Influences on independent nurse prescribers' antimicrobial prescribing behaviour: a systematic review

Ness, Valerie; Price, Lesley; Currie, Kay; Reilly, Jacqui

doi:10.1111/jocn.13249

Cited by 17 publications

(28 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…*Exact date not found. The date shown are in accordance with Licensure Information on the YRNA website These factors were further confirmed in a systematic review of independent nurse prescriber's antimicrobial behaviour published the same year (Ness, Price, Currie, & Reilly, 2016). This systematic review included seven studies (Abbo, Smith, Pereyra, Wyckoff, & Hooton, 2012;Adorka, Dikokole, Mitonga, & Allen, 2013;Goolsby, 2007aGoolsby, , 2007bLadd, 2005;Rowbotham et al, 2012;Wright & Neill, 2001), three studies examined choice of antibiotic when prescribing of an antibiotic was a certainty (Goolsby, 2007a(Goolsby, , 2007bWright & Neill, 2001) and the other four (Abbo et al, 2012;Adorka et al, 2013;Ladd, 2005;Rowbotham et al, 2012) explored factors influencing the choice to prescribe an antibiotic or not.…”

Section: Factors That Influence Prescribingmentioning

confidence: 72%

A survey of nurse practitioner controlled drugs and substances prescribing in three Canadian provinces

O’Rourke

Kirk

Duff

et al. 2019

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives In Canada, nurse practitioners (NP) were legally authorised to prescribe controlled drugs and substances (CDS) in 2012. The objective of this study was to understand current NP‐CDS prescribing in Alberta, Manitoba and Saskatchewan, Canada. This study is a component of a larger three‐phase survey of NP practice patterns in these same provinces. Background Nurse practitioners are nurses with a graduate degree who have the legal authority to perform expanded functions in health systems, including prescribing CDS. Given the novelty of CDS prescribing for NPs in Canada, little is known about this component of their role. Design A secondary analysis of survey data collected between March 2016 and May 2017 was used to examine NP‐CDS‐prescribing patterns and identify potential associated factors. Methods Nurse practitioners in Alberta, Manitoba and Saskatchewan were invited to complete a professional practice pattern survey. The survey was administered through a secure electronic data collection software application (redcap). In the practice pattern survey, 42 variables from 15 distinct conceptual questions were analysed in this study as potential predictors of NP‐CDS prescribing within a purposeful selection ordinal logistic regression model. This scientific submission has been assessed for accuracy and completeness using the Equator STROBE guideline criteria (see Appendix S1). Results/Findings Five variables were found to be associated with an increased odds of more frequent NP‐CDS prescribing in addition to three confounders/clinically relevant variables. Factors commonly associated with an increased frequency of NP‐CDS prescribing relate to location of practice, area of practice, previous nursing experience, team environments and common diagnoses. Conclusion Little is known about NP‐CDS prescribing. Understanding this important component of the NPs emerging legal scope of professional practice can contribute to the continued refinement of this role as well as support ongoing enquiry into the causes of, and potential interventions to prevent, the present opioid overdose deaths occurring while under an active prescription. Relevance to clinical practice Understanding factors that influence NP‐CDS prescribing has relevance to the current drug‐related prescription fatalities crisis in all countries.

show abstract

Section: Factors That Influence Prescribingmentioning

confidence: 72%

A survey of nurse practitioner controlled drugs and substances prescribing in three Canadian provinces

O’Rourke

Kirk

Duff

et al. 2019

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…Most were deemed of high quality, although one would have benefited from searching country-specific databases and lacked quality assessment, 12 and qualitative findings could have been subjected to meta-synthesis in another. 13…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Five focused solely on nurse prescribing, [12][13][14][15][16] with two discussing all nonmedical prescribers. 17,18 While five included all studies irrespective of country or setting, [13][14][15][16]18 one included only those conducted in Western European and Anglo-Saxon countries, 12 and one was restricted to the UK. 17 The number of studies reviewed ranged from 3 to 124.…”

Section: Data Extractionmentioning

confidence: 99%

“…Two reviews focused on aspects of influences on prescribing decision making generally 17 and prescribing behaviour related to antimicrobials. 13 One reported the extent of implementation of nurse prescribing, 12 one processes of prescribing and associated barriers and facilitators to implementation, 16 with three on various patient outcome measures. 14,15,18 Box 2.…”

Section: Data Extractionmentioning

confidence: 99%

See 1 more Smart Citation

Future perspectives on nonmedical prescribing

Stewart

Jebara

Cunningham

et al. 2017

Therapeutic Advances in Drug Safety

View full text Add to dashboard Cite

Many countries have implemented nonmedical prescribing (NMP) and many others are scoping prescribing practices with a view to developing NMP. This paper provides a future perspective on NMP in light of findings of an umbrella review of aspects of NMP. This is followed by coverage of the Scottish Government strategy of pharmacist prescribing and finally, consideration of two key challenges. The review identified seven systematic reviews of influences on prescribing decision-making, processes of prescribing, and barriers and facilitators to implementation. Decision making was reported as complex with many, and often conflicting, influences. Facilitators of NMP included perceived improved patient care and professional autonomy, while barriers included lack of defined roles and resource pressures. Three systematic reviews explored patient outcomes that were noted to be equivalent or better to physician prescribing. In particular, a Cochrane review of 46 studies of clinical, patientreported, and resource-use outcomes of NMP compared with medical prescribing showed positive intervention-group effects. Despite positive findings, authors highlighted high bias, poor definition and description of 'prescribing' and the 'prescribing process' and difficulty in separating NMP effects from the contributions of other healthcare team members. While evidence of benefit and safety is essential to inform practice, for NMP to be implemented and sustained on a large scale, there needs to be clear commitment at the highest level. The approach being taken by the Scottish Government to pharmacist prescribing implementation may inform developments in other professions and countries. The vision is that by 2023, all pharmacists providing pharmaceutical care will be pharmacist-independent prescribers. There are, however, challenges to implementing NMP into working practice; two key challenges are the need for sustainable models of care and evaluation research. These challenges could be met by considering the theoretical basis for implementation, and robust and rigorous evaluation.

show abstract

“…Key barriers were perceived by experts to be the veterinarian's belief that their clients both expected and wanted antibiotics, and would go elsewhere if they were not prescribed to them, as well as lack of sufficient time in a consultation for client education. Comparable perceptions regarding the pressure of patient expectations to be given an antibiotic are reported in the literature exploring medical doctors and registered nurses' prescribing behaviours, 29 with a survey of 1000 UK general practitioners reporting that 90 per cent felt pressure from patients to prescribe antibiotics. 30 While the concerns raised by our expert participants may be credible risks in the context of small business veterinary practices, the commonality of these perceptions across animal and human health prescribers suggests that interventions should focus on social influence and address veterinarian's beliefs about their client's expectations and the consequences of their stewardship behaviour (ie, challenging the belief that clients will go elsewhere for antimicrobials).…”

Section: Interactions With Clientsmentioning

confidence: 99%

Expert consensus regarding drivers of antimicrobial stewardship in companion animal veterinary practice: a Delphi study

et al. 2018

Self Cite

View full text Add to dashboard Cite

Antimicrobial resistance (AMR) is a global challenge facing both human and animal healthcare professionals; an effective response to this threat requires a 'One-Health' approach to antimicrobial stewardship (AMS) to preserve important antibiotics for urgent clinical need. However, understanding of barriers and enablers to effective AMS behaviour in companion animal veterinary practice is currently limited. We conducted a Delphi study of 16 nationally recognised experts from UK-based veterinary policymakers, university academics and leaders of professional bodies. This Delphi study sought to identify veterinary behaviours which experts believe contribute to AMR and form vital aspects of AMS. Analysis of Delphi findings indicated a perceived hierarchy of behaviours, the most influential being antibiotic prescribing behaviours and interactions with clients. Other veterinary behaviours perceived as being important related to interactions with veterinary colleagues; infection control practices; and the use of diagnostic tests to confirm infection. Key barriers and enablers to AMS within each of these behavioural domains were identified. Specific interventions to address important barriers and enablers are recommended. To the authors' knowledge, this is the first study to establish expert consensus at a national level about which 'behaviours' (aspects of veterinarian practice) should be targeted in relation to AMR and AMS in companion animal veterinary practice.

show abstract

Influences on independent nurse prescribers' antimicrobial prescribing behaviour: a systematic review

Cited by 17 publications

References 20 publications

A survey of nurse practitioner controlled drugs and substances prescribing in three Canadian provinces

A survey of nurse practitioner controlled drugs and substances prescribing in three Canadian provinces

Future perspectives on nonmedical prescribing

Expert consensus regarding drivers of antimicrobial stewardship in companion animal veterinary practice: a Delphi study

Contact Info

Product

Resources

About