Nurse prescribing: radicalism or tokenism? (original) (raw)
Related papers
Journal of Nursing Management, 2008
Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists Aim Nurses and midwives are expanding the scope of their professional practice, assuming additional responsibilities including the management and prescribing of medications. The aim of the study was to discover the attitudes of clinical nurse specialists (CNSs) in Ireland to nurse prescribing and to examine perceived barriers to engaging in this aspect of future role expansion. Background The expansion of the nursing role in relation to nurse prescribing is an ongoing process and is subject to incremental iterations of legislation and professional policy. Nurse prescribing as an expanded role function has become a reality in many countries. Ireland has addressed the matter in a formal and systematic way through legislation. Method A questionnaire was administered to a sample of 283 CNSs practising in a variety of care settings in Ireland. Attitudes were measured using Likert-type attitudinal scales, designed specifically for the study. Results and conclusions Findings indicate that the majority of clinical nurse specialists were positively disposed toward nurse prescribing as a future role expansion. The fear of litigation was identified as the most significant barrier to nurse prescribing. The majority of respondents equated nurse prescribing with increased autonomy and holistic care. The findings indicate that there is a need for further examination of the educational requirements of the CNS in relation to nurse prescribing. The legislative implications for nurse prescribing and fear of legal consequences need to be considered prior to any implementation of nurse prescribing. Implications for nursing management While senior clinicians are willing to embrace future role expansion in the area of nurse prescribing, their Nurse Managers should recognize that facilitation of nurse prescribing needs to address the legal and educational requirements for such activity. Failure to address these requirements can represent a barrier to role expansion. This paper offers new understandings on the views of senior clinicians concerning nurse prescribing at a time of ongoing professional policy iteration and practice change in the area.
Benefits and challenges of nurse prescribing
2004
Benefits and challenges of nurse prescribing Background. Since 1999, all health visitors and district nurses in the United Kingdom (UK) have received additional education to permit their registration as independent prescribers from a limited list of medicinal products. Little research has investigated how more than 20 000 health visitor and district nurse prescribers have implemented their new role since the evaluation of the pilot sites. Aims. The aims of the study were to describe prescribing practices of health visitors and district nurses, the factors (contextual and professional) which enable and facilitate nurse prescribing, and views about the Nurse Prescribers' Formulary. Method. A mail survey was conducted of all health visitors and district nurses working in three trusts in southern England. A 74% response rate was achieved (n ¼ 91). Findings. Most respondents prescribed less than three times a week, with district nurses prescribing significantly more than health visitors (P £ 0AE001). Over twothirds of the sample found nurse prescribing at least moderately helpful to their professional role and over four-fifths reported that they were more than moderately confident nurse prescribers. A range of information sources was identified as helpful, regarding both new products and for continuing educational needs. Over two-thirds reported that the current Nurse Prescribers' Formulary did not cover their prescribing needs, and a number of factors were identified as hindering prescribing. Most respondents said that their general practitioner/primary care team was at least moderately supportive of their prescribing role. Limitations. The survey was conducted in three primary care trusts in southern England, which may be unrepresentative of trusts elsewhere in UK.
Nurse Prescribing From the Global Vantage Point: The Intersection Between Role and Policy
Policy, Politics, & Nursing Practice
Nurses around the world are increasingly prescribing and managing pharmaceutical agents. Prescribing by nurses is currently based on varying nursing roles, depending on national and regional norms and practices. Prescribing occurs within the advance practice, advanced level, and task-sharing roles, depending on the country. It is evolving both within and outside of traditional regulatory frameworks. Therefore, the purpose of this article is to describe the nurse prescribing globally among various nursing roles that support and facilitate the practice. We gathered practice, statutory, and regulatory information from gray and peer-reviewed literature, Google search and Google scholar, government websites, PubMed, and CINAHL electronic databases. In contrast to previous global policy reviews that focus primarily on high-income nations, our findings suggest that nurse prescribing occurs extensively in all six continents. Nurse prescribing within the context of advanced practice nursing ...
The Necessity of Nursing Prescription from the Perspectives of Nursing Policymakers
Journal of Qualitative Research in Health Sciences, 2016
Introduction: Presently, in many countries, certain groups of nurses are allowed to prescribe medicine. Despite the increasing attention of the world to nursing prescription and emphasis of the World Health Organization (WHO) on its implementation in regional countries, a review of literature indicated that there is no evidence of nursing prescription in Iran. Thus, this study aimed to assess the necessity of nursing prescription from the perspective of the Iranian nursing policymakers. Method: This descriptive qualitative study was performed through interviews with 14 nursing policymakers. The participants were selected through purposive sampling method. Semi-structured interviews were used to collect data. Interviews were conducted after coordination with participants and in their workplace. All interviews were recorded using a digital voice recorder. Interviews were simultaneously transcribed verbatim and analyzed using conventional content analysis through inductive approach. The coding was performed using MAXQDA software. To achieve the accuracy and reliability of the data, the Lincoln and Guba authenticity criteria were used. Results: Analysis of the recorded interviews resulted in the extraction of the 3 main categories of "the right to health and individual's requirements", "the current situation of the clinical setting", and "nursing prescription outcomes". Conclusion: The views and perspectives of nursing policymakers indicated that due individuals' right to health and need for health care services, and also the positive outcomes that may result from nursing prescription, the necessity of its implementation is felt. However, there are challenges to its implementation that require the relevant authorities' efforts to resolve them.
Nurse prescribers: who are they and how do they perceive their role?
Journal of Advanced Nursing, 2005
Aims. This paper reports a study to elicit background data from recently qualified nurse prescribers and explore aspects of their work.Background. Nurse prescribing has been introduced quite recently in the United Kingdom. Although a certain amount of information is available about the characteristics of nurse prescribers, relatively little is known about their professional backgrounds, their reasons for choosing to become nurse prescribers and their perceptions of their emerging role. More information is needed to inform the selection, education and support of nurse prescribers.Method. All nurses who undertook a nurse prescribing course in one university in the West Midlands during 2003–2004 were invited to participate in the study. A 40-item questionnaire was used to gather data on demographics, expectations of nurse prescribing, personal and professional development and perceived education needs.Findings. Respondents considered that, despite initial problems, the nurse prescribing initiative would ultimately prove to be a cornerstone of improved service delivery for service users. The majority of nurses were already heavily involved in prescribing ‘by proxy’ and the course merely formalized what they were currently doing. Potentially, prescribing could advance the professional development of nurses, improve communication between professionals and patients, and make the experience of patients more beneficial. However, some concerns were expressed about how supportive the current climate in health care could be, given the multiple demands on time and energy required by so many other innovations.Conclusions. Respondents appeared balanced in their perceptions of this innovation and what it could realistically achieve. They were not indifferent to the many short and long-term problems that need to be resolved before it can be claimed to have become embedded in practice. The success of non-medical prescribing may depend on organizational support, coupled with a robust continuing professional development strategy for all nurse prescribers.
Journal of Nursing Management, 2014
Nurse prescribing in primary care in Spain: legal framework, historical characteristics and relationship to perceived professional identity Aim To identify the extent of nurse prescription and determine specific medications and/or health-care supplies routinely prescribed by primary care nurses in Spain in a changing legal context. To explore nurse perceptions of legalized nurse prescription's relationship to professional identity. Background Although the Spanish public has similar confidence in nurses and physicians, professional identity remains a concern for nurses. Nurse prescription has a confusing history in Spain but is increasingly common elsewhere, and may enhance nursing's professional profile. Method A cross-sectional survey reporting the occurrence of nurse prescription in one province in Spain and primary care nurses' perceptions of nurse prescription and professional identity in this province. Result The response rate was 69.6% (87 nurses). Frequent nurse-prescribed medications were vaccinations (63.1%), topical antiseptics (60.7%) and antipyretics (44.8%); health-care supplies included supplies for diabetes (51.8%), wound care dressings (44.2%) and incontinence (26.7%). Respondents indicated that nurse prescription positively contributes to the profession and to its development. Conclusion Nurse prescribing exists in primary care in Spain, and formal legalization is in progress but awaits a consensus formulary. Nurses indicated that full legalization would increase professional autonomy and contribute positively to the profession, as an example of how policy can have an impact on practice. Implications for nursing management Spain's experience with inconclusive shifts in the legal status of nurse prescribing may contribute to the discussion in countries where this professional practice is not yet established.
Journal of Advanced Nursing, 2014
Aims: To assess changes in the prescribing practices and views about nurse prescribing of Registered Nurses in the Netherlands between 2006 and 2012. Background: Considering the developments that took place in the Netherlands between 2006 and 2012, such as increased opportunities for nurse prescribing education and stricter control of nurses' prescribing practices, this study examines the extent to which nurses' prescribing practices and views have changed in the intervening years. In both years, nurses were not legally allowed to prescribe. Design: Survey study. Methods: Surveys were conducted in 2006 and 2012. Questionnaires were sent to a national sample of nurses. The questionnaires addressed nurses' views on nurse prescribing and the extent to which nurse prescribing took place in the respondents' work setting. Results: There were 386 and 644 respondents to the 2006 and 2012 surveys respectively. The proportion of nurses who said that they felt adequately equipped to prescribe medicines remained constant around 12%. Insufficient knowledge to prescribe remained the most important reason for feelings of inadequacy. More than a quarter of the nurses in both surveys stated that nurses in their team sometimes write prescriptions. There were few changes in views on the consequences of nurse prescribing for nurses' practice. Conclusion: Overall, nurses' support for nurse prescribing remained stable at a fairly cautious level, while the number of nurses feeling inadequately equipped to prescribe remained high. As nurse prescribing is expected to improve the quality and continuity of care, this should be taken into account in policy expectations.
Challenges to medicine: the case of prescribing
Sociology of Health & Illness, 2008
This paper examines recent developments in primary care prescribing as potential challenges to the dominance of medicine. These developments, as possible forces for the deprofessionalisation and proletarianisation of medicine, were examined using unstructured interviews with five Family Health Service Authority (FHSA) medical advisors and 23 general practitioners (GPs). Three themes emerged from the data. First, GPs did not find the role of the FHSA advisor to be either constraining or inappropriate in relation to prescribing. Secondly, GPs recognised prescribing as a crucial discretionary power in which the prescription was used 'irrationally' to cope with a variety of patient, practice or workload pressures. Thus, the only serious managerial threat came from the possibility that such 'irrational' prescribing could be curtailed. Finally, GPs felt most concemed by the growing demands and expectations of patients, exacerbated by govemment policies endorsing greater consumerism. The greatest perceived challenge to clinical autonomy comes, not from proletarianisation in the sense of greater managerial control over medicine's work, but from deprofessionalisation through lay challenges to general practitioners' professional medical expertise.
Enabling legislation in diagnosis and prescribing of medicine by nurses/health practitioners
Curationis, 2001
The South African health system has undergone major changes over the last 5 - 1 0 years. These rapid changes have not only significantly increased the visibility of the nurse practitioner in South Africa, but are also posing challenges to the profession and health care services that need to be addressed. In its Health Policies the Government has indicated that the nursing/midwifery profession, as the biggest group of health care professionals, should be the practitioners to provide primary health care services to the communities. But to do this, they require enabling legislation. The “permit system” has been in place for non-pharmacists and institutions other than hospitals and pharmacies to acquire, possess, use and supply medication for a number of years. This system has been fraught with problems mainly due to a lack of clarity on exactly how the system works and the system has been abused. The purpose of this article is to explore the current situation with the aim to analyze th...