Exploring the views of nurse prescribing among Macmillan nurses

Abstract

Nurse prescribing is a key government initiative which aims to enhance patient care. The aim of this study was to investigate the prescribing practice of specialist nurses working in cancer and palliative care and to explore the benefits of and barriers to uptake of nurse prescribing training. A national postal survey of 2252 Macmillan nurses was undertaken using a structured questionnaire with open-ended questions. Data were analyzed using thematic content analysis for 1575 respondents (70% response rate). Only 13% (203) had undergone prescribing training and of these 105 provided responses to the open questions concerning training and of the 87% (1372) who had not undergone the training, 423 provided details on barriers to nurse prescribing training. The data presented in this paper draw from this data. The findings indicate that those who prescribed gave the prospect of improving care as the main reason for undertaking nurse prescribing training. The main reasons why these specialist nurses did not undertake training were: resource issues particularly with respect to backfill while training, lack of medical support and mentorship, concerns about the relevance of prescribing as a nursing role and prioritizing other courses. If nurse prescribing is to be more widely available for cancer and palliative care patients it is important in both primary and secondary care to address the resource and support issues.

The necessity and possibility of implementation of nurse prescribing in China: An international perspective

“…Nurses benefited from increased job satisfaction, credibility with patients and healthcare professionals and also gained knowledge through prescribing.Qualitative studyInterviews27.Berry et al., 2008 [28]Patients indicated a relatively high level of confidence in nurse prescribing and stated that they would be very likely to take the selected medication.Quantitative studyQuestionnaire surveys28.Offredy et al., 2008 [35]The majority of participants were unable to identify the issues involved in all the scenarios; they also failed to provide an acceptable solution to the problem. The lack of appropriate pharmacological knowledge coupled with lack of confidence in prescribing was demonstrated.Qualitative studyInterviews29.Carey et al., 2008 [37]A medicines management intervention, provided by a Diabetes Specialist Nurse prescriber, had a positive effect on the system of delivering medicines to patients with diabetes and significantly reduced the number of errors.Quantitative studyLongitudinal analysis30.Ryan-Woolley et al., 2008 [66]Only 13% (203) had undergone prescribing training and of these 105 provided responses to the open questions concerning training and of the 87% (1372) who had not undergone the training, 423 provided details on barriers to nurse prescribing training.Quantitative methodsQuestionnaire surveys31.Latter et al., 2007 [51]Only half of the sample had experience of formally provided professional development opportunities. Approximately half (52% 127/246) of the sample identified needs for continuing professional development.Quantitative studyQuestionnaire surveys32.Courtenay et al., 2007 [60]Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines.…”

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

“…Nevertheless, a number of recurring themes could be discerned, such as the views of nurses, doctors and other parties involved concerning nurse prescribing [45,47,51,53,81,94,108,109,115,121,139], prescribing behaviours of nurses [36,43,124,126,128,129,131,137], and nurse prescribing in relation to specific diseases [38,44,84,89,91-93,101,108,116,125] - most notably concerning nurse prescribing in mental health care [21,32,39,67,76,83,100,102,104-106,132,135]. Also, a number of publications focussed on the history and evolution of (nurse) prescribing of medicines, but these remained relatively limited [5,6,46,48,49,75,90,96,103,142].…”

“…Table 2 presents an overview of the (expected) year of introduction of nurse prescribing in Western European and Anglo-Saxon countries. While community nurses were the first group of nurses to start prescribing in the UK in 1998, one should note that in the years thereafter two other models of nurse prescribing were introduced there: in 2002 the form now known as 'independent prescribing' was implemented [5,6,24,32,48,49,56,68,72,76,84,87,100,101,121,124,136], followed by 'supplementary prescribing' in 2003 [5,6,24,26,27,32,35,36,40,42,46,47,49,52,56,62,67-69,72,76,78,81,83,91-94,101,104,121,123,124,136,138]. Currently, nurses in the Netherlands are awaiting for the final amendments to legislation to enable them to start prescribing [5,58,117,118], and in Spain the legal regulation of nurse prescribing is in the procedural phase [5].…”

“…In Ireland nurse prescribers may independently prescribe from an open formulary specific to their field of clinical practice [5,139] whereas in the UK independent prescribers can prescribe from the entire British National Formulary (BNF), including unlicensed medicines and some controlled drugs [5,24,26,35,44-46,48,49,51-53,63,65,68,69,76,78,83,84,92,94,100-103,105,108,109,113,126,128,136,137,139]. Supplementary prescribers in the UK can in addition prescribe all controlled drugs, provided they are listed in a clinical management plan agreed by the independent prescriber, nurse and patient [5,21,24,26,27,35,38,40,43-45,48-53,63,76,78,82,95,100,101,108,114,123-126]. Community practitioner nurse prescribers in the UK however, have their own more limited formulary to prescribe from [5,27] and in South Australia, every nurse practitioner has their own individual formulary of medicines from which to prescribe [129].…”

Views and perceptions of Australian physiotherapists and physiotherapy students about the potential implementation of physiotherapist prescribing in Australia: a survey protocol

“…Anecdotal evidence suggests that physiotherapists prescribing may retain Australian physiotherapists within the profession, as they would be able to optimally utilise their knowledge and skills, providing seamless patient care regardless of geographical location or health sector [1, 7]. However, survey literature investigating the views of NMP professions in the UK and USA suggests that views about NMP by the individual professional may vary depending on the individual’s job specification, access to medical support, geographical location, health sector, level of experience and the timespan of the individual’s career [8–12]. …”