Nurse prescribing: Attitudes of medical doctors towards expanding professional competencies of nurses and midwives.

OBJECTIVE: To identify the attitudes of doctors regarding prescriptive competences of nurses and midwives since these have been recently regulated in several countries. . METHODS: The cross-sectional study was conducted at the Medical University of Warsaw from February 1to7, 2016 and comprised doctors working at the Prof. Jan Nielubowicz Regional Medical Chamber in Warsaw, Poland. A specially designed 36-item questionnaire that had 22 statements was used regarding the role of the reform in the healthcare system; the need of granting nurses and midwives particular competencies; and their preparation and readiness for these competencies. The respondents assessed the statements using a Likert scale (1=strongly disagree; 5=strongly agree). STATISTICA 13.2 was used for data analysis. . RESULTS: Of the 436 doctors, 245(56%) were women. The subjects presented different opinions about the reforms, especially about possible improvement in patient care with nurses prescribing, or the process getting simplified for the care-seekers. Most doctors believed that nurses and midwives were not yet equipped enough to prescribe certain medicines or issue prescriptions (1,79/5). Only in case of nurses and midwives being able to 're-order' medicines earlier prescribed by a doctor, the attitudes of primary care physicians was significantly different than those involved with hospital care (p=0.048). CONCLUSIONS: Doctors were sceptical about expanding professional competences of nurses and midwives regarding drug prescription.

Validation study of the Polish version of the Evidence-Based Practice Profile Questionnaire.

BACKGROUND: Decisions about patient care in clinical practice should be made based on proven scientific evidence of efficacy and safety (i.e., evidence-based practice [EBP]). Currently, there are no available tools in Poland for assessing the knowledge and attitudes of specialists in health sciences towards EBP. Therefore, by validating the Polish version of the original English Evidence-Based Practice Profile Questionnaire (EBP2Q), we may provide an appropriate instrument for assessing EBP. METHODS: The validation group consisted of 1,362 people, including nurses and midwives taking the specialization exam, second-degree students in nursing/midwifery, and staff of selected municipal and clinical hospitals in Warsaw, Pruszkow, and Chelm. The study was conducted from March to June 2014. The following psychometric properties of the EBP2Q were assessed: reliability (Cronbach's alpha coefficient, and test-retest), validity (exploratory factor analysis, Spearman's r correlation coefficient, and assessment of inter-group differences), as well as unidimensionality of domains (principal component analysis). RESULTS: All domains of the EBP2Q were characterized by high reliability (Cronbach's alpha ranging from 0.800 to 0.972). The Polish version showed a strong similarity of factor structure with the original English EBP2Q, indicating that the condition for theoretical validity is fulfilled. Maintenance of the theoretical and discriminative validity and unidimensionality of five domains of the EBP2Q was confirmed. CONCLUSIONS: The Polish version of the EBP2Q is comparable in terms of psychometry to the original English version. This questionnaire can be used to assess knowledge, attitudes, and skills concerning EBP among students and practicing professional nurses and midwives. The future validation of the EBP2Q in other groups of specialists in health sciences may increase the scope of applicability of this tool.

Evidence-based selection process to the Master of Public Health program at Medical University.

BACKGROUND: Evaluation of the predictive validity of selected sociodemographic factors and admission criteria for Master's studies in Public Health at the Faculty of Health Sciences, Medical University of Warsaw (MUW). METHODS: For the evaluation purposes recruitment data and learning results of students enrolled between 2008 and 2012 were used (N = 605, average age 22.9 ± 3.01). The predictive analysis was performed using the multiple linear regression method. In the proposed regression model 12 predictors were selected, including: sex, age, professional degree (BA), the Bachelor's studies grade point average (GPA), total score of the preliminary examination broken down into five thematic areas. Depending on the tested model, one of two dependent variables was used: first-year GPA or cumulative GPA in the Master program. RESULTS: The regression model based on the result variable of Master's GPA program was better matched to data in comparison to the model based on the first year GPA (adjusted R2 0.413 versus 0.476 respectively). The Bachelor's studies GPA and each of the five subtests comprising the test entrance exam were significant predictors of success achieved by a student both after the first year and at the end of the course of studies. CONCLUSIONS: Criteria of admissions with total score of MCQs exam and Bachelor's studies GPA can be successfully used for selection of the candidates for Master's degree studies in Public Health. The high predictive validity of the recruitment system confirms the validity of the adopted admission policy at MUW.

NURSE PRESCRIBING. KNOWLEDGE AND ATTITUDES OF POLISH NURSES IN THE EVE OF EXTENDING THEIR PROFESSIONAL COMPETENCES: CROSS-SECTIONAL STUDY.

In Poland, since 1 January 2016 nurses who graduated from the master studies or hold a title of a specialist may ordain and prescribe specific medicines ("independent nurse prescribing" - INP). Nurses, who completed bachelor studies or hold a title of a specialist are allowed to prescribe drugs to continue the patient's treatment as ordered by a physician ("supplementary nurse prescribing" - SNP). The aim of this paper was to analyze the knowledge and attitudes of the Polish nurse specialists to their new professional rights in the independent ordaining of some drugs and drug prescribing. Participants were 902 women and 26 men. The age average was 42.4 (min. 26, max. 65, SD = 7.56, median: 43, mode: 40). 300 respondents - secondary medical education, 325 - the bachelor degree, 277 - the master degree. Own, validated questionnaire. Attitudes with answers based on the Likert scale (1-5) assessed by the nonparametric ANOVA Kruskal-Wallis test with the post-hoc analysis. The same statistical model was used in the evaluation of potential differences for the total scale of knowledge and attitudes.On average less than half of answers about the knowledge were correct (average of difficulty index was 39%). Nurses believe that the introduction of nurse prescribing will increase the nurse's control of the therapeutic process (mean: 3.22/5). No significant differences between the attitudes of respondents with different education level (p = 0.206; H = 3.160). 55% of nurses supports the introduction of INP. Respondents with the master education significantly more frequently support INP than those with secondary education (p = 0.001; z = 3.685). The knowledge of nurses on the extension of their professional rights is unsatisfactory and requires urgent complementation. The health policy makers should consider an extensive information campaign, especially in the group of nurses with advanced practice who will have prescribing competences. Nurses' attitudes to nurse prescribing are generally positive. Concerns expressed are the same as in the opinions of nurses from countries where the professional rights underwent extension earlier.

[Attitudes of polish physicians towards extending competencies of nurses and midwives with respect to prescribing medicines].

INTRODUCTION: Due to the amendment of the Nurse and Midwife professions Act, since 1st of January 2016 Polish nurses and midwives with certain qualifications are able to prescribe medicines and referral for diagnostic tests. THE AIM: To analyse attitudes of physicians on new professional competencies of nurses and midwives regarding: prescribing medicines and referring patients for certain diagnostic tests. MATERIAL AND METHODS: In the study took part 436 physicians (245 women, 193 man). The average age was 36,6 years old (min.: 21; max.: 76; SD: 11,65; median: 31). 274 people lived in a city with over 500 thousand citizens, 70 people - city below 100 thousand citizens, 54 people - city between 100-500 thousands citizens and 14 people lived in a country. Most of people lived in masovian district. Authors prepared and validated own questionnaire, which contained statements assessed in Likert scale (1-strongly disagree, 5-stronlgy agree). It contained 22 questions about opinions of new abilities of nurses and midwives. The questionnaire was sent three times to Regional Medical Chamber in Warsaw via an online questionnaire: https://docs.google.com/forms/d/1cxiaJFPxDVphByhBTk4gDIBsm6bQsxGLVXDK-RtpGnk/ The reliability of the questionnaire used was tested in a pilot study by the coefficient α-Cronbach, which amounted to 0.937. Due to the fact that the study was performed in a group of doctors they did not require the consent of the Bioethics Committee, of Medical University of Warsaw to carry them out. The results are presented using descriptive statistics, which were obtained through statistical analysis using Microsoft Excel and StatSoft Statistica 12.0 (license Medical University of Warsaw). RESULTS: 53% of doctors claim that the new powers do not improve patient care. 35% of respondents disagreed with the opinion that the new powers will raise the prestige of professional nurses and midwives. At the same time 49% believe that prescriptions for nurses and midwives reduce the responsibilities of doctors. Only 9% agreed that the new abilities are needed in Poland. 65% of doctors have expressed the opinion that nurses and midwives should not have permission to prescriptions and 81% believe that they are not prepared for those abilities. CONCLUSION: Doctors have divided opinion about the benefits of the introduction of the nursing prescriptions for the patient. It is therefore, considered an information campaign through the mass media, or training in the workplace, where they will be presented in an objective manner the consequences of the introduction of new regulations.

Promoting evidence-based practice - perceived knowledge, behaviours and attitudes of Polish nurses: a cross-sectional validation study.

Purpose. Evidence-based practice (EBP) is recognized by the healthcare community as the gold standard for the provision of safe and compassionate healthcare. The aim was to describe nurses' knowledge, behaviours and attitudes regarding EBP. Materials and methods. A cross-sectional approach was conducted during specialty state examinations in Poland in 2014 in a sample of 548 nurses. The self-completed reliable and valid evidence-based practice profile questionnaire (Australia) was used. Statistical analysis included Cronbach's α coefficient, analysis of variance, the Guttman split-half method and calculations in Statistica version 12. Results. Although the participants' beliefs about the benefits of EBP were high, their knowledge was relatively low. Statistically significant correlations were found between barriers and practice, knowledge and attitudes in relation to the level of nurses' education (p < 0.001 to p < 0.05). Total Cronbach's α coefficient was 0.970. Conclusions. Study findings highlight the importance of further supplementation of knowledge about EBP. The difficulties in using EBP in clinical practice are objective and require changes in the Polish system of nursing care. Additionally, life-long updating knowledge in the area of EBP by participation in various forms of postgraduate education can produce improvements in the knowledge, behaviours and attitudes of nurses in creating a positive EBP profile.

Stress at work: The case of municipal police officers.

INTRODUCTION AND OBJECTIVE: Occupational stress-related factors among working municipal police officers in Poland have not been examined in the literature. The purpose of the paper was to evaluate the impact of selected work-related factors on occupational stress in active municipal police officers in Warsaw by using configural frequency analysis (CFA). MATERIALS AND METHODS: A cross-sectional study was conducted among 578 participants, which accounted for 55.1% of all municipal police officers in Warsaw. The majority of study participants were men (72%) (mean age 43 years old). Two groups of workplace-related stress factors were analysed in the study: physical conditions and organisational working conditions causing stress. The study was carried out using the PAPI method (Paper-and-Pencil Interviewing), based on a proprietary questionnaire developed for the study. CFA searches for templates and patterns in contingency tables. RESULTS: Municipal police officers who claimed that stress did not affect health, took advantage of psychological/psychiatric advice less often than those who thought so (1.7% vs 10.1%; χ2 = 20.152, df = 2, P = 0.000). Those who declared that they often experienced stress at work were also more prone to claiming that one or two factors affected their level of stress: physical abuse, contact with infectious materials, working at uncomfortable temperatures or working in a noisy environment. In the opinion of the study population, there were some factors which contributed to the occurrence of stress at work, and these factors included: working in a hurry, lack of necessary resources, devices and materials at work, the need to be available at all times and the unpredictability of the work. The municipal police officers from the study population combined two or three methods to cope with stress, such as watching TV, surfing the Internet and talking with their families. CONCLUSION: Due to the specificity of a municipal police officer's occupation, special attention should be paid to the occupational stress risk factors characteristic for this group of professionals, and measures should be taken to reduce the number of stressors. It is important to organise training events devoted to effective methods of coping with stress. There is need to carry out more in-depth studies of occupational stress among municipal police officers.

Communication skills attitude scale: a translation and validation study in asample of registered nurses in Poland.

OBJECTIVES: To translate and validate the Communication Skills Attitude Scale in the Polish language (CSAS-P) and its adaptation for use among registered nurses. DESIGN: A cross-sectional descriptive design was used in order to translate and validate the CSAS-P. The following psychometric properties of CSAS-P were evaluated: content validity (content validity index), theoretical relevance (exploratory and confirmative factor analysis), one-dimensionality of subscales (principal component analysis), internal consistency (Cronbach's α), test-retest reliability and discriminant validity. SETTING: Participants were identified and recruited from the Centre for Postgraduate Education for Nurses and Midwives in Warsaw, Poland. PARTICIPANTS: The validation group comprised 2014 registered nurses who were undertaking a spring specialisation exam in 2017. RESULTS: The overall content validity index was >0.80, which was interpreted as indicating validity. The factor structure of CSAS-P differed from the original version, and removing three items from the scale better fit the data. The positive attitude subscale (11 items) and negative attitude subscale (12 items) were characterised by one-dimensionality and high internal consistency (Cronbach's α=0.901 and 0.802, respectively). Test-retest analysis confirmed the stability of the measurement for both subscales and particular items. Nurses with prior participation in communication courses scored significantly higher than those without such education (p<0.05), confirming the discriminant validity of CSAS-P. CONCLUSIONS: The psychometric properties of CSAS-P were comparable to the English language original. Further validation of CSAS-P in other groups of healthcare professionals may increase its applicability. CSAS-P can be used to evaluate attitudes towards learning communication skills among registered nurses.

Validation of the positive health behaviours scale: a nationwide survey of nurses in Poland.

PURPOSE: The aim was to adjust the positive health behaviours scale (PHBS) to make it suitable for use by nurses, and to validate the new version of the tool. METHODS: A previously formulated PHBS was modified. The scale comprises 29 statements describing certain positive health behaviours in four subscales: nutrition, physical activity, relaxation and behaviours related to mental health, and preventive behaviours. The scale was enriched with items on avoiding risky behaviours and a question regarding respondents' own assessment of their care for health. Analyses were conducted of reliability, construct validity, criterion validity and dimensionality of subscales. The questionnaire was completed by 1017 nurses. RESULTS: Cronbach's α reached 0.844 for the entire scale and 0.623-0.761 for specific subscales. Empirical data did not confirm theoretical assumptions regarding the existence of a four-element structure of the PHBS. The scale's diagnostic criteria were validated on the basis of positive results of correlation and trend analysis. Only one of the subscales proved homogeneous and could be considered unidimensional. CONCLUSIONS: The results confirmed the high internal consistency of the scale and its subscales. The factor structure of the PHBS was equivocal. The PHBS could be used in workplace-based health promotion programmes designed for nurses.