Challenges to nurse prescribers of a no‐antibiotic prescribing strategy for managing self‐limiting respiratory tract infections

Abstract

Training for nurses and other non-medical prescribers should focus on building their confidence and skills to manage people with respiratory tract infections without recourse to antibiotics. Further work should seek to explore which strategies are most effective in managing respiratory tract infections while maintaining patient satisfaction with care.

Association between point-of-care CRP testing and antibiotic prescribing in respiratory tract infections: a systematic review and meta-analysis of primary care studies

“…2 However, RTIs are most often self-limiting and seldom require antibiotics for treatment. 3 The increased use of antibiotics is significantly associated with the development of drugresistant bacteria. Clinical guidelines do not support routine antibiotic treatment for patients with RTIs.…”

Influences on prescribing decision-making among non-medical prescribers in the United Kingdom: systematic review

“…Key strengths of the studies included the justification and appropriateness of the qualitative approaches and corresponding study designs. Two of the studies provided clear statements of study aims (32,33) ; this was absent in the third (40) . Study limitations were: a general lack of detail over recruitment strategies and processes (e.g.…”

“…Study limitations were: a general lack of detail over recruitment strategies and processes (e.g. one study described purposive sampling but with no further details of strata (40) ; no justification of sample size and consideration of saturation; and the absence in two of the studies of any theoretical underpinning in the construction of the data generation tools and data analysis (32,33) . The third study (40) applied to Hammond's Cognitive Continuum Theory which places the cognitive activities of decision-makers into six broad categories: scientific experiment; controlled trial; quasi-experiment; system aided judgement; peer-aided judgement; and intuitive judgement (41) .…”

“…There is limited evidence regarding non-medical prescribing decision-making although it has been evaluated as safe across a range of settings (28,29,30,31) . NMPs assert that they adhere strictly to evidence-based practice (28) , yet this may not always be the case (32,33) . NMPs have disparate professional backgrounds but unlike doctors, none comes from a tradition of sometimes paternalistic relationships with patients or from a position at the top of the healthcare hierarchy (34,35) .…”

Access to Point-of-Care Tests Reduces the Prescription of Antibiotics Among Antibiotic-Requesting Subjects With Respiratory Tract Infections

“…However, training in communication skills, which has been shown to effectively deal with patients without prescribing antibiotics in other studies, was not carried out in the HAPPY AUDIT study. [19][20][21] Only those GPs assigned to the full intervention group significantly reduced the amount of antibiotics prescribed after the intervention had taken place. The only difference between the full and the partial intervention groups was the access to rapid tests, and this was associated with a 18.9% reduction in antibiotic prescribing.…”