Int J Pharm Pract 2002:10:273-80
School of Nursing, Midwifery & Health Visiting, Coupland Building III, University of Manchester, Oxford Road, Manchester, England M13 9PL
Karen A. Luker, PhD, RHV, professor of community nursing
Gretl A. McHugh, MSc, RHV, research fellow
Correspondence: Professor Luker
Original Papers
Nurse prescribing from the community nurse's perspective
KAREN A. LUKER and GRETL A. McHUGH
Background — Since
1994, district nurses and health visitors in the United Kingdom
have been able to prescribe from a limited formulary. Items which
are prescribed by these nurses are wound care products, incontinence
appliances and medicinal preparations such as paracetamol and emollients.
There is a planned expansion of prescribing by nurses, in terms
of both the range of products and drugs that are prescribable and
the types of nurses eligible for training for this new role.
Objective — To investigate patterns of nurse prescribing
among community nurses in three primary care trusts in the United
Kingdom.
Methods — Postal survey to 164 community nurses who were
qualified to prescribe. Responses were received from 129 (79
per cent) with 35 nurses identifying themselves as not prescribing
and excluded from the sample; 93 (72 per cent) of the questionnaires
were entered on a database for analysis.
Key findings — Prescribing costs for district nurses ranged
from £7.65 to £18,053 (median £2,023.64) and for health visitors
from £0.73 to £2,556 (median £42.77) for a 12-month period. Nineteen
per cent (n=28) of community nurses had decided not to prescribe
even though they were trained to do so. Infrastructures and mechanisms
to support nurses with nurse prescribing have been slow to emerge.
Nurses perceived that their ability to prescribe was benefiting
their patients and that they were providing better care. Community
nurses cautiously welcomed the proposed extension of nurse prescribing.
Conclusions — Nurse prescribing has allowed community
nurses more autonomy in managing a patient's total care. Our
findings suggest that around one-quarter of nurses qualified
to prescribe are not doing so. With the imminent extension of
nurse prescribing for other nurses, action is needed by primary
care trusts to put structures in place to ensure that nurses
take on board this extension and challenge to their role.