ObjectivesSafe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses’ roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses’ practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists.DesignA cross-sectional survey.SettingThe study was conducted in 17 European countries, each with their own health systems.ParticipantsPharmacists, physicians and nurses with an active role in PC were surveyed.Main outcome measuresNurses’ involvement in PC, experiences of interprofessional collaboration and communication and views on nurses’ competences.ResultsA total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses’ involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC.ConclusionsME, MMA, PEI and prescribing are part of nurses’ activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.

Objectives To understand healthcare professionals’ experiences and perceptions of nurses’ potential or ideal roles in pharmaceutical care (PC). Design Qualitative study conducted through semi-structured in-depth interviews. Setting Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses’ autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.

Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.

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Introduction. The medicine management is considered an important area of health care, which is ensured by various healthcare professionals including nurses. Nurses gain the competence of medicines administration immediately after graduation. This competence can be applied to any area of healthcare. Even in specialized settings such as intensive care units, any additional qualification e.g. specialized education is not required. On the contrary, appropriate education is considered an important factor that could help to reduce the risk of adverse events related to medication management. Aim. The aim of this study was to analyse the students’ knowledge in this field at the end of nursing studies at bachelor level (n = 67) and specialized intensive care nursing studies at master level (n = 42). Methodology. Knowledge was assessed using a written test, which was related to the management of medicinal products administered commonly at intensive care units by qualified nurses as well as nurse specialists without distinction. From the point of view of the formal competencies of healthcare professionals, the questions were divided into three categories. Results. The mean success rate on the test was 53.4%. The highest range of knowledge was demonstrated by already qualified students at the end of specialised studies with prior work experience in ICU, the lowest by students just before graduation. The highest rating was achieved by all students in the activity-oriented category for which the responsibility lies primarily with the medical doctor, but nurses were expected to have this knowledge and participate at related activities on the basis of a physician’s order. This knowledge included also the area of clinical pharmacology. On the other hand, the lowest score was achieved by all groups of students in the category of activities that are not treated by the physician’s order, and the use of diverse knowledge from different areas was usually necessary. Conclusions. Clinical practice has an irreplaceable role for nurses in the process of qualifying education as well as lifelong learning. The extent of nursing education in medicine management, the manner of nursing training, as well as the proportion of nursing specialists in the nursing team at specialised workplaces, deserves much greater attention in terms of ensuring safe care in this area. Shifting some competencies and duties in medicine management, especially related to intravenous (IV) therapy, to less qualified healthcare professionals appears to be highly controversial and risky.