,护士处方的引入与执业护士的作用同时发展(新西兰护理委员会,2005年)。自1999年以来,新西兰的执业护士只要完成了必要的教育准备,就可以开处方(Lim, Honey, & Kilpatrick, 2007)。1981年的《药品法》和1984年的《药品条例》概述了新西兰的规定权力。根据该法,具有开处方权的卫生专业人员(授权开处方者)可以开出《药品条例》附表1第1A部分或第1B部分的所有药物。直到1999年(1999年《药品修正法》),三个保健专业团体被授权开处方(医生、牙医和助产士),新西兰政府审议了护士的处方权力,并修订了立法。医生、牙医和助产士的本科课程中包括了开处方的教育准备,而护士则没有。因此,在《法令》修正案中增加了“指定处方者”一词。与授权开处方者不同,指定开处方者需要接受额外的药理学和治疗学教育才能成为开处方者。自1999年以来,该法案的进一步修订(2011年)将处方权力扩大到药剂师和糖尿病护理专家,因此药剂师、糖尿病护理专家和执业护士可以成为指定的处方者。该扩展在2013年进一步完善(2013年药品修正法案),当时执业护士处方者获得了与医生,牙医和助产士相同的授权处方者的处方权力,并且在该法案中添加了一个新的处方者类别,称为委托处方者。新西兰现在有三个级别的规定性权力:授权、指定和授权。这些立法变化给护士的处方角色带来了挑战和潜在的混乱。护士开处方的教育准备一直是立法改革中需要考虑的问题。教育准备包括应用生物科学、高级评估和诊断、药理学和治疗学知识,以及在临床环境中应用这些知识的处方实习。…
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信