Independent Extended and Supplementary Nurse Prescribing Practice in the UK: A National Questionnaire Survey

University of Reading, UK.
International Journal of Nursing Studies (Impact Factor: 2.9). 10/2007; 44(7):1093-101. DOI: 10.1016/j.ijnurstu.2006.04.005
Source: PubMed


Nurses are able to prescribe independently from a list of nearly 250 prescription only medicines for a range of over 100 medical conditions or, from the whole British National Formulary as a supplementary prescriber. There is some evidence available on the prescribing practices of district nurses and health visitors and early independent extended prescribers. Little or no attention has focussed on supplementary nurse prescribing.
To provide an overview of the prescribing practices of independent extended/supplementary nurse prescribers and the factors that facilitate or inhibit prescribing.
National questionnaire survey.
United Kingdom.
A convenience sample of 868 qualified independent extended/supplementary nurse prescribers self-completed a written questionnaire.
A total of 756 (87%) used independent extended prescribing; 304 (35%) used supplementary prescribing to treat a range of chronic conditions (including asthma, diabetes and hypertension); 710 (82%) nurses worked in primary care. Nurses in general practice reported the largest number of reasons preventing prescribing. Reasons included the inability to computer generate prescriptions and to implement the Clinical Management Plan. Nurses in primary care reported more continuing professional development needs. These needs included update on prescribing policy and the treatment management of conditions. A total of 277 (32%) nurses were unable to access continuing professional development.
Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines. These nurses are highly qualified and have many years clinical experience. Supplementary prescribing is used by a minority of nurses. Implementing the Clinical Management Plan is a barrier preventing the use of this mode of prescribing. The continuing professional development needs of independent extended/supplementary nurse prescribers are frequently unmet. It will become increasingly important that these needs are met once nurses are able to prescribe the full range of medicines included in the British National Formulary, limited only by their area of competence.

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Available from: Molly Courtenay, Aug 26, 2014
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    • "Restrictions to medication access can be reviewed as a major barrier ( Courtenay et al . , 2006 ) ; however after 2 INP left the ED the benefits of having active PGDs were emphasised as the remain - ing nursing staff had independent access to medication despite not being INP . This is particularly important as statistical tests from the main study ( Black , 2012 ) have shown a significant association be - tween having access to me"
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    ABSTRACT: AIM: To explore nurse prescribing in an emergency department using patient group directions versus independent nurse prescribing. BACKGROUND: Patient group directions allow restricted access to medication in unselected patients using pre-set criteria. Independent nurse prescribing is a flexible method of medication provision. Limited data exists on the application of either method in clinical practice. METHODS: Exploration of patient group directions and independent nurse prescribing application in an emergency department using 617 nurse practitioners' clinical notes; 235 and 382 respectively. Patient attendances from 01/07/2009 to 30/06/2010 were randomly sampled. Prescribing frequency; range of medications and diagnoses; independent episode completion and prescribing safety was explored. RESULTS: Statistical difference exists in prescribing frequency between the independent nurse prescribers (51.6%, n=197) and patient group directions (32.3%, n=76). Appropriate medication given by 99.7% (n=381) of independent nurse prescribers, with 1 contraindicated drug provided. The limitations of patient group directions was highlighted in 11.8% (n=9) of cases, however all drugs given were appropriate for the diagnosis. No statistical difference in independent episode completion. CONCLUSIONS: Nurses provide appropriate medication in an emergency department. Patients being managed by nurse prescribers were more likely to receive medication. Further investigation is required to justify this.
    Full-text · Article · May 2013 · International emergency nursing
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    • "Si se analiza el modelo de prescripción colaborativo o dependiente, es posible compararlo con la Nurse Supplementary Prescribing [47] (NSP), la cual puede, después de que un prescriptor independiente (médico u odontólogo) haga una valoración, diagnóstico y tratamiento médico individualizado con una serie de fármacos pautados (normalmente a un enfermo crónico), prescribir cualquiera de los fármacos incluidos en el plan, aunque éstos no se encuentren en el formulario cerrado de medicamentos que puede prescribir la NIP. Cada una de estas capacitaciones prescriptoras requiere una acreditación, tanto la NIP como la NSP, y en el Reino Unido existen más de 10.000 enfermeras que poseen ambas [48]. En los artículos encontrados para esta revisión ocurre un hecho curioso puesto que varios autores afirmaban que la PE se realizaba a diario [3] [20] [25] [26] [31] [33] [34] [38] [39], pero en nuestro país no existe, prácticamente, literatura sobre la eficacia o los beneficios sobre la salud de los usuarios de una PE. "
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    ABSTRACT: To describe and to summarize the content of publications in scientific journals on nurse prescribing in Spain A literature review Database searches: CINAHL, CUIDEN, ENFISPO, IBECS and PubMed were searched for articles published between January 2000 and March 2010. It also included an editorial in a journal indexed in any of the above databases, whose content was not only nursing prescribing in Spain. Any type of publication (studies, opinion articles, editorials or letters to the editor) about the PE, which was indexed in one of the databases mentioned above. We included 24 articles published in: a) the alegal stage when there was no clear jurisdiction over the drugs' prescription and medical devices by nurses (5 articles); b) the illegal when legally regulated that nurse prescribing was illegal (17 articles); c) the legal stage, when it ruled that the nurses could prescribe (2 items). 96 articles were excluded. The vast majority of the articles are favorable views of nurse prescribing. It proposes an independent nurse prescribing and a collaborative nurse prescribing role to improve the quality of healthcare offered. Pharmacology training is needed in university education and during the development of nurse career Nurse prescribing is a necessity for the full autonomy of the nursing profession in Spain, since the nurse can't provide their care without the power to prescribe medicinal products. Studies are needed to demonstrate the benefits and effectiveness of nurse prescribing.
    Full-text · Article · Jun 2011 · Revista de enfermeria (Barcelona, Spain)
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    • "Previous studies have found a small percentage of non medical prescribers never use their qualification, or let it lapse (Latter et al, 2005; Courtenay et al, 2007). Other studies have reported a higher percentage of nurses (Larsson, 2004; Courtenay & Carey 2008a) and particularly pharmacists (George et al, 2007; Baquir et al 2010), which is a similar effect as reported by the first studies of health visitor or district nurses. "

    Full-text · Article · Jul 2010
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