scope of practice

实践范围
  • 文章类型: Journal Article
    背景:人乳头瘤病毒(HPV)和COVID-19是存在有效疫苗的传染性疾病。建议牙科护理专业人员参与针对这些疾病的疫苗接种活动,但对牙医在疫苗接种中的作用缺乏了解,特别评估患者对牙医作为HPV和COVID-19疫苗接种者的态度。
    方法:使用横截面设计和方便采样,向社区成员分发了一项12项经过验证的调查,以确定对牙医在HPV和COVID-19疫苗接种中的作用的看法。人口特征,疫苗接种状况,疾病的知识,疫苗接种意向,以及接受教育的意愿,建议,并评估了牙医接种疫苗的情况。使用双变量和多变量分析对反应进行分析。
    结果:在618名参与者中,大多数人以前接种过HPV和COVID-19疫苗(n=462[75.6%]和n=371[61.0%],分别)。参与者对牙医参与教育的反应更有利,讨论,和施用COVID-19疫苗比HPV疫苗(P<0.05)。与COVID-19相比,参与者对HPV的了解较低。不同人口群体之间存在显著差异,种族最常与对COVID-19和HPV相关问题的反应差异相关。
    结论:提供了制定干预措施以支持牙医参与疫苗接种运动的形成性数据。参与者接受COVID-19疫苗接种超过HPV疫苗接种可能反映了公众对COVID-19与HPV的认识,因为这种疾病的日常相关性,或者缺乏关于HPV的知识,特别是它的口咽影响。
    结论:作者提供了支持牙医参与疫苗教育和分发的证据,将以前的文献扩展到对新疾病背景的评估(COVID-19)。缺乏HPV知识可能会影响接种HPV疫苗的意愿。提供教育机会。
    BACKGROUND: Human papillomavirus (HPV) and COVID-19 are contagious diseases for which effective vaccines exist. Dental care professionals\' involvement in vaccination campaigns for these conditions has been proposed, but there is a lack of understanding of dentists\' roles in vaccination, specifically assessing patients\' attitudes around dentists as vaccinators for HPV and COVID-19.
    METHODS: Using a cross-sectional design and convenience sampling, a 12-item validated survey was distributed to community members to determine perceptions about dentists\' roles in vaccination for HPV and COVID-19. Demographic characteristics, vaccination status, knowledge of the diseases, vaccination intentions, and willingness to receive education about, recommendations for, and administration of vaccine from a dentist were assessed. Responses were analyzed using bivariate and multivariate analysis.
    RESULTS: Of 618 participants, most were vaccinated previously against HPV and COVID-19 (n = 462 [75.6%] and n = 371 [61.0%], respectively). Participants responded more favorably to dentist involvement in educating, discussing, and administering COVID-19 vaccines than HPV vaccines (P < .05). Participants\' knowledge of HPV was found to be low compared with that of COVID-19. There were significant differences across demographic groups, with race most frequently associated with differences in responses to COVID-19 and HPV-related questions.
    CONCLUSIONS: Formative data to develop interventions to support dentists\' participation in vaccination campaigns are provided. Participants\' acceptance of COVID-19 vaccination over HPV vaccination may reflect the public awareness of COVID-19 vs HPV due to daily relevance of this disease, or the lack of knowledge about HPV, particularly its oropharyngeal impacts.
    CONCLUSIONS: The authors provide evidence to support dentists\' involvement in vaccine education and distribution, expanding previous literature into evaluation of a new disease context (COVID-19). Lack of knowledge of HPV may affect willingness to receive the HPV vaccine, presenting an opportunity for education.
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  • 文章类型: English Abstract
    目标:医疗支持人员护士传统上为医生执行各种支持任务,通常超出标准护理角色。尽管这些长期的做法,这些扩大的责任明显缺乏官方认可和法律保护,导致越来越多的法律问题。因此,有必要提出一个合理的解决方案来解决这些问题。
    方法:医疗支持人员护士的数量正在增加,特别是他们填补了2024年住院医师罢工留下的空白。该研究的重点是确定这一转变带来的潜在挑战,并制定战略改进措施,以有效地应对这些挑战。
    结果:这项研究提出了从法律上扩大护理职责的范围,并建立一个强大的系统来培训和认证护士以有效地处理这些职责,通过在高级执业护士(APN)框架内整合这些角色。
    结论:在APN框架内整合这些角色可以为持续的医疗保健危机提供可持续且合法的解决方案。确保患者安全,保障医护人员的合法权益。
    OBJECTIVE: Medical support staff nurses have traditionally performed various supportive tasks for physicians, often extending beyond standard nursing roles. Despite these long-standing practices, there is a notable lack of official recognition and legal protection for these expanded responsibilities, leading to increasing legal concerns. Therefore, there is a need for proposing a rational solution to address these issues.
    METHODS: The number of medical support staff nurses is rising, particularly as they fill gaps left by the 2024 resident physician strike. The study focuses on identifying potential challenges arising from this shift and developing strategic improvements to address these challenges effectively.
    RESULTS: This study proposed legally expanding the scope of nursing duties and creating a robust system for training and certifying nurses to handle these responsibilities effectively, by integrating these roles within the advanced practice nurse (APN) framework.
    CONCLUSIONS: Integrating these roles within the framework of APN can offer a sustainable and legally sound solution to the ongoing healthcare crisis, ensuring patient safety and safeguarding healthcare workers\' legal rights.
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  • 文章类型: Journal Article
    提供有关2022-2023年期间担任世界验光理事会(WCO)成员的国家的验光师人口统计数据和验光专业法规的信息。
    非随机,我们采用了目的性抽样和关键的线人策略,对以下方面进行了一项基于调查的横断面研究:2022-2023年期间世界海关组织成员国家的视光师的专业状况和分布;教育状况;该专业的立法方面;以及验光实践的范围.WCO国家成员领导人确定了关键线人。
    在接受调查的39个国家中,一名验光师平均服务23200人。只有46.2%的国家达到了国际建议的1:10,000验光师与人口的比例。男性与女性的平均比例为45%男性/55%女性,平均年龄划分如下:45岁以下为46%,45岁以上为54%。据报道,验光在法国不受管制,葡萄牙,印度,肯尼亚和卡梅伦。13个国家(33%)不需要学士学位作为至少练习验光。20%的国家禁止使用诊断药物,25%的国家限制使用治疗药物。
    许多验光被公认的国家很难拥有足够数量的验光师;这阻碍了获得眼部护理。入门级验光从业人员的最低教育水平不受管制,加剧了这种情况。此外,一些国家限制或禁止许多验光程序,这些程序限制了验光师在初级保健水平上提供眼保健和视力健康服务的能力。
    UNASSIGNED: To provide information on the demographics of optometrists and regulation of the optometry profession in countries who were members of the World Council of Optometry (WCO) during the period 2022-2023.
    UNASSIGNED: A non-random, purposive sampling and a key informant strategy was employed to conduct a survey-based cross-sectional study on the professional landscape and distribution of optometrists; educational landscape; legislative aspects of the profession; and the scope of optometry practice in countries who were members of WCO during the period 2022-2023. Key informants were identified by WCO country members\' leadership.
    UNASSIGNED: In the 39 countries surveyed, one optometrist serves 23,200 persons on average. Only 46.2% of the countries met the internationally suggested 1:10,000 optometrist-to-population ratio. The average male-to-female ratio was 45% males/55% females, with a division of average age as follows: under 45 years of age 46% as compared to above 45 years of age 54%. It was reported that optometry is not regulated in France, Portugal, India, Kenya and Cameron. Thirteen countries (33%) do not require a Bachelor\'s degree as a minimum to practice optometry. Use of diagnostic drugs is prohibited in 20% of the countries, with 25% of the countries limiting the use of therapeutic pharmaceutical agents.
    UNASSIGNED: Many countries where optometry is recognized struggle to have an adequate number of optometrists; this hinders access to eye care. This is compounded by unregulated minimum levels of education for entry-level optometric practitioners. In addition, several countries limit or prohibit many optometric procedures that restrict the ability of optometrists to provide eye care and vision health services at the primary care level.
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  • 文章类型: Journal Article
    背景:寻求田纳西州高级执业注册护士(APRN)的完整执业授权(FPA)始于1960年代后期。然而,进展在随后的时间里停滞不前,推进FPA的前景看起来并不乐观。
    目的:本文的目的是记录田纳西州对FPA的追求,对迄今为止发生的事情进行反思,并建议前进的道路。
    方法:使用各种来源的各种数据来记录田纳西州FPA的历史,证明它的需要,找出更好的成功方法。
    结论:由于没有FPA的州数量不断减少,获得初级保健保健服务和田纳西州社区的经济活力令人关注。
    结论:在田纳西州实现FPA的前进道路需要改变方法和参与者。提出了具体建议。
    BACKGROUND: The quest for full practice authority (FPA) for Tennessee Advanced Practice Registered Nurses (APRNs) began with promise in the late 1960s. However, progress has stalled in the ensuing time, and prospects for advancing FPA do not look promising.
    OBJECTIVE: The purpose of this article is to chronicle the pursuit of FPA in Tennessee, offer reflections on what has transpired to date, and suggest a path forward.
    METHODS: Various data from various sources were used to chronicle the history of FPA in Tennessee, make the case for its need, and identify better approaches for success.
    CONCLUSIONS: As one of a dwindling number of states without FPA, access to primary care health services and the economic vitality of Tennessee communities are of concern.
    CONCLUSIONS: The path forward for achieving FPA in Tennessee necessitates changes in approach and players. Specific recommendations are offered.
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  • 文章类型: Journal Article
    行政任务增加,不断变化的护理期望和实践范围的进步迅速推进了数字健康。卫生政策已经承认需要进行评估,以确定临床医生的技术需求,包括药剂师,练习到最大的范围。迫切需要提出建议来解决技术转型,以使社区药剂师能够实践。这项研究旨在制定数字健康建议,通过专家共识,对政府来说,药学专业协会,制药企业和软件供应商,促进社区药剂师的实践。在2024年2月至3月进行了修改后的Delphi调查。有目的地招募了具有数字健康专业知识的药剂师。在第一轮中,参与者被要求对他们与最初的24项研究得出的陈述的一致性水平进行评分。共识先验定义为≥80%的参与者强烈同意或同意声明,标准偏差≤1.00。审查参与者的自由文本评论逐渐减少和完善了声明。所有22名参与者在3轮调查中完成了改良的Delphi研究。与会者代表了澳大利亚的每个司法管辖区。18名参与者拥有超过10年的专业经验。出现了16项建议:6针对政府,2为药学专业协会,4为制药企业,4为软件供应商。大多数建议要求金融投资和跨司法管辖区的立法协调。通过这些建议,在医疗保健系统和技术提供商的合作伙伴之间进行了大量投资,将使药剂师能够更有效和安全地使用技术解决方案。
    Increased administrative tasks, evolving expectations of care and advancement in practice scope have rapidly advanced digital health. Health policy has acknowledged the need for evaluation to determine the technological needs of clinicians, including pharmacists, to practice to full and top of scope. There is an emergent need for recommendations to address the technological transformation to enable community pharmacists\' practice. This study aimed to develop digital health recommendations, through expert consensus, for the government, pharmacy professional associations, pharmacy enterprises and software vendors, to facilitate community pharmacists\' practice. A modified Delphi survey was conducted online in February-March 2024. Pharmacists with digital health expertise were purposively recruited. Participants were asked to rate their level of agreement with the initial 24 research-derived statements in round 1. Consensus was defined a priori as ≥80% of participants strongly agreeing or agreeing with a statement and a standard deviation of ≤1.00. Review of participants\' free-text comments progressively reduced and refined the statements. All 22 participants completed the modified Delphi study in 3 survey rounds. Participants represented every Australian jurisdiction. Eighteen participants had more than 10 years of professional experience. Sixteen recommendations emerged: 6 for government, 2 for pharmacy professional associations, 4 for pharmacy enterprises and 4 for software vendors. The majority of recommendations require financial investment and harmonization of legislation across jurisdictions. Adoption of these recommendations, with significant investment across partners in the healthcare system and technology providers, will enable pharmacists to more effectively and safely practice utilizing technology solutions.
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  • 文章类型: Journal Article
    冠状动脉疾病(CAD)是美国最常见的心脏病,与白人患者相比,它对黑人的影响不成比例。定期的初级保健和血脂异常筛查和管理对于最佳的CAD护理至关重要。执业护士(NPs)越来越多地提供初级保健服务,尽管缺乏支持的实践环境可能会限制他们这样做的能力。
    为了检查患有CAD的黑人和白人患者之间的脂质筛查差异是否与NP实践环境评分相关。
    来自初级保健实践和医疗保险索赔的NPs的横断面调查数据与111,911名CAD患者的评估结果相关(94%白人,6%的黑人)在四个州(加利福尼亚州,佛罗里达,新泽西,和宾夕法尼亚州)在2016年。NP-初级保健组织氛围问卷,它提供了一个关于受访者实践的支持性的分数,用于评估NP实践环境。考虑患者和实践特征的多水平回归模型用于评估研究目标。
    与患有CAD的白人患者相比,患有CAD的黑人患者接受年度脂质筛查的频率较低(77.0%与70.6%;p<.001)。在考虑患者和实践特征的逻辑回归模型中,对于练习环境分数的每一个标准差增加,黑人患者接受脂质筛查的几率增加了5%。
    投资NP实践环境,包括增加NP角色可见性和加强与医生和管理员的关系,可以缩小CAD管理中的种族差异。
    UNASSIGNED: Coronary artery disease (CAD) is the most prevalent heart disease in the United States, and it disproportionately affects Black compared to White patients. Regular primary care and dyslipidemia screening and management are essential for optimal CAD care. Nurse practitioners (NPs) increasingly provide primary care services, though unsupportive practice environments may constrain their ability to do so.
    UNASSIGNED: To examine whether disparities in lipid screening between Black and White patients with CAD were associated with the NP practice environment scores.
    UNASSIGNED: Cross-sectional survey data from NPs in primary care practices and Medicare claims were linked to evaluate outcomes among 111,911 CAD patients (94% White, 6% Black) across 456 primary care practices in four states (California, Florida, New Jersey, and Pennsylvania) in 2016. The NP-Primary Care Organizational Climate Questionnaire, which provides a score on the supportiveness of a respondent\'s practice, was used to evaluate the NP practice environment. Multilevel regression models that accounted for patient and practice characteristics were used to evaluate the study aim.
    UNASSIGNED: Compared to White patients with CAD, Black patients with CAD less frequently received annual lipid screening (77.0% vs. 70.6%; p < .001). In logistic regression models accounting for patient and practice characteristics, for every standard deviation increase in the practice environment score, Black patients experienced a 5% increase in odds of receiving lipid screening.
    UNASSIGNED: Investing in the NP practice environment, including increasing NP role visibility and strengthening relationships with physicians and administrators, may narrow racial disparities in CAD management.
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  • 文章类型: Journal Article
    简介社区药房高度可访问,并为患者和社区成员提供多种服务。最近,沙特阿拉伯已经取得了一些进展,以加强社区药剂师对医疗保健系统的作用和贡献,包括扩大其实践范围。本研究旨在评估当前的药物活性,药物,产品,以及社区药房提供的服务。方法本研究是以横断面问卷调查为基础的描述性研究。问卷由三个部分组成。第一部分包括参与者的人口特征。第二部分探讨了社区药房销售的药品和产品的类型,第三部分探讨了药房目前提供的专业服务和活动。这项研究是在沙特阿拉伯Qassim地区的社区药剂师中进行的。总体结果,109/115社区药房参与了这项研究,产生94.78%的响应率。大多数参与者(97.25%)是男性,31-40岁占42.20%。所有药房(100%)配发处方及提供非处方药,自我护理疗法,维生素,矿物,和膳食补充剂。然而,只有少数药房控制和麻醉药品服务(5.50%)并提供疫苗(3.67%)。几乎所有药房都提供草药产品(97.25%),自我诊断测试/家庭测试套件(97.25%),急救箱(95.41%),和医疗器械及其配件(89.91%)。所有药店(100%)销售健康相关产品,包括口服,皮肤,和护发产品。所有药剂师(100%)都提供药物咨询。然而,只有55.96%的药房提供电子处方服务(Wasfaty)。大多数药剂师提供健康教育和促进(95.41%),小病管理(88.99%),以及对患者使用医疗器械的培训(92.66%)。其他药物活动包括旅行健康建议(52.29%)和戒烟(31.19%)。然而,病人护理服务,包括疫苗接种服务(0.92%),患者评估和监测服务(0.92%),和即时护理(POC)测试(0.92%),是有限的。其他服务包括网上购物(66.97%),送药家庭(54.13%),以及与药店的即时/实时聊天通信(70.64%)。结论社区药房在沙特阿拉伯的医疗体系中起着至关重要的作用。这些措施包括提供药品,医疗设备,以及与健康和保健相关的各种产品。社区药房提供公共卫生服务。然而,他们的临床服务有限。因此,需要一个涉及所有利益攸关方的整体战略,以进一步加强社区药剂师的作用,更好地利用他们的技能和培训,提供预防性保健服务,并优化初级保健环境中的药物治疗。
    Introduction  Community pharmacies are highly accessible and provide access to several services to patients and community members. Recently, several developments have been made in Saudi Arabia to enhance the roles and contributions of community pharmacists to the healthcare system, including expanding their scope of practice. This study aims to evaluate the current pharmaceutical activities, medicines, products, and services offered by community pharmacies.  Methods This was a cross-sectional questionnaire-based descriptive study. The questionnaire consisted of three sections. The first section comprised the demographic characteristics of the participants. The second section explored the types of pharmaceuticals and products sold by community pharmacies, while the third section explored the current professional services and activities offered by pharmacies. This study was conducted among community pharmacists in the Qassim region of Saudi Arabia. Results  Overall, 109/115 community pharmacies participated in the study, yielding a response rate of 94.78%. Most participants (97.25%) were men, and 42.20% were 31-40 years old. All pharmacies (100%) dispensed prescriptions and provided over-the-counter medicines, self-care therapeutics, vitamins, minerals, and dietary supplements. However, only a few pharmacies had controlled and narcotic medicine services (5.50%) and supplied vaccines (3.67%). Almost all pharmacies provided access to herbal products (97.25%), self-diagnostic test/home-test kits (97.25%), first-aid kits (95.41%), and medical equipment and devices and their accessories (89.91%). All pharmacies (100%) sold health-related products, including oral, skin, and hair care products. All pharmacists (100%) provided medication counseling. However, e-prescription services (Wasfaty) were provided in only 55.96% of the pharmacies. Most pharmacists provided health education and promotion (95.41%), management of minor ailments (88.99%), and patient training on the use of medical devices (92.66%). Other pharmaceutical activities included travel health advice (52.29%) and smoking cessation (31.19%). However, patient care services, including vaccination services (0.92%), patient assessment and monitoring services (0.92%), and point-of-care (POC) testing (0.92%), were limited. Additional services included online shopping (66.97%), home delivery of medicines (54.13%), and instant/live chat communication with pharmacies (70.64%). Conclusion  Community pharmacies play a crucial role in Saudi Arabia\'s healthcare system. These include providing access to medicines, medical equipment, and various products related to health and wellness. Community pharmacies provide public health services. However, their clinical services are limited. Consequently, a holistic strategy involving all stakeholders is required to further enhance the role of community pharmacists and better utilize their skills and training to provide preventive healthcare services and optimize medication therapy in primary care settings.
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  • 文章类型: Journal Article
    医疗改革的成功取决于决策者,调节器,以及在各个级别形成策略的管理员操作。这些政策可以促进或阻碍医疗保健专业人员和协作工作环境的实践。所有医疗保健专业人员都必须充分利用他们的教育和认证,培养公平的工作场所文化对于留住员工和改善获得护理的机会至关重要。以执业护士(NPs)为样本,本文旨在明确医疗改革的系统性障碍,并呼吁决策者,监管者,和临床机构管理员制定变更。NP实践的障碍包括外部利益相关者的限制性监督,间接计费的财务激励措施,和等级约束限制了NP对医疗保健系统的贡献。日益增长的医疗保健提供者短缺对初级保健和农村环境造成了不成比例的影响。NPs比医生更有可能担任这些角色,并且已经记录了积极的患者健康结果。消除NP实践的系统性障碍增加了获得护理的机会。护理-拥有不同角色的最大医疗保健队伍-在多个组织的复杂监督下运营,认证,认证,和教育。外部利益相关者影响和要求额外监督的最新趋势给护理实践带来了障碍。尽管国民教育,认证,和认证标准,护理执照和实践越来越多地与外部利益相关者进行谈判,并在州和机构层面进行监督。支持所有医疗保健专业人员根据他们的教育和认证进行实践,可以推进医疗保健改革,解决劳动力短缺问题,增加获得护理的机会,改善健康。
    The success of healthcare reform hinges on policymaker, regulator, and administrator actions that shape policies at various levels. These policies can either facilitate or hinder the practice of healthcare professionals and collaborative work environments. It is imperative for all healthcare professionals to fully utilize their education and certification, as fostering an equitable workplace culture is vital for retaining staff and improving access to care. Using nurse practitioners (NPs) as an exemplar, this article aims to specify systemic barriers to healthcare reform and call for policymakers, regulators, and clinical agency administrators to enact change. Barriers to NP practice include restrictive oversight by external stakeholders, financial incentives for indirect billing, and hierarchical constraints that limit NP contributions to the healthcare system. The growing healthcare provider shortage disproportionately impacts primary care and rural settings. NPs are increasingly more likely to fill these roles than medical doctors and have documented positive patient health outcomes. Removing systemic obstacles for NP practice increases access to care. Nursing-the largest healthcare workforce with diverse roles-operates under complex oversight from multiple organizations for licensure, accreditation, certification, and education. The recent trend of external stakeholders influencing and requiring additional oversight has created barriers to nursing practice. Despite national education, accreditation, and certification standards, nursing licensure and practice are increasingly negotiated with external stakeholders and supervised at the state and institutional levels. Supporting all healthcare professionals to practice according to their education and certification can advance healthcare reform, address workforce shortages, increase access to care, and improve health.
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  • 文章类型: Journal Article
    随着最近颁布的国家护理和助产委员会(NNMC)法案,2023年,预计印度注册护士和助产士的执业和自治范围将发生重大变化。然而,除了这些预期的进步,人们对该法案的各个方面都感到担忧,需要严格的检查。在这篇文章中,我们旨在探讨护理教育和服务的预期变化以及对NNMC法案的担忧,提供有关NNMC法案对印度护理和助产专业的监管和发展的影响的见解。预计该法案将引入统一标准,实施出入境考试,认识到助产是一个独特的学科,并确定护士和助产士的执业范围。此外,预计将实施执业护士计划及其有限处方权限的指南.对委员会和董事会成员的组成存在担忧,足够的利益相关者代表,缺乏确保持续能力的规定,护士和助产士的工作条件,命名法,整合新术语,明确定义角色。这些担忧强调了可行的职业道路的必要性,统一的干部,和简化的注册系统,对于推进印度的护理和助产专业至关重要。担忧和预期并存凸显了在护理和助产方面进行监管改革的复杂性。政策制定者可以为全面、包容性监管体系,促进卓越的护理和助产实践,最终使医疗保健提供者和患者受益。
    With the recent enactment of the National Nursing and Midwifery Commission (NNMC) Act, 2023, significant changes are anticipated in the scope of practice and autonomy for registered nurses and midwives in India. However, alongside these anticipated advancements, concerns have emerged regarding various aspects of the Act, necessitating critical examination. In this article, we aim to explore expected changes in nursing education and service and concerns about the NNMC Act, providing insights into the implications of the NNMC Act on the regulation and advancement of the nursing and midwifery profession in India. The Act is anticipated to introduce uniform standards, implement entry and exit examinations, recognize midwifery as a distinct discipline, and determine the scope of practice for nurses and midwives. Moreover, the implementation of the Nurse Practitioner Program and guidelines for its limited prescribing authority is anticipated. Concerns exist regarding the composition of the commission and board members, adequate stakeholder representation, lacking provisions for ensuring continued competence, working conditions of nurses and midwives, nomenclature, integrating new terms, and clearly defining roles. These concerns emphasize the need for viable career pathways, uniform cadres, and a streamlined registration system, crucial for advancing nursing and midwifery profession in India. The coexistence of concerns and anticipation highlights the complexity of enacting regulatory reforms in nursing and midwifery. Policymakers can lay the foundation for a comprehensive, inclusive regulatory system that promotes excellence in nursing and midwifery practice, ultimately benefiting both healthcare providers and patients.
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  • 文章类型: Journal Article
    两个州-康涅狄格州和新罕布什尔州-已经创建或试图创建高级药房技术员(APhT)许可证。两个许可证,提出的和实际的,有很高的进入壁垒,如要求1至3年的技术经验和通过各种评估或培训,例如特定于国家的法学考试。那些获得APhT执照的人被授予额外的权力,例如执行最终产品验证(例如,技术检查技术)和疫苗管理。与其他州的做法相比,CT和NH中的APhT角色相对于强加的要求提供了最小的范围增益;因此,目前的技术人员吸收有限(<1%)。因此,技术人员的分级执照似乎不太可能成为各州未来扩大药学技术人员作用的首选机制。
    Two states-Connecticut and New Hampshire-have created or attempted to create advanced pharmacy technician (APhT) licenses. Both licenses, proposed and actual, have high barriers to entry, such as requiring 1 to 3 years of prior technician experience and passage of various assessments or trainings, such as a state-specific jurisprudence exam. Those obtaining APhT licensure are granted additional authority, such as performing final product verification (e.g., tech-check-tech) and vaccine administration. Compared with practices in other states, the APhT role in CT and NH provides minimal scope gains relative to the requirements imposed; as a result, there has been limited uptake (<1%) among current technicians. As such, it appears unlikely that tiered licensure for technicians will be the preferred mechanism for states to expand the role of pharmacy technicians in the future.
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