Independent extended and supplementary nurse prescribing practice in the UK: A national questionnaire survey
Section snippets
What is already known about this topic?
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Factors influencing independent prescribing practice include the size and make-up of the practice population, the role of the nurse, interprofessional relationships, informal peer support, access to continuing professional development and the limited choice of medicines available to nurse prescribers.
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There is evidence of low prescribing rates amongst health visitor and district nurse prescribers. This is in contrast to high prescribing rates reported by some early independent extended
What this paper adds
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Supplementary prescribing is used by nurses to prescribe medicines for a range of conditions but it is used to a much lesser extent than independent extended prescribing. Implementing the Clinical Management Plan is a barrier preventing the use of this mode of prescribing.
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The large majority of nurses who access prescribing programmes have more than 10 yr experience as a qualified nurse and academic qualifications at degree level and higher.
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Qualified independent extended/supplementary nurse
Background
To date, a relatively small number of empirical studies have been conducted to evaluate nurse prescribing. Following a review of the literature, Latter and Courtenay (2004) concluded that the impact and effectiveness of nurse prescribing has largely been a positive development. However, the authors noted that the majority of the studies to date, have largely been confined to the prescribing practices of DNs and HVs. Luker et al., 1997, Luker et al., 1998, for example, in a national evaluation
Aim
To provide a national overview of the prescribing practices of independent extended/supplementary nurse prescribers and the factors that facilitate or inhibit prescribing.
Methodology
A survey design was used, in which participants were asked to self-complete a postal questionnaire. All questions were ‘closed’ in nature. Respondents were asked to tick a box to indicate their responses. Quantitative data was generated from this study.
Questionnaire
A questionnaire booklet was developed for the purpose of this study. Its
Job title
Respondents were asked to indicate their job title. A total of 437 (50.4%) worked in general practice (practice nurses, nurse practitioners), 256 (29.5%) as specialist nurses (clinical nurse specialists, specialist nurse practitioner, nurse clinician), 93 (10.7%) as senior nurses (nurse consultants, senior nurses, charge nurses, sisters, managers) and 82 (9.4%) worked as community nurses (HVs, DNs, children's community nurse specialist).
Part time/full time
The majority of respondents worked full time (580 or
Discussion
Before summarising the key findings and drawing conclusions, two potential limitations of the methodology must be taken into account. Firstly, the sample included all the qualified independent extended/supplementary nurse prescribers registered on the medical reference guide. It was not a random sample. A second potential limitation is that the length of time participants had been prescribing was not taken into account. This may have affected responses. This is unlike previous work (Latter et
Conclusions
Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines. Supplementary prescribing is used by a minority of nurses. Barriers to implementing the CMP require further exploration. The large majority of nurses who access prescribing programmes have more than 10 yr experience as a qualified nurse and academic qualifications at degree level and higher. However, once qualified, the CPD needs of these nurses are frequently unmet. This requires
Acknowledgments
This study was undertaken with the help of a research grant provided by Galderma UK.
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