Perspectives of nurses’ role in interprofessional pharmaceutical care across 14 European countries: A qualitative study in pharmacists, physicians and nurses

Abstract

Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC). Design Qualitative study conducted through semi-structured in-depth interviews. Setting Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses’ autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.

Understanding pharmaceutical care and nurse prescribing in Spain: A grounded theory approach through healthcare professionals’ views and expectations

“…Interviews consisted of open-ended questions in a structure previously agreed by the European Demophac partnership around four topics associated with the Nursing ideal role in PC and the ideal interaction with other healthcare professionals finishing with a classic SWOT matrix which is a strategic planning technique used to identify strengths, weaknesses, opportunities, and threats. The main four topics were: (a) Nursing responsibilities; (b) Tasks related to those responsibilities; (c) Nursing Interaction with physicians and pharmacists; (d) SWOT analysis about the current situation in Spain [ 16 ]. The interviews were part of the Demophac study [ 17 ] although those questions directly asking about NP in Spain were specifically context-based for the Spanish team due to the historical transitioning situation in the country.…”

The NUPHAC-EU Framework for Nurses’ Role in Interprofessional Pharmaceutical Care: Cross-Sectional Evaluation in Europe

“…The results of the previous quantitative cross-sectional study [33] and the qualitative interview study [34] in European nurses, physicians and pharmacists, followed by the scoping review [35] of the literature, resulted in an overview of seven PC domains, 26 tasks for nurses and 20 contextual factors, which were potential barriers or enablers for nurses taking up tasks in PC (Table 1). Based on this overview, a framework, called the NUPHAC-EU framework (Nurse and Pharmaceutical Care Europe), was created.…”

“…Taking into account the results of a previous quantitative cross-sectional study [33] and a qualitative interview study [34] in European nurses, physicians and pharmacists, followed by a scoping review of the literature [35], together with the responses in the current cross-sectional evaluation, we developed a framework for nurses' role in interprofessional pharmaceutical care in Europe (Figure 1). The framework consists of several parts.…”

“…Healthcare professionals confirmed the positive impact on care quality and patient outcomes when nurses assumed PC responsibilities. The study evidenced the need for a unique and consensus-based PC framework across Europe [34]. In the subsequent scoping review of international literature related to PC by nurses, an overview was given of the variety within nurses' responsibilities and tasks in PC.…”

“…Overview of 26 potential tasks within 7 pharmaceutical care domains, and 20 contextual factors, for nurses in interprofessional pharmaceutical care, extracted from previous DeMoPhaC studies[33][34][35]. Colors indicate whether the task was part of a pharmaceutical care domain (green) or not (red).…”