Nurse Prescribing From the Global Vantage Point: The Intersection Between Role and Policy

Abstract

Nurses around the world are increasingly prescribing and managing pharmaceutical agents. Prescribing by nurses is currently based on varying nursing roles, depending on national and regional norms and practices. Prescribing occurs within the advance practice, advanced level, and task-sharing roles, depending on the country. It is evolving both within and outside of traditional regulatory frameworks. Therefore, the purpose of this article is to describe the nurse prescribing globally among various nursing roles that support and facilitate the practice. We gathered practice, statutory, and regulatory information from gray and peer-reviewed literature, Google search and Google scholar, government websites, PubMed, and CINAHL electronic databases. In contrast to previous global policy reviews that focus primarily on high-income nations, our findings suggest that nurse prescribing occurs extensively in all six continents. Nurse prescribing within the context of advanced practice nursing occurs mostly in high-income countries. However, the predominant model of nurse prescribing from the global context occurs within the advanced level role by postbasic or postprofessional nurses. Additional nurse prescribing occurs through less formal task-sharing arrangements, primarily in low- to middle-income countries. In general, nurse prescribing is evolving rapidly around the world but within highly variable roles and regulatory frameworks. Codifying these roles by strengthening of educational and regulatory standards may serve to enhance the health system capacity, especially in low- to middle-income countries.

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

“…Countries such as the United States of America, Canada and Australia have nurse practitioner roles which require additional Master level tertiary education and authorize independent prescribing, however, papers reporting research on nurse practitioners was excluded from this review. In low‐ and middle‐income countries, task‐sharing has been adopted (Ladd & Schober, 2018). Task sharing is described as rapidly evolving in countries such as the Caribbean, Papua New Guinea, Mexico and parts of Africa and a model that does not require regulation at the same level of advanced practice but allows nurses to share prescribing responsibilities (Ladd & Schober, 2018).…”

“…In low‐ and middle‐income countries, task‐sharing has been adopted (Ladd & Schober, 2018). Task sharing is described as rapidly evolving in countries such as the Caribbean, Papua New Guinea, Mexico and parts of Africa and a model that does not require regulation at the same level of advanced practice but allows nurses to share prescribing responsibilities (Ladd & Schober, 2018). This model of prescribing is yet to be examined.…”

“…While UK nurses have been prescribing for close to 30 years, expansion of nursing scope of practice is now gaining popularity more broadly. Literature suggests that nurse prescribing is rapidly increasing worldwide in low‐, middle‐ and high‐income countries utilizing various models, governance processes and practices (Ladd & Schober, 2018; Ling et al, 2018). Nurse prescribing is at various stages of implementation and expansion in many countries, including Australia, Canada, China, Cyprus, Denmark, Finland, Israel, Iran, Ireland, New Zealand, the Netherlands, Poland, Spain, Sweden and the USA (Binkowska‐Bury et al, 2016; Drennan et al, 2011; Kroezen et al, 2012; Ladd & Schober, 2018; Ling et al, 2018; Maier, 2019; Wilkinson, 2015).…”

“…Literature suggests that nurse prescribing is rapidly increasing worldwide in low‐, middle‐ and high‐income countries utilizing various models, governance processes and practices (Ladd & Schober, 2018; Ling et al, 2018). Nurse prescribing is at various stages of implementation and expansion in many countries, including Australia, Canada, China, Cyprus, Denmark, Finland, Israel, Iran, Ireland, New Zealand, the Netherlands, Poland, Spain, Sweden and the USA (Binkowska‐Bury et al, 2016; Drennan et al, 2011; Kroezen et al, 2012; Ladd & Schober, 2018; Ling et al, 2018; Maier, 2019; Wilkinson, 2015). The expansion of nurse prescribing more broadly has been suggested as the next logical step to ensure timely, high‐quality health care (NMBA, 2018) and additional flexibility in the profession to meet specific, identified health care needs of the community (Courtenay, Deslandes, et al, 2018; Courtenay, Franklin, et al, 2018; Gielen et al, 2014).…”

Gastroenterology nurse prescribing in China: A Delphi method

“…The levels of education, practice and expertise of nurses who prescribe medicinal products differ between countries. The same is often true among regions in a single country, as a result of regional conditions and distinct requirements imposed by local legislation or institutional characteristics (Ladd & Schober, 2018). Among countries, there are significant differences in the scope of prescribed drugs, the nurse prescribing models used and the list of available prescription drugs (Kroezen et al, 2011).…”