Independent extended and supplementary nurse prescribing practice in the UK: a national questionnaire survey.
BACKGROUND
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.


OBJECTIVE
To provide an overview of the prescribing practices of independent extended/supplementary nurse prescribers and the factors that facilitate or inhibit prescribing.


METHODS
National questionnaire survey.


METHODS
United Kingdom.


METHODS
A convenience sample of 868 qualified independent extended/supplementary nurse prescribers self-completed a written questionnaire.


RESULTS
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.


CONCLUSIONS
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.
Courtenay
Molly
M
University of Reading, UK. m.courtenay@reading.ac.uk
Carey
Nicola
N
Burke
Joanna
J
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003152:Community Health Nursing; D032022:Delegation, Professional; D011307:Drug Prescriptions / Q000451:nursing* / Q000706:statistics & numerical data; D004509:Education, Nursing, Continuing; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008875:Middle Aged; D009718:Nurse Administrators; D009720:Nurse Clinicians; D009722:Nurse Practitioners; D024802:Nurse's Role / Q000523:psychology; D009726:Nurses / Q000458:organization & administration / Q000523:psychology; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D010602:Pharmacopoeias as Topic; D011320:Primary Health Care; D017009:Professional Autonomy; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D006113:United Kingdom