Exploring midwifery prescribing in Australia

Small, Kirsten; Sidebotham, Mary; Gamble, Jenny; Fenwick, Jennifer

doi:10.1016/j.wombi.2016.02.001

Cited by 11 publications

(14 citation statements)

References 19 publications

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“…Nurse practitioners have been able to prescribe from the PBS since 2010; they are often asked to prescribe antibiotics in primary care and hospital emergency departments 50 . Midwives were given prescribing rights in 2010; and two in five are endorsed 49 . Midwives can prescribe antibiotics in the prenatal, intrapartum and post‐natal stages of pregnancy 51…”

Section: Discussionmentioning

confidence: 99%

“…All prescribers (medical and non‐medical) need core competencies in prescribing medicines 48 . This is particularly so for some professions (e.g., midwives and nurse practitioners) who can have quite wide scopes of practice 49 . Nurse practitioners have been able to prescribe from the PBS since 2010; they are often asked to prescribe antibiotics in primary care and hospital emergency departments 50 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Antimicrobial stewardship: Prescribing across the primary care health professions

Hollingworth

McGuire

Driel

et al. 2023

Pharmacology Res & Perspec

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We examined the patterns of antibiotic prescribing by medical and non‐medical prescribers (dentists, nurse practitioners, and midwives) in Australia. We explored trends in the dispensed use of antibiotics (scripts and defined daily dose [DDD] per 1000 population/day) by Australian prescribers over the 12‐year period, 2005–2016. We obtained data on dispensed prescriptions of antibiotics from registered health professionals subsidized on the Pharmaceutical Benefits Scheme (PBS). There were 216.2 million medical and 7.1 million non‐medical dispensed prescriptions for antibiotics over 12 years. The top four antibiotics for medical prescribers were doxycycline; amoxicillin, amoxicillin plus clavulanic acid, and cefalexin, constituting 80% of top 10 use in 2005 and 2016; the top three for non‐medical were amoxicillin, amoxicillin plus clavulanic acid and metronidazole (84% of top 10 use in 2016). The proportional increase in antibiotic use was higher for non‐medical than medical prescribers. While medical prescribers preferentially prescribed broad‐spectrum and non‐medical prescribers moderate‐spectrum antibiotics, there was a large increase in the use of broad‐spectrum antibiotics over time by all prescribers. One in four medical prescriptions were repeats. Overprescribing of broad‐spectrum antibiotics conflicts with national antimicrobial stewardship initiatives and guidelines. The proportional higher increase in antibiotic use by non‐medical prescribers is a concern. To reduce inappropriate use of antibiotics and antimicrobial resistance, educational strategies targeted at all medical and non‐medical prescribers are needed to align prescribing with current best practice within the scope of practice of respective prescribers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Antimicrobial stewardship: Prescribing across the primary care health professions

Hollingworth

McGuire

Driel

et al. 2023

Pharmacology Res & Perspec

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show abstract

“…Although the majority of nurses and midwives' decisions are clinically appropriate, continuing education and evaluating prescriptive performance, especially in relation to drugs and interactions, are needed to achieve the most appropriate and safe administration (24). Small et al study also showed that high-quality education, combined with professional support, personal motivation and trusted midwives to overcome common barriers at the beginning of the prescription, was helpful for improving the prescribing skills of midwives in Australia (25). Midwifery's enhanced prescribing skills have benefits in individual, patient, and organizational dimensions.…”

Section: Discussionmentioning

confidence: 99%

Impact of Workshop Training on Prescription Writing Skills of Senior Midwifery Students

2020

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Background: Prescription writing is one of the most important stages of medical treatment, and following its principles improves efficiency and effectiveness of treatment. Midwifery students are the group of a medical team who are authorized to prescribe medications. However, clinical evidence suggests that their skills are inadequate in the area. Objectives: Therefore, this study was designed to investigate the effect of a workshop on the prescription writing skills of midwifery students. Methods: This was a quasi-experimental study conducted among 32 senior undergraduate midwifery students. The students were divided into two groups. A two-day workshop was held for each group. Each group was divided into three subgroups for practical work. The training was provided based on the general principles of prescribing in four parts including superscription, general principles of prescription, standard principles of prescription, and instruction of using medications. Adherence to the principles of prescribing by students was evaluated through a checklist before and after training and four weeks later. Data were analyzed with a general linear model and repeated measures analysis. Results: Patient's name was the most common record in the prescriptions. The mean number of drug items was 3.7 ± 0.04, which decreased to 2 ± 0.03 after the intervention. The name and signature of the prescribed drugs were in less than 15% of the prescriptions, with 85% improvement after the intervention. Moreover, 40.6% of the prescriptions were readable, but in none of them, the reason for visit and diagnosis were mentioned (over 50% increases after training). Form of drug, dose and medication number were listed in 45% of the prescriptions that rose to more than 70% in all the three cases. The most responses on the instruction of using the medication were related to the method of use and drug use intervals. Repeated measures ANOVA showed a significant difference in the mean scores of students' prescriptions after education and four weeks after the workshops in all the four parts of prescription principles (P < 0.001). This significant difference was also observed in all four common diseases in gynecology (P < 0.001). Conclusions: The prescription workshop had a significant positive effect on the knowledge and skills of midwifery students in the field of prescription writing. Therefore, this strategy can be used as a useful approach for the rational use of medicines by midwives. Because of the importance of prescription writing, we suggest including it in the curriculum of midwifery students.

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“…he studies reviewed included "Study on the Eligibility Criteria for Prescriptive Authority for Nurses and the Prescriptive-Authority-Related Courses for Undergraduate Curriculum," "Study on Aptitude of Supervising Nurse for Grading Nursing Care by Peer Review," 7 and "A Primary Study on Applying the Delphi Method for Screening Authentication and Evaluation Indexes of Clinical Nursing Specialists". 8 The training content, scope of practice, drugs and auxiliary examination covered by prescriptive authority were identified by referencing college textbooks such as Obstetrics and Gynecology, 9 Obstetrical Nursing, 10 Obstetrics Clinical Work Handbook, and Obstetrician Prescription.…”

Section: Roundmentioning

confidence: 99%

The eligibility criteria, training content, and scope of practice for prescriptive authority for midwives: a modified Delphi study^†

Han

Ren

Wang

et al. 2019

Frontiers of Nursing

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Objective To investigate the necessary eligibility criteria for prescriptive authority for midwives, gather suggestions from experts on training content for prescriptive authority for midwives, and explore the scope of practice of their prescriptive authority in certain circumstances. The results of this study could serve as a reference for the development of policies on prescriptive authority for midwives. Methods Based on a literature search and semistructured interviews, a modified Delphi method was first used to conduct 2 rounds of expert consultation on eligibility criteria and training content for prescriptive authority for midwives. This stage included nursing experts (20) and medical experts (16) engaged in midwifery in many tertiary Grade A hospitals in China. Subsequently, consultation on the scope of practice of prescriptive authority for midwives was conducted with nursing experts (18) and medical experts (14) engaged in midwifery in many tertiary Grade A hospitals in China. The suggestions from the experts were analyzed using statistical methods to confirm the eligibility criteria for prescriptive authority, training content, circumstances, scope of practice for prescriptive authority, and the prescription forms. Results Among the consulted experts, 70.59% (the highest acceptance rate) considered an undergraduate degree to be the minimum educational requirement for midwives to be eligible for prescriptive authority, 85.29% (the highest acceptance rate) considered the supervisor nurse to be the minimum technical position experience necessary for midwives to be eligible for having prescriptive authority, and 50% (the highest acceptance rate) considered 5 years to be the minimum number of years of experience in the specialty for midwives to be eligible for prescriptive authority. The applicants should at least be practicing at Grade C hospitals, which was the consensus among 91.18% of the consulted experts. Among the consulted experts, 100%, 100%, 97.06%, 94.12%, and 94.12% agreed that the applicants should have knowledge in pharmacology, laws and ethics, nursing, diagnostics, and midwifery, respectively. The consulted experts confirmed 22 related course topics and identified 6 specific circumstances in which the midwives could partially practice prescriptive authority, including uterine atony, excessive uterine contraction, postpartum hemorrhage, premature rupture of fetal membranes, normal labor, and neonatal asphyxia. Under these 6 circumstances, the consulted experts commonly agreed that there were 20 medication prescriptions and 13 auxiliary examination prescriptions that could be prescribed by midwives. Of these prescriptions, 51.5% were independent prescriptions, 30.3% were protocol prescriptions, and the remaining 18.2% were both independent and protocol prescriptions. Conclusions Midwives who have an undergraduate degree, supervisor nurse position, and 5 years of practice in Grade C hospitals are considered eligible to apply for prescriptive authority. Partial prescriptive authority could be granted after regulated training in fundamental theories and practices, which could improve the independence and professionalism of midwifery.

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Exploring midwifery prescribing in Australia

Cited by 11 publications

References 19 publications

Antimicrobial stewardship: Prescribing across the primary care health professions

Antimicrobial stewardship: Prescribing across the primary care health professions

Impact of Workshop Training on Prescription Writing Skills of Senior Midwifery Students

The eligibility criteria, training content, and scope of practice for prescriptive authority for midwives: a modified Delphi study^†

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Exploring midwifery prescribing in Australia

Cited by 11 publications

References 19 publications

Antimicrobial stewardship: Prescribing across the primary care health professions

Antimicrobial stewardship: Prescribing across the primary care health professions

Impact of Workshop Training on Prescription Writing Skills of Senior Midwifery Students

The eligibility criteria, training content, and scope of practice for prescriptive authority for midwives: a modified Delphi study†

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Product

Resources

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The eligibility criteria, training content, and scope of practice for prescriptive authority for midwives: a modified Delphi study^†