Nurses' view on nurse prescribing in Sweden : A mixed method study

Sammanfattning

Background: Prescribing authority for nurses has existed in Sweden since 1994 and is established in more than 40 countries worldwide. Previous studies indicate limited use of nurse prescribing in Sweden compared with several other countries. Motive: Previous Swedish studies have primarily focused on prescribing patterns, while international research has examined the effectiveness and safety of nurse prescribing. There is limited knowledge regarding nurses’ views and perspectives on the Swedish prescribing authority as well as desired changes. Aim: The aim of the study was to explore nurses’ views on nurse prescribing in Sweden Methods: A mixed-methods approach with a convergent design was employed. A survey was completed by nurses with prescribing authority. A smaller subset of these participants also took part in semi-structured interviews. Survey data were analysed using descriptive statistics and correlation analysis, while interviews were analysed using qualitative content analysis with an inductive and manifest approach. Results: Prescribing frequency varied, and 50% of the nurses considered the list of medications to be insufficient. No clear associations were observed between years of experience, prescribing frequency, and perceived sufficiency of the medication list. Four categories emerged from the interviews: Nurse prescribing as a resource in different operational contexts, Balance between regulations, economics and patient benefit, Professional identity as reflected through nurse prescribing and Future development of nurse prescribing. Further insight, through the integration of interview- and survey data, showed that prescribing was largely dependent on clinical context, and that perceived competence and confidence, rather than years of professional experience, influenced its use. Conclusion: Nurses’ views on nurse prescribing are closely linked to clinical context. An expansion of nurse prescribing may influence continued professional development for nurses. Future research should focus on the impact of clinical roles, as well as attitudes toward and the safety of an expanded prescribing authority.