Nurses’ Experiences of Practical Challenges Associated with Nurses’ Prescription: A Qualitative Study

Kurosh Jodaki, Mohammad Abbasi, Nahid Dehghan Nayeri

Abstract


Background: Because nurse prescription has numerous benefits for the health systems, in many countries around the world, nurses are given the right to prescribe medication. In Iran, the role of nurses in prescription drugs is not well understood, and nurses face various challenges in this regard.

Materials and Methods: A qualitative content analysis methodology based on the Graneheim and Lundman model was used. Thirteen nurses working in medical wards of hospitals affiliated with the Tehran University of Medical Science were selected to participate in this study by purposeful sampling. Participants were interviewed via telephone using a semi‑structured tool. After thirteen interviews, data saturation was reached. Data collection was undertaken between April 2020 and April 2021.

Results: The results of this study are summarized in one theme, four categories, and ten subcategories. The theme extracted from the data analysis was “the practical challenges of nurse prescription,” which included four main categories: structure challenges, personnel‑related barriers, interprofessional separation, and society’s attitudes.

Conclusions: The results of this study explain the barriers and practical challenges of nurse prescription in Iran. Identifying these challenges and barriers provides the necessary evidence for policymakers to remove and adjust these challenges and barriers. Moreover, the elimination of identified challenges will help nurses better perform their new roles and develop the nursing scope and profession.



Keywords


Iran, nurses, prescription, qualitative study

Full Text:

PDF

References


Berman A, Snyder SJ, Kozier B, Erb GL, Levett Jones T, Dwyer T, et al. Kozier and Erb’s Fundamentals of Nursing Australian edition. Pearson Higher Education AU; 2021.

Fong J, Buckley T, Cashin A. Nurse practitioner prescribing: an international perspective. Nursing: Research and Reviews. 2015; 5: 99-108.

Kroezen M, van Dijk L, Groenewegen PP, Francke AL. Knowledge claims, jurisdictional control and professional status: The case of nurse prescribing. PLoS One 2013;8:e77279.

Arian M, Nobahar M, Raiesdana N, Oghazian MB. Identifying the fields of activity, challenges and positive outcomes of nursing prescription: A systematic review. Hayat. 2018;24:279-95.

Summers RE, East L. Nurse prescribing: Developing confidence, autonomy and collaboration. Primary Health Care 2022;3;32.

Maier CB. Nurse prescribing of medicines in 13 European countries. Hum Resour Health 2019;17:1 10.

Sangster Gormley E. Prescribing patterns of nurse practitioners in Canada. CMAJ 2016;188:173 4.

Gielen SC, Dekker J, Francke AL, Mistiaen P, Kroezen M. The effects of nurse prescribing: A systematic review. Int J Nurs Stud 2014;51:1048 61.

Kroezen M, van Dijk L, Groenewegen PP, de Rond M, de Veer AJ, Francke AL. Neutral to positive views on the consequences of nurse prescribing: Results of a national survey among registered nurses, nurse specialists and physicians. Int J Nurs Stud 2014;51:539 48.

Kroezen M, van Dijk L, Groenewegen PP, Francke AL. Nurse prescribing of medicines in Western European and Anglo Saxon countries: A systematic review of the literature. BMC Health Services Research 2011;11:1 17.

Zarzeka A, Panczyk M, Belowska J, Mazur N, Lourido BP, Gotlib J. Nurse prescribing: Attitudes of medical doctors towards expanding professional competencies of nurses and midwives. J Pak Med Assoc 2019;69:1199 204.

Courtenay M, Carey N, Gage H, Stenner K, Williams P. A comparison of prescribing and non prescribing nurses in the management of people with diabetes. J Adv Nurs 2015;71:2950 64.

Courtenay M. An overview of developments in nurse prescribing in the UK. Nurs Stand 2018;33:40 4.

Han S F, Zhu R F, Han H H. A research report on the prescription rights of Chinese nurses. Chinese Nurs Res 2015;2:12 23.

Darvishpour A, Joolaee S, Cheraghi MA. The necessity of nursing prescription from the perspectives of nursing policymakers. J Qual Res Health Sci 2020;5:56 70.

Ruotsalainen H, Kyngäs H, Tammelin T, Kääriäinen M. Systematic review of physical activity and exercise interventions on body mass indices, subsequent physical activity and psychological symptoms in overweight and obese adolescents. J Adv Nurs 2015;71:2461 77.

Polit D, Beck C. Essentials of Nursing Research: Appraising Evidence for Nursing Practice. 10th ed. Wolters Kluwer Health; 2020.

Faseleh Jahromi M, Moattari M. Prescriptive authority for Iranian nurses: A qualitative study. IJNR 2013;8:9 18.

Lockwood EB, Fealy GM. Nurse prescribing as an aspect of future role expansion: The views of Irish clinical nurse specialists. J Nurs Manag 2008;16:813 20.

Zimmermann A, Cieplikiewicz E, Wąż P, Gaworska-Krzemińska A, Olczyk P. The implementation process of nurse prescribing in Poland–A descriptive study. Int J Environ Res Public Health 2020;17:2417.

Haririan H, Seresht DM, Hassankhani H, Porter JE, Wytenbroek L. Nurses, physicians and patients’ knowledge and attitudes about nurse prescribing. BMC Nurs 2022;21:1 8.

Bartosiewicz A, Różański A. Nurse prescribing readiness of polish nurses to take on new competencies A cross sectional study. Healthcare (Basel) 2019;7:151.

Naderi A, Janatolmakan M, Jalali R, Andayeshgar B, Khatony A. Iranian nurses’ attitudes towards the necessity and barriers to developing nurse prescribing roles. BMC Nurs 2021;20:1 8.

Nuttall D. Nurse prescribing in primary care: A metasynthesis of the literature. Prim Health Care Res Dev 2018;19:7 22.

Ling D L, Lyu C M, Liu H, Xiao X, Yu H J. The necessity and possibility of implementation of nurse prescribing in China: An international perspective. Int J Nurs Sci 2018;5:72 80.

Avery AJ, James V. Developing nurse prescribing in the UK. BMJ 2007;335:316.

Kroezen M, Francke AL, Groenewegen PP, van Dijk L. Nurse prescribing of medicines in Western European and Anglo Saxon countries: A survey on forces, conditions and jurisdictional control. Int J Nurs Stud 2012;49:1002 12.

McBrien B. Personal and professional challenges of nurse prescribing in Ireland. Br J Nurs 2015;24:524 8.

Snell H, Budge C, Courtenay M. A survey of nurses prescribing in diabetes care: Practices, barriers and facilitators in New Zealand and the United Kingdom. J Clin Nurs 2022;31:2331 43.

Weglicki RS, Reynolds J, Rivers PH. Continuing professional development needs of nursing and allied health professionals with responsibility for prescribing. Nurse Educ Today 2015;35:227 31.

Mahmoodian F, Seyed Jafari S, Keshmiri M, Azimi A, HVosoughi M. Nurses’ Experiences about the challenges of Nurse Physician Professional Relationships, in 1390. Sadra Med J 2013;2:31 42.

Shokri A, Yazdan Panah A, Vahdat S. The professional relationship between the nurses and physicians from their own point of view. J Health Care 2013;15:76 69.

Mohammadi S, Borhani F, Roshanzadeh M. Moral distress and relationship between Physician and nurses. Medical Ethics Journal. 2016; 10:7-14.

Masror D, Heydarikhayat D, Joolaee S. Assessing patient safety events and it’s correlation with nurse-physician interaction from nurses’ view. Quarterly Journal of Nursing Management. 2012;1:37-45.

Naderi A, Abbaszadeh A, Pazokian M, Rohani C, Jalali R. The expansion of the role of nurse prescribing in intensive care units in the healthcare system of Iran: A qualitative content analysis. J Med Life 2022;15:298 304.

Andrilla CH, Jones KC, Patterson DG. Prescribing practices of nurse practitioners and physician assistants waivered to prescribe buprenorphine and the barriers they experience prescribing buprenorphine. J Rural Health 2020;36:187 95.

Karimi-Shahanjarini A, Shakibazadeh E, Rashidian A, Hajimiri K, Glenton C, Noyes J, et al. Barriers and facilitators to the implementation of doctor-nurse substitution strategies in primary care: A qualitative evidence synthesis. Cochrane Database Syst Rev 2019;4:CD010412.

Shoqirat N, Cameron S. Promoting hospital patients’ health in Jordan: Rhetoric and reality of nurses’ roles. Int J Nurs 2012;1:27 36.

Sanagoo A. Improving the public image of the nursing profession: An enduring challenge for nurses. Curr Res Med Sci 2016;1:46 9.


Refbacks

  • There are currently no refbacks.