EUPRON: nurses’ practice in interprofessional pharmaceutical care in Europe. A cross-sectional survey in 17 countries

Abstract Objectives Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists. Design A cross-sectional survey. Setting The study was conducted in 17 European countries, each with their own health systems. Participants Pharmacists, physicians and nurses with an active role in PC were surveyed. Main outcome measures Nurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences. Results A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. Conclusions ME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more

The NUPHAC-EU Framework for Nurses' Role in Interprofessional Pharmaceutical Care: Cross-Sectional Evaluation in Europe.

Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses' responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC and to investigate nurses' level of responsibility. A framework of PC tasks and contextual factors was developed based on literature review and previous DeMoPhaC project results. Tasks and context were cross-sectionally evaluated using an online survey in 14 European countries. A total of 923 nurses, 240 physicians and 199 pharmacists responded. The majority would consider nurses responsible for tasks within: medication self-management (86-97%), patient education (85-96%), medication safety (83-95%), monitoring adherence (82-97%), care coordination (82-95%), and drug monitoring (78-96%). The most prevalent level of responsibility was 'with shared responsibility'. Prescription management tasks were considered to be nurses' responsibility by 48-81% of the professionals. All contextual factors were indicated as being relevant for nurses' role in PC by at least 74% of the participants. No task nor contextual factor was removed from the framework after evaluation. This framework can be used to enable healthcare professionals to openly discuss allocation of specific (shared) responsibilities and tasks

Self-heating of bulk high temperature superconductors of finite height subjected to a large alternating magnetic field

In this work we study, both experimentally and numerically, the self-heating of a bulk, large YBCO pellet of aspect ratio (thickness / diameter) ~ 0.4 subjected to a large AC magnetic field. To ensure accurate temperature measurements, the sample was placed in an experimental vacuum chamber to achieve a small and reproducible heat transfer coefficient between the superconductor and the cryogenic fluid. The temperature was measured at several locations on the sample surface during the self-heating process. The experimentally determined temperature gradients are found to be very small in this arrangement (< 0.2 K across the radius of the superconductor). The time-dependence of the average temperature T(t) is found to agree well with a theoretical prediction based on the one-dimensional (1-D) Bean model, assuming a uniform temperature in the sample. A 2-D magneto-thermal model was also used to determine the space and time-dependent temperature distribution T(r, z, t) during the application of the AC field. The losses in the bulk pellet were determined using an algorithm based on the numerical method of Brandt, which was combined with a heat diffusion algorithm implemented using a finite-difference method. The model is shown to be able to reproduce the main trends of the observed temperature evolution of the bulk sample during a self-heating process. Finally, the 2-D model is used to study the effect of a non-uniform distribution of critical current density Jc(r, z) on the losses within the bulk superconductor

Sagittaria trifolia

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