Electronic Medicines Management and Non-medical Prescribing

Social Science & Medicine

Mistiaen

Dijk

et al. 2014

This paper reports on a multiple-case study of prescribing by nurse specialists in Dutch hospital settings. Most analyses of interprofessional negotiations over professional boundaries take a macro sociological approach and ignore workplace jurisdictions. Yet boundary blurring takes place and healthcare professionals renegotiate formal policies in the workplace. This paper studies the division of jurisdictional control over prescribing between nurse specialists and medical specialists in the workplace, and examines the relationship between workplace jurisdiction and legal jurisdiction over prescribing. Data collection took place in the Netherlands during the first half of 2013. The study used in-depth interviews with fifteen nurse specialists and fourteen medical specialists, non-participant observation of nurse specialists' prescribing consultations and document analysis. Great variety was found in the extent to which and way in which nurse specialists' legal prescriptive authority had been implemented. These findings suggest that there is considerable discrepancy between the division of jurisdictional control over prescribing at the macro (legal) level and the division at the micro (workplace) level.

Section: Jurisdiction In the System Of Professionsmentioning

confidence: 99%

Negotiating jurisdiction in the workplace: A multiple-case study of nurse prescribing in hospital settings

Social Science & Medicine

Mistiaen

Dijk

et al. 2014

“…Traditionally, the task of prescribing medicines has been the sole domain of the medical profession ( [Buckley et al, 2006], [Fisher, 2010] and [Goundrey-Smith, 2008]). With the development of nurse prescribing, doctors are confronted with a 'rival' profession in this domain.…”

Section: Theoretical Backgroundmentioning

confidence: 99%

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: A survey on forces, conditions and jurisdictional control

International Journal of Nursing Studies

Francké

Groenewegen

et al. 2012

“…Traditionally, the task of prescribing medicines has been the domain of the medical profession [ 8 , 9 ], but the development of nurse prescribing represents an incursion on the medical profession's jurisdiction over prescribing. According to Abbott [ 7 ], jurisdiction - 'the link between a profession and its work' - forms the central phenomenon of professional life.…”

Section: Introductionmentioning

confidence: 99%

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature

Dijk

Groenewegen

et al. 2011

BMC Health Serv Res

152

211

BackgroundA growing number of countries are introducing some form of nurse prescribing. However, international reviews concerning nurse prescribing are scarce and lack a systematic and theoretical approach. The aim of this review was twofold: firstly, to gain insight into the scientific and professional literature describing the extent to and the ways in which nurse prescribing has been realised or is being introduced in Western European and Anglo-Saxon countries; secondly, to identify possible mechanisms underlying the introduction and organisation of nurse prescribing on the basis of Abbott's theory on the division of professional labor.MethodsA comprehensive search of six literature databases and seven websites was performed without any limitation as to date of publication, language or country. Additionally, experts in the field of nurse prescribing were consulted. A three stage inclusion process, consisting of initial sifting, more detailed selection and checking full-text publications, was performed independently by pairs of reviewers. Data were synthesized using narrative and tabular methods.ResultsOne hundred and twenty-four publications met the inclusion criteria. So far, seven Western European and Anglo-Saxon countries have implemented nurse prescribing of medicines, viz., Australia, Canada, Ireland, New Zealand, Sweden, the UK and the USA. The Netherlands and Spain are in the process of introducing nurse prescribing. A diversity of external and internal forces has led to the introduction of nurse prescribing internationally. The legal, educational and organizational conditions under which nurses prescribe medicines vary considerably between countries; from situations where nurses prescribe independently to situations in which prescribing by nurses is only allowed under strict conditions and supervision of physicians.ConclusionsDifferences between countries are reflected in the jurisdictional settlements between the nursing and medical professions concerning prescribing. In some countries, nurses share (full) jurisdiction with the medical profession, whereas in other countries nurses prescribe in a subordinate position. In most countries the jurisdiction over prescribing remains predominantly with the medical profession. There seems to be a mechanism linking the jurisdictional settlements between professions with the forces that led to the introduction of nurse prescribing. Forces focussing on efficiency appear to lead to more extensive prescribing rights.