Increased Accessibility to Primary Healthcare Due to Nurse Prescribing of Medicines

Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe medicines. Consequently, Polish patients received the same opportunity as in other countries worldwide: easier access to certain health services, i.e., medical prescribing. The aim of this study was to assess the impact of structural changes which increased the nurses’ competences on the accessibility to prescription visits for patients receiving primary healthcare on the example of Medical and Diagnostic Centre (MDC), and to discuss the general trend of legal changes in nursing profession regulations. We performed a detailed analysis of the data on the MDC patient population in Siedlce who received at least one prescription written by a general practitioner and/or a nurse/midwife in the years 2017–2019.The largest number of prescription visits made by nurses concerned patients aged 50–70 years, as this age range includes the largest number of patients with chronic diseases who need continued pharmacological treatment originally administered by doctors. An increasing tendency for prescription visits made by nurses was recorded, with a simultaneous downward trend in the same type of visits undertaken by doctors at MDC. Nurses’ involvement in prescribing medications as a continued pharmacotherapy during holiday seasons results in patients having continuous access to medication. An upward trend was also observed in the number of medications prescribed by nurses per patient. Structural changes in the legal regulations of the nursing profession improve patients’ access to prescription visits under primary healthcare. Further research is recommended to evaluate the dynamics of these trends and the impact of newly introduced nursing competences on the accessibility of prescription visits for patients.

Experiences of advanced psychiatric nurses regarding the need for prescriptive authority in KwaZulu-Natal

Background: Nurse prescribing has become a global and transformational practice to ensure the achieving of optimal health outcomes, including advanced psychiatric nurses. Despite the transformational practice globally, South Africa seems to lag behind because nurses do not have permission to prescribe medication.Aim: To describe the experiences of advanced psychiatric nurses regarding the need to prescribe medication treatment in KwaZulu-Natal.Setting: The study took place in three mental healthcare institutions in KwaZulu-Natal in inpatient units.Method: The qualitative, descriptive design was used to collect the experiences of advanced psychiatric nurses in KwaZulu-Natal regarding the need for prescriptive authority. Six focus group interviews were conducted to gather information. The seven steps of Colaizzi’s method were used to analyze the data.Results: The study found two primary themes and two sub-themes. The findings highlighted the necessity for advanced psychiatric nurse role recognition and prescribing. Insufficient use of skilled psychiatric nurses caused delays in addressing mental health patients in emergencies.Conclusion: The two themes, prescribing role of advanced psychiatric nurses and role recognition, revealed that granting advanced psychiatric nurses’ autonomy to prescribe remained a challenge. Advanced psychiatric nurses are expected to provide high-quality care, but they are limited in their abilities. Because advanced psychiatric nurses are not used to prescribe in KwaZulu-Natal, they rely on psychiatrists to manage psychotic patients.Contribution: The evaluation of policies and procedures that guide advanced psychiatric nurses in prescribing psychotropic medications.

Competences of polish nurses in the field of prescribing medications: A systematic review

Purpose: The purpose of the following systematic review is to present polish regulations in terms of education, acquiring competencies in the field of prescribing drugs and medical devices. Methodology: The following review can be helpful to conduct comparative meta-analyses. Internet System of Legal Acts, PubMed, Google Scholar research was used to analyze the topic. The selected keywords were used to find information sources: law, competence, nurse, prescribing, medication, medical devices. Articles were selected according to regulations in Poland in terms of education, acquiring competencies in the field of prescribing drugs and medical devices. Main findings: The increase in nurses' competencies is equivalent to a greater need for knowledge and new knowledge acquired. Nurses take part not only in care and treatment, but also takes independent actions. In such enormous responsibilities, it is crucial to focus on the development of skills. Thus, a competent nurse is interested in continuous professional and personal growth and provides patients with high-quality nursing trustees. Implications of this study: The results should be considered in health care units, especially Primary Healthcare Units. The paper indicates the regulations in terms of education, acquiring competencies in the field of prescribing drugs which should be revised by personnel and implemented to improve the work of the healthcare unit. Novelty in this study: There is a lack of systematic reviews of the regulations in Poland in terms of education, acquiring competencies in the field of prescribing drugs and medical devices. The paper is an attempt to assess the topic.

Nurse prescribing in end-of-life care in the community: meeting patients' needs

This article outlines the important role of medicines in managing community-based palliative care in the last year of life, together with the central role of nurses prescribing in this context. The article discusses the key needs of patients and carers managing palliative care medicines in the home setting, which include a requirement for streamlined, rapid access to medicines, as well as information about and support for daily self-management of medicines. The article draws on recent research in the field of palliative care medicines management and highlights the implications for nurse prescribers.

Current Challenges Lack of the legality of Nurse Prescribing in Intensive Care Units: A Qualitative Study

Background Nurse prescribing is a successful innovation in the role of nurses in the world. It is crucial to assess the challenges of nurse prescribing roles in the Intensive Care Units (ICU), due to the needs of the patients in these units. This qualitative study aimed was to explore the experts’ experiences regarding lack of the legality of nurse prescribing in ICU in the healthcare system of Iran. Methods Data were collected through semi structured face-to-face interviews with 33 experts chosen according to purposive and snowballing sampling with maximum variation. The interviews were analysed using Graneheim and Lundman's conventional content analysis method. After overviewing the interviews, semantic units, codes, subcategories, categories and themes were extracted. The qualitative data were analysed using MAXQDA software version 10. Results The main theme of the study was “The current challenges due to the illegality of nurse prescribing” with five categories and 12 subcategories. The five categories included the "current reality of illegal prescribing", "patient safety threat", "current conflicts", "physician as an autocratic group," and "prescribing demands." Conclusion Despite the nurse prescribing role has been legalized and implemented in many countries, there is still no law in the ICU and other places in Iran, and this lack of legality has led to the conflicts and challenges for the patients, nurses and healthcare system. The legality of nurse prescribing in the ICU can prevent medication errors and endangering patient safety.

Prescribing practice: an overview of the principles

Nurse prescribing has become a well-established aspect of advanced clinical practice working alongside key NHS principles and drivers to address the increasing complexities in patient care and the demands on the health service. Prescribing practice is governed by ethical and legal principles to ensure a holistic patient-centred approach. It has been recognised as a valuable resource that could effectively transform healthcare services to reduce hospital admissions and long hospital stays and improve the quality of life for patients with long-term conditions and multiple comorbidities. This article will provide an overview of prescribing practice.

Iranian nurses’ attitudes towards the necessity and barriers to developing nurse prescribing roles

Background Prescribing medication by nurses as an approach to rational drug prescription has been proposed in many countries. Nursing prescribing is an effective measure in the management of critically ill patients admitted to intensive care units (ICU). This study investigated the attitude of ICU nurses towards the necessity and the barriers to developing nursing prescribing. Materials and methods In this cross-sectional study, 136 ICU nurses were included by stratified random sampling. The data collection tool was the researcher-made questionnaire. Cronbach’s alpha method was used to evaluate the reliability of the instrument. The validity of the instrument was also verified by the content validity method. To collect the data, the researcher referred to the nurses’ workplace and provided them with a questionnaire and collected it after completion.The collected data were analyzed by IBM SPSS 16 using descriptive and inferential statistics. Results It was revealed that 58.8 % of nurses were familiar with the term ‘nursing prescribing’; a majority (92.1 %) of whom considered it vital to develop this role in the ICU. Moreover, 86 % (n = 98) of the nurses assumed that it is possible to implement this role in ICU. The most potential barriers to its implementation were lack of legitimacy, disapproval of physicians, and the reluctance of nursing managers. Conclusions Most nurses maintained a positive attitude towards nursing prescribing; hence, its legitimacy seems vital in ICUs. For the development of the ‘nurse prescribing’ role, the Nursing System Organization may be helpful.