Patients' level of satisfaction and self-reports of intention to comply following consultation with nurses and midwives with prescriptive authority: a cross-sectional survey.
BACKGROUND
Prescriptive authority for nurses and midwives was introduced in Ireland in 2007. This allows nurses and midwives who have completed a prescribing preparation programme to independently prescribe a wide-range of medications. To date little is known of patient outcomes such as satisfaction with the consultation process and intention to comply as a consequence of the introduction of nurse and midwife prescribing.


OBJECTIVE
There are four principal objectives within this study: (1) to measure the level of patients' satisfaction with education and advice received from a nurse or midwife with a prescribing remit; (2) to measure patients' satisfaction with the consultation process; (3) to measure patients' self-reports of their intention to comply with the prescriber's prescription and advice; and (4) to identify the variables that predict patients' intention to comply with the prescription and advice provided by a nurse or midwife with prescriptive authority.


METHODS
Cross-sectional descriptive survey.


METHODS
A total of one hundred and forty respondents completed the survey. Respondents consisted of adult patients who had received a prescription from a nurse prescriber in a general hospital, women who had received a prescription from a midwife in a maternity hospital and parents whose child received a prescription from a nurse in a children's hospital.


METHODS
Instruments used to measure patient outcomes included the Consultation Satisfaction Questionnaire (CSQ) and the compliance intent subscale of the Medical Interview Satisfaction Scale (MISS). A linear multiple regression model was performed to identify the variables that predicted patients' intent to comply.


RESULTS
Patients and parents surveyed were highly satisfied with the care they received from nurses and midwives with prescriptive authority. Respondents also reported that they received comprehensive education and advice. Predictors of compliance intent included patient satisfaction with the time spent with the nurse or midwife during the prescribing consultation, overall satisfaction with the consultation process and patients' health status.


CONCLUSIONS
Extending a prescribing remit to nurses and midwives has been an effective addition to the provision of health care. Providing patients with time to address their questions and concerns during the consultation process impacts positively on patient outcomes and develops a philosophy of concordance between the patient and nurse/midwife prescriber.
School of Nursing, Midwifery and Health Systems, University College Dublin, Belfield, Dublin 4, Ireland. Jonathan.Drennan@ucd.ie
Jonathan
J
Drennan
Corina
C
Naughton
Deirdre
D
Allen
Abbey
A
Hyde
Kathy
K
O'Boyle
Patrick
P
Felle
Margaret Pearl
MP
Treacy
Michelle
M
Butler
D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009721:Nurse Midwives; D009723:Nurse-Patient Relations; D009726:Nurses; D010349:Patient Compliance; D017060:Patient Satisfaction; D011247:Pregnancy