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

Abstract

Aim:The aim was to explore nurses' preparedness to expand their practice to prescribe medicines under a supervision model. Design:This was a cross-sectional study. Methods: A convenience sample of Australian nurses recruited from memberships of State-based Nursing and Midwifery Unions and professional bodies from diverse care settings. Nurses undertook an online researcher-constructed survey between March and July 2021 to identify current prescribing practices, motivations for undertaking education in prescribing and perceived barriers to implementation of nurse prescribing under supervision. Data related to demographics, nursing experience and barriers to becoming a prescriber were analysed descriptively. Logistic regression was used to model nursing experience variables with desire to become a prescriber.Results: A total of 4424 nurses participated with the majority (n = 3645, 82%) reporting they were highly likely to expand their practice to prescribe medicines under supervision. The main motivations to prescribe were to enhance patient care and job satisfaction. Nurses were more likely to want to prescribe if they had <10 years experience (95% CI = 0.3-0.5, p < 0.001), held a bachelor's degree (95% CI = 1.3-2.2, p < 0.001) or higher qualification (95% CI = 1.8-2.9, p < 0.001). Most reported lack of acknowledgement of increased responsibility and workloads (n = 4098, 93%), and insufficient organizational support (n = 4197, 95%) may prevent uptake of nurse prescribing. Conclusions:Most Australian nurses demonstrated their preparedness to embrace the role of prescribing under supervision. The perceived barriers identified in this study can inform future implementation of this expanded nursing role. Impact:The Nursing and Midwifery Board of Australia has proposed a standard of practice to enable nurses to prescribe under supervision. Models of nurse prescribing are being considered globally to address population needs. Successful adoption of this practice is dependent on aspects such as key personnel's acceptance of the initiative.

Nurses’ readiness to prescribe under supervision in Saudi Arabia: A cross-sectional study

“…Most participants agreed that the implementation of nurse prescribing under supervision would improve the outcomes of patients, clinicians, and organizations in Saudi Arabia. Comparable findings from other countries have shown that expanding prescribing practices to nurses would increase the benefits of and access to healthcare services and medicine ( Armstrong, 2015 , Casey et al, 2020 , Fox et al, 2022 , Gielen et al, 2014 , Nuttall, 2018 ), provide patient-centered care to maintain the continuity of care ( Armstrong, 2015 , Casey et al, 2020 , Fox et al, 2022 , Nuttall, 2018 ), improve nurse experiences and satisfaction ( Armstrong, 2015 , Casey et al, 2020 , Cousins and Donnell, 2012 , Fox et al, 2022 , Gielen et al, 2014 , Lennon and Fallon, 2018 ), and enhance the safety and effectiveness of clinical practices and optimal care ( Armstrong, 2015 , Azami et al, 2018 , Tinelli et al, 2015 , Wilson et al, 2021 ). Although previous studies identified several professional advancements for nurses as outcomes for prescribing practices ( Fox et al, 2022 , McBrien, 2015 , Romero-Collado et al, 2014 ), this study did not explore the potential professional advancements that are expected when granting nurses prescribing authority.…”

“…Furthermore, the rated facilitating factors for nurse prescribing reported in this study were consistent with those reported in previous studies. For instance, organizational and collegial factors that influenced nurse prescribing include support from their organization as well as nurses and non-nursing colleagues ( Bowskill et al, 2013 , Brimblecombe and Dobel-Ober, 2022 , Fox et al, 2022 , Smith et al, 2014 , Snell et al, 2022 , Stenner et al, 2010 ), having a mentor and continuing professional training ( Carey and Courtenay, 2008 , Carey et al, 2010 , Courtenay and Carey, 2008 , Snell et al, 2022 , Stenner et al, 2010 ), unrestricted scope of practice ( Lockwood and Fealy, 2008 , Muyambi et al, 2018 , Stenner et al, 2010 ), and financial reward for prescribing practice ( Maddox et al, 2016 ). Other factors include acceptance and support from patients ( McCann and Clark, 2008 ) and perceived confidence and competency ( Carey et al, 2014 , Maddox et al, 2016 ).…”

“…A survey developed by Fox et al (2022) was used to assess nurses’ readiness to prescribe medications under supervision. The survey was modified by the investigators to suit the Saudi healthcare context.…”

“…However, owing to the shortage of providers, limited access to healthcare, increase in chronic health conditions, increased interprofessional teamwork, and advancement in nursing higher education, an increasing number of countries have enacted reforms to widen access to medications, which grants nurses prescribing capacity ( Gielen et al, 2014 , Maier, 2019 , Weeks et al, 2013 ). Countries that do not predominately have authorized independent nurse prescribers, such as advanced practice nurses, allowed registered nurses (RNs) to prescribe some medications under supervision after the completion of adequate prescribing qualification and training ( Bartosiewicz and Różański, 2019 , Brimblecombe and Dobel-Ober, 2022 , Fox et al, 2022 , Lennon and Fallon, 2018 , Maier, 2019 , Romero-Collado et al, 2017 ).…”

“…Additionally, nurses with prescribing capacity attain levels of patient satisfaction comparable to those attained by other providers ( Courtenay et al, 2011 , Lennon and Fallon, 2018 , Tinelli et al, 2015 , Weiss et al, 2015 ). Furthermore, allowing nurses to prescribe under supervision contributed positively on the nursing profession by promoting autonomy, professional identity, and job satisfaction ( Fox et al, 2022 , McBrien, 2015 , Romero-Collado et al, 2014 ).…”