title: Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a survey on forces, conditions and jurisdictional control.
abstract: BACKGROUND
  The number of Western European and Anglo-Saxon countries where nurses are legally allowed to prescribe medicines is growing. As the prescribing of medicines has traditionally been the task of the medical profession, nurse prescribing is changing the relationship between the medical and nursing professions.
  
  
  OBJECTIVE
  To gain more insight into the forces that led to the introduction of nurse prescribing of medicines in Western European and Anglo-Saxon countries, as well as into the legal, educational and organizational conditions under which nurses prescribe in these countries. Moreover, this study sought to determine which consequences nurse prescribing has for the division of jurisdictional control over prescribing between the nursing and medical professions.
  
  
  METHODS
  International survey.
  
  
  METHODS
  An email survey was sent to 60 stakeholders of professional nursing or medical associations or government bodies, at national, state or provincial level across ten Western European and Anglo-Saxon countries, namely Australia, Canada, Finland, Ireland, the Netherlands, New Zealand, Spain, Sweden, the United Kingdom and the United States of America.
  
  
  METHODS
  The survey addressed the reasons for the introduction of nurse prescribing and the conditions under which nurses are or will be prescribing medicines.
  
  
  RESULTS
  The response rate was 65% (n=39). It was shown that a diversity of forces led to the introduction of nurse prescribing, and respondents from nursing and medical associations and government bodies cited different forces as being important for the introduction of nurse prescribing. Representatives of nurses' associations oftentimes emphasized the medication needs of patients living in remote geographical areas, while representatives of medical associations more often pointed to workforce shortages within the health care service. The conditions under which nurses prescribe medicines vary considerably, from countries where nurses prescribe independently to countries in which prescribing by nurses is only allowed under strict conditions and the supervision of physicians.
  
  
  CONCLUSIONS
  Citing different forces as being important in the introduction of nurse prescribing can be conceived as a professional 'problem construction' in order to gain jurisdiction over the prescribing task. In most countries, nurses prescribe in a subordinate position and the jurisdiction over prescribing remains predominantly with the medical profession.
authors.affiliation: NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500 BN Utrecht, The Netherlands. M.Kroezen@nivel.nl
authors.forename: Marieke
authors.initials: M
authors.lastname: Kroezen
authors.forename: Anneke L
authors.initials: AL
authors.lastname: Francke
authors.forename: Peter P
authors.initials: PP
authors.lastname: Groenewegen
authors.forename: Liset
authors.initials: L
authors.lastname: van Dijk
mesh_terms: D044362:Australasia; D011307:Drug Prescriptions; D004358:Drug Therapy / Q000451:nursing*; D004335:Drug and Narcotic Control; D004506:Education, Nursing; D005060:Europe; D019538:Health Care Surveys; D006801:Humans; D009656:North America; D009722:Nurse Practitioners; D024802:Nurse's Role; D019555:Physician-Nurse Relations; D057184:Practice Patterns, Nurses'; D017009:Professional Autonomy