Contrastación de hipótesis:

Hábitos Alimenticios

3.2. Contrastación de hipótesis:

Report. It took 13 years for the vision to be realized and for nurse pre-scribing to be piloted in the community setting using a very limited for-mulary. Following a successful pilot, non-medical prescribing became a national initiative in 1998. Initially, it was aimed at health visitors and district nurses. Then in 2002 this was extended to enable nurses in other clinical areas, including palliative care, to train as non-medical prescribers using a limited formulary. In 2006 the decision was made to allow nurses, who had completed relevant training, to prescribe independently within their profes-sional scope of practice, from the whole British National Formulary (with the exception of certain controlled drugs).

Evaluations of non-medical prescribing have been favourable, with patients and doctors being generally positive about the concept.¹ The majority of nurse prescribers feel strongly that prescribing has had a positive impact on quality of patient care and improved access to medicines. Nurses have also reported that the training to be a non-medical prescriber has enhanced their knowledge about medication and increased their conﬁ dence to engage in prescribing decisions.²

With end of life care and choice of place of care being key principles of palliative care, nurse prescribing could play an important role in devel-oping and meeting these challenges in the future. We repeatedly hear how there have been delays in gaining a prescription for a patient in the community, causing them to have to wait to commence new medication, or in the extreme case needing to be admitted to hospital. Non-medical prescribing is an option to be considered to assist in meeting these issues as community palliative care nurses will often advise GPs on medication options. Community palliative care nurses who have become non-medical prescribers suggest that patients receive medicines more quickly which they have interpreted as improving patient care.³

It is not only community palliative care nurses who should consider non-medical prescribing as part of their role. Hospital palliative care nurses and hospice nurses need to consider whether there is a place for non-medical prescribing within their role, asking the question would it improve the care I provide for patients?

1 Latter S., et al. (2005) An Evaluation of Extended Formulary Independent Nurse Prescribing: Final Report. London: Department of Health.

2 Bradley E., Nolan P. (2007) Impact of nurse prescribing: a qualitative study. Journal of Advanced Nursing, 59(2): 120–8.

3 Ryan-Woolley B., McHugh G., Luker K, (2007) Prescribing by specialist nurses in cancer and palliative care: results of a national survey. Palliative Medicine, 21: 273–7.

Chapter 4e

Non-medical prescribing

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Venkatesan P., et al. (1990) A hospital study of community acquired pneumonia in the elderly.

Thorax, 45(4): 254–8.

Vitetta L., Kenner D., Sali A. (2000) Bacterial infections in terminally ill hospice patients. Journal of Pain and Symptom Management, 20(5): 326–34.

White P. H., et al. (2003) Antimicrobial use in patients with advanced cancer receiving hospice care.

Journal of Pain and Symptom Management 25(5): 438–43.

The best sentence in the English language is not ‘I love you’ but ‘It’s benign’.

Woody Allen, Deconstructing Harry, 1998

The commonest cancers are of the lung, breast, skin, gastrointestinal tract and the prostate gland

Introduction

Cancer is an important cause of morbidity and mortality, particularly in industrialized countries. Currently in the UK one person in three will be diagnosed with cancer during their lifetime and one in four will die of their disease.

Cancer incidence increases exponentially with age, and with increasing life expectancy cancer will become an even more common problem in the future.

Cancers may develop in all body tissues. The cells that form cancers can be differentiated from cells in normal tissues in a number of ways, including:

Cell division that has escaped the control of normal homeostasis Abnormalities of cell differentiation—in general terms cancer cells tend to be less well differentiated than their non-malignant counterparts Resistance to programmed cell death

The potential for cancerous cells to invade local tissues and metastasize.

The development of cancer is associated with the accumulation of defects or ‘mutations’ in a number of critical genes within the cell.

Many cancers are associated with mutations leading to overactivity of growth-promoting genes, commonly known as ‘oncogenes’. Conversely, cancers may also be associated with mutations leading to underactivity of genes which act to suppress growth.

Although our understanding of the genetic abnormalities underlying cancer has grown exponentially over the last decade, the factors that cause these changes are not clear for most cancers.

There is evidence that exogenous carcinogens may be closely linked to some cancers. Smoking, for example, is a causative factor in lung, cervix and bladder cancer.

In other cancers there is an inherited susceptibility to particular types of malignancy. In the majority of common cancers, however, the cause remains elusive. It is likely that for many of these cancers both environ-mental and genetic factors are implicated.

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Oncology and

In document “Hábitos alimenticios y rendimiento académico en los estudiantes de la Escuela de Educación Superior Técnico Profesional Policial de la Región Moquegua, 2018” (página 55-65)