Nurse prescribing in low-resource settings: professional considerations.
OBJECTIVE
This paper reviews the professional issues relating to nurse prescribing in low-resource countries.


BACKGROUND
In order to meet community healthcare need, nurses in low-resource settings often perform roles such as prescribing medication, for which they may not have had adequate training, often in the absence of supervision, legislation and regulation. In general, however, there is a paucity of published evidence relating to nurse prescribing in low-resource settings. Several studies have demonstrated improved health and social outcomes resulting from nurse-prescribing interventions. Alternatively, other studies have shown unsatisfactory nurse-prescribing patterns, such as overuse of antibiotics and poor adherence to national treatment guidelines. There are several examples of how nurse prescribing in low-resource countries has been recognized and addressed at national level; these are discussed in detail. However, given that it is widely acknowledged how crucial nurses are for the delivery of health care in regions where there are no medical personnel, international policy and guidance relating to this issue is only just beginning to acknowledge and address the relevant issues.


CONCLUSIONS
Where there is a need for nurses to extend their role in the ordering of medicines and other treatments, the responsibilities, training, rights and roles of these nurses need to be clearly defined and recognized at all levels of the health service. There is a need for rigorous evaluations incorporating health, social and economic outcomes of nurse-prescribing interventions, in addition to close monitoring of legislative and regulatory changes related to nursing roles.
Miles
K
K
Camden Primary Care Trust/Centre for Sexual Health and HIV Research, Royal Free and University College Medical School, University College London, London, UK. kmiles@gum.ucl.ac.uk
Seitio
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McGilvray
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D003906:Developing Countries; D011307:Drug Prescriptions / Q000451:nursing*; D004358:Drug Therapy / Q000451:nursing*; D004335:Drug and Narcotic Control; D006291:Health Policy; D006801:Humans; D024802:Nurse's Role; D017009:Professional Autonomy; D011787:Quality of Health Care; D012449:Safety