Programmaleider Verpleging, Verzorging en Ouderenzorg; bijzonder hoogleraar 'Verpleging en verzorging in de laatste levensfase', Vrije Universiteit / Amsterdam UMC
Publicatie
Substitution of prescribing tasks from doctors to nurses: an international expert survey on forces, conditions and jurisdictional control.
Kroezen, M., Francke, A.L., Groenewegen, P.P., Dijk, L. van. Substitution of prescribing tasks from doctors to nurses: an international expert survey on forces, conditions and jurisdictional control. European Journal of Public Health: 2011, 21(suppl. 1) Abstract. 4th European Public Health Conference: 'Public Health and Welfare - Welfare Development and Public Health' 9-12 november 2011, Copenhagen.
Background: Nurse prescribing is highly relevant in the current climate of cost containment and task substitution in health care, and is being introduced in a growing number of countries. However, international comparisons are scarce. This survey aims to provide a comprehensive and recent overview of the organization of nurse prescribing internationally and the ensuing division of urisdictional control between the medical and nursing professions. Moreover, this study pays attention to the forces which different stakeholders see as being important for the introduction of nurse prescribing and hypothesizes on their influence on the actual organization of nurse prescribing. Methods: An email questionnaire was sent to 60 representatives 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. Data were analyzed descriptively, including calculations of response frequency and percentages. Results: The response rate was 65% (N = 39). It was shown that a diversity of forces led to the introduction of nurse prescribing. However, differences were found between representatives of nurses organizations, medical organizations and government bodies regarding the number and kind of forces they cited as being important for the introduction of nurse prescribing. Moreover, it was shown that the conditions under which nurses prescribe medicines vary considerably, from countries where nurses are allowed to prescribe independently to countries in which prescribing by nurses is only allowed under strict conditions and supervision of physicians. Conclusions: Stressing certain forces as important for the introduction of nurse prescribing, seems to be a strategy of the different parties involved to influence the actual organization of nurse prescribing in practice. Furthermore, even though we found differences in the organization of nurse prescribing internationally, in most countries nurses prescribe in a subordinate position. Hence, the jurisdiction over prescribing remains predominantly with the medical profession. (aut. ref.)
Background: Nurse prescribing is highly relevant in the current climate of cost containment and task substitution in health care, and is being introduced in a growing number of countries. However, international comparisons are scarce. This survey aims to provide a comprehensive and recent overview of the organization of nurse prescribing internationally and the ensuing division of urisdictional control between the medical and nursing professions. Moreover, this study pays attention to the forces which different stakeholders see as being important for the introduction of nurse prescribing and hypothesizes on their influence on the actual organization of nurse prescribing. Methods: An email questionnaire was sent to 60 representatives 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. Data were analyzed descriptively, including calculations of response frequency and percentages. Results: The response rate was 65% (N = 39). It was shown that a diversity of forces led to the introduction of nurse prescribing. However, differences were found between representatives of nurses organizations, medical organizations and government bodies regarding the number and kind of forces they cited as being important for the introduction of nurse prescribing. Moreover, it was shown that the conditions under which nurses prescribe medicines vary considerably, from countries where nurses are allowed to prescribe independently to countries in which prescribing by nurses is only allowed under strict conditions and supervision of physicians. Conclusions: Stressing certain forces as important for the introduction of nurse prescribing, seems to be a strategy of the different parties involved to influence the actual organization of nurse prescribing in practice. Furthermore, even though we found differences in the organization of nurse prescribing internationally, in most countries nurses prescribe in a subordinate position. Hence, the jurisdiction over prescribing remains predominantly with the medical profession. (aut. ref.)
