title: Dutch travel health nurses: prepared to prescribe?
abstract: BACKGROUND
  In travel medicine, as in other specialties, independent prescribing of medication has traditionally been the domain of practitioners like physicians, dentists, and midwives. However, a 2011 ruling in the Netherlands expands independent prescribing and introduces supplementary prescribing by nurses, with expected implementation over the next few years. As specialist nurses will not be eligible for independent prescribing, this study addresses supplementary prescribing, specifically by travel health nurses. Such nurses will work in partnership with an independent prescriber, usually a physician. After the physician evaluates a patient's condition and needs, the nurse may prescribe from an open or limited formulary. This supplementary approach seems appropriate in travel medicine, which is highly protocolized. A questionnaire survey was conducted to assess whether travel health nurses themselves aspire and feel competent to prescribe, and what training they might need.
  
  
  METHODS
  All travel health nurses in the Netherlands received a questionnaire seeking their anonymous response.
  
  
  RESULTS
  The response rate was 58%. Self-reported compliance with protocols and quality criteria was high; 82% of respondents aspire to prescribe and 77% feel competent to prescribe. Of the latter, 22% indicated that ongoing access to a doctor would remain important, and 14% preferred to prescribe under certain conditions like a restricted number of medicines. The reason most frequently given for not feeling competent was the need for additional education before obtaining prescribing rights (40%). Aspiration to prescribe was the only significant predictor for feeling competent to prescribe (odds ratios: 6.8; 95% confidence intervals: 3.5-13). Of all the responding nurses, 95% reported one or more educational needs related to prescribing, particularly in pharmacology.
  
  
  CONCLUSIONS
  Most Dutch travel health nurses aspire to prescribe and feel competent for the supplementary approach, but require further education before the approach is implemented in travel medicine.
authors: National Coordination Centre for Traveler's Health Advice (LCR), Amsterdam, The Netherlands. foverbosch@ggd.amsterdam.nl
authors: Femke W
authors: FW
authors: Overbosch
authors: Susan C
authors: SC
authors: Koeman
authors: Anneke
authors: A
authors: van den Hoek
authors: Gerard J B
authors: GJ
authors: Sonder
mesh_terms: D011307:Drug Prescriptions / Q000451:nursing*; D004509:Education, Nursing, Continuing; D019538:Health Care Surveys; D006801:Humans; D020380:Needs Assessment; D009426:Netherlands; D009722:Nurse Practitioners / Q000592:standards*; D024802:Nurse's Role; D009726:Nurses; D017009:Professional Autonomy; D011361:Professional Competence / Q000592:standards*; D057566:Self Report; D011795:Surveys and Questionnaires; D057236:Travel Medicine / Q000379:methods / Q000592:standards; D000078329:Workforce