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“Providing a complete episode of care”: A survey of registered nurse and registered midwife prescribing behaviours and practices

Author

Listed:
  • Mary Casey
  • Daniela Rohde
  • Agnes Higgins
  • Tom Buckley
  • Andrew Cashin
  • Jacqueline Fong
  • Mary Hughes
  • Aine McHugh

Abstract

Aims and objectives To describe the prescribing behaviours and practices of registered nurse and midwife prescribers and to explore experiences of enablers and barriers to prescribing practices. Background The extension of prescriptive authority to nurses and midwives internationally has created new opportunities for them to expand their scope of practice and is of significant benefit to effective and efficient health service provision. Design Cross‐sectional national survey of registered nurse and midwife prescribers. Methods Data were collected through an online survey between April–July 2018. A total of 84 nurse and midwife prescribers participated. The STROBE checklist was applied as the reporting guideline for this study. Results Respondents estimated that two‐fifths of their consultations involved an episode of prescribing. Nurse and midwife prescribers engaged in similar prescribing behaviours spanning the range of activities from initiating new medications to ceasing medicines. The most frequently selected criterion for prescribing was clinical effectiveness. Prescribing was viewed as essential to respondents' clinical practice, allowing them to provide a complete episode of care and leading to a reduction in medication errors and reduced delays and waiting times for patients. Enablers of prescribing included knowledge, experience, education and access to continuous professional development, as well as support from colleagues and organisations. Conclusion Little is known about the prescribing behaviours and practices of registered nurse and midwife prescribers. While prescribing authority enables nurse and midwife practitioners to deliver holistic care, there remain significant barriers and challenges including increased workloads, lack of continuous professional development, lack of support and overly restrictive rules and policies governing prescribing. Relevance to clinical practice Addressing the barriers identified in this study could enable more nurse and midwife prescribers to work to their full scope of practice, enabling populations to fully capitalise on the contributions of registered nurse and midwife prescribing services.

Suggested Citation

  • Mary Casey & Daniela Rohde & Agnes Higgins & Tom Buckley & Andrew Cashin & Jacqueline Fong & Mary Hughes & Aine McHugh, 2020. "“Providing a complete episode of care”: A survey of registered nurse and registered midwife prescribing behaviours and practices," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(1-2), pages 152-162, January.
    • Handle: RePEc:wly:jocnur:v:29:y:2020:i:1-2:p:152-162
    DOI: 10.1111/jocn.15073
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    References listed on IDEAS

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    1. Gerard Fealy & Mary Casey & Daniela Rohde & Anne‐Marie Brady & Josephine Hegarty & Catriona Kennedy & Martin McNamara & Pauline O'Reilly & Geraldine Prizeman, 2015. "Scope of practice decision making: findings from a national survey of Irish nurses and midwives," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(19-20), pages 2871-2880, October.
    2. Gerard M Fealy & Daniela Rohde & Mary Casey & Anne‐Marie Brady & Josephine Hegarty & Catriona Kennedy & Martin McNamara & Pauline O'Reilly & Geraldine Prizeman, 2015. "Facilitators and barriers in expanding scope of practice: findings from a national survey of Irish nurses and midwives," Journal of Clinical Nursing, John Wiley & Sons, vol. 24(23-24), pages 3615-3626, December.
    3. Anecita Gigi Lim & Nicola North & John Shaw, 2018. "Beginners in prescribing practice: Experiences and perceptions of nurses and doctors," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(5-6), pages 1103-1112, March.
    4. Roisin Lennon & Anne Fallon, 2018. "The experiences of being a registered nurse prescriber within an acute service setting," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(3-4), pages 523-534, February.
    5. Nicola Carey & Molly Courtenay, 2010. "An exploration of the continuing professional development needs of nurse independent prescribers and nurse supplementary prescribers who prescribe medicines for patients with diabetes," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(1‐2), pages 208-216, January.
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