Evidence‐informed implementation of nurse prescribing under supervision: An integrative review

Abstract

Aim To explore evidence reporting facilitators and barriers to implementation of nurse prescribing and provide practical recommendations for evidence‐informed implementation and adoption of nurse prescribing under a supervision model. Background As demand for access to quality health care services increases, health professional roles are expanding to meet population needs. Nurse prescribing has been effective in some countries and is being considered globally to address growing health care demand. Successful implementation of health service models requires careful planning and consideration. No existing reviews have examined implementation factors in the literature. Design Integrative review. Data sources CINAHL, MEDLINE, PubMed and EMBASE databases were searched from inception to 15 April 2020. Review methods This integrative review is guided by Whittemore and Knafl and adheres to PRISMA reporting guidelines. The sustainability of innovation framework was used to synthesize data concerning implementation and sustainability factors (i.e. innovation, organizational, political, workforce and financial) for nurse prescribing. Results A total of 39 articles were reviewed with literature predominantly reporting findings related to non‐medical and nurse prescribing under various models. Variable evidence was found to inform nurse prescribing across five implementation and sustainability factors identifying several areas that require in‐depth consideration. Very little evidence is available on nurse prescribing under supervision. Conclusion Introduction of service reform is often costly. This review highlights gaps in the literature and raises areas for consideration prior to implementation of this new service delivery model. The introduction of nurse prescribing must be planned and informed by available evidence to support effective adoption, practice and patient outcomes. Impact There are significant gaps in evidence related to nurse prescribing under a supervision model. Based on the evidence synthesized in this review, this paper provides practical recommendations for health service providers, managers, clinicians, educators and researchers to support implementation and adoption of nurse prescribing.

Nurse and pharmacist systemic anti‐cancer therapy review clinics and their impact on patient experience and care: A systematic review

“…Nurse prescribing is well‐established in many countries, albeit with varying levels of autonomy and integration (Fox et al, 2022 ). While it is accredited in the UK, USA, the Netherlands, Norway and Poland (Fox et al, 2022 ), it is not in Germany, Czech Republic, Italy and Turkey. This precludes nurses in these countries from prescribing SACT or supportive medications for toxicity management.…”

“…Nurse prescribing is well-established in many countries, albeit with varying levels of autonomy and integration (Fox et al, 2022).…”

“…While it is accredited in the UK, USA, the Netherlands, Norway and Poland (Fox et al, 2022), it is not in Germany, Czech Republic, Italy and Turkey. This precludes nurses in these countries from prescribing SACT or supportive medications for toxicity management.…”

Is the Australian nursing workforce ready to embrace prescribing under supervision? A cross‐sectional survey

“…An online survey was developed by the research team (RJC, AF, RJ, LC, PY, DT, LN) comprising senior academics with expertise in nursing, nurse‐led models of care, policy, pharmacy and non‐medical prescribing and informed by a recent integrative review conducted by the research team (Fox et al, 2021 ). The content validity of the initial survey was assessed by 10 experts who participated as panel members using the Content Validity Index in terms of relevance and clarity (Grant & Davis, 1997 ; Lynn, 1986 ).…”

“…In a study of Australian mental healthcare professionals (49 nurses, 7 medical practitioners, 26 allied health professionals), participants reported that the introduction of nurse prescribing under supervision would potentially improve patient access to medicines but also voiced concerns about prescribing accuracy and patient safety (Muyambi et al, 2018 ). Research on nurse prescribing is dominated by the United Kingdom experience and whilst this is valuable, exploring local contextual considerations and involving key personnel during implementation is imperative (Fox et al, 2021 ).…”