Nurse prescribing in acute care

Motivation and commitment on the part of nurse prescribers themselves helped make the introduction of nurse prescribing successful in one acute care trust, as described in this article. Clinical teams recognised that the development represented both progression for individual nurses, and for the teams to which they belonged, and colleagues saw the new roles as fitting into existing team structures and being of benefit.

Imperial College Healthcare NHS Trust (ICHT) has trained over a third of its clinical nurse specialists to become non-medical prescribers and will be training 30 more non-medical prescribers a year. How has it implemented this initiative and overcome the barriers such as lack of support or appropriate systems that can hinder successful implementation?

Using a ‘force field analysis’ with ‘driving’ and ‘restraining’ forces, the new prescribing policies included guidelines to maintain the driving forces and promote support, team work, good supervision, effective mentorship and access to information, education and training programmes. The prescribing practice of the 66 independent nurse prescribers trained so far relates directly to the development of new roles and services, for example in caseload management in renal services and round-the-clock prescribing. They are all responsible for evaluating their own practice and use peer audit and professional development activities including action learning sets, small groups who meet regularly to raise concerns, discuss solutions and identify actions (both doing and learning).

An evaluation of the nurse prescribing roles identified a shared vision of, and commitment to, working differently among staff as a key factor in success. This allowed nurse prescribers to overcome some of the barriers to prescribing.

Jones K. Developing a prescribing role for acute care nurses. Nursing Management 2009; 16(7): 24-28.