title: Why do district nurse prescribers alter their prescribing patterns?
abstract: This paper describes how district nurses decide what products to start prescribing and explores the reasons why prescribing patterns change. It is based on semi-structured interviews with fourteen nurses from one primary care trust. The first products prescribed immediately following qualification depended on the route taken to becoming a prescriber. These were either the same products they had been using before qualifying as a prescriber or if prescribing was included with their district nurse training then it was the same products that their mentor prescribed. The two drivers for changes in prescribing patterns were patients, whose current therapy was ineffective, and products, where patients were selected to try new products on. Representatives from the pharmaceutical industry and fellow nurses had the greatest influence on product selection for those prescribers that changed their prescribing. The nurse's own experience had the greatest impact on the decision to continue prescribing a new product.
authors.affiliation: School of Pharmaceutical Sciences, University of Manchester, Manchester, UK. jason.hall@manchester.ac.uk
authors.forename: Jason
authors.initials: J
authors.lastname: Hall
authors.forename: Peter
authors.initials: P
authors.lastname: Noyce
authors.forename: Judith
authors.initials: J
authors.lastname: Cantrill
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003657:Decision Making; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008611:Mentors; D024802:Nurse's Role / Q000523:psychology*; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D009936:Organizational Innovation; D018579:Patient Selection; D055656:Prescriptions / Q000451:nursing*; D011320:Primary Health Care / Q000458:organization & administration; D017009:Professional Autonomy; D011637:Public Health Nursing / Q000193:education / Q000458:organization & administration*; D036301:Qualitative Research; D012449:Safety; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom