Mental health nurse prescribing: issues for the UK

Abstract

Supplementary nurse prescribing holds the key to rapid developments in psychiatric nursing and the care received by patients. In this paper, the origins, context and research data on nurse prescribing are reviewed, as a backdrop to a discussion on potential application of supplementary prescribing in a number of mental health settings. We describe a number of practice settings where nurse prescribing could be implemented, and argue that given service changes and informative educational preparation, access to care and user experience of that care will be enhanced. We conclude the paper by reviewing a number of clinical, organizational and research factors important for the success of nurse prescribing.

Expanded Practice Roles for Community Mental Health Nurses: What Do Consumers and Carers Have to Say?

“…These sentiments confirmed the views raised in the literature about the need for training programs to support mental health nurses' development in expanded practice (Elsom, Happell, & Manias, 2005;Jones, & Jones 2005). Jones and Jones highlighted a problem of currently available prescribing programs in the UK since they are available to nurses of all disciplines and the uptake by mental health nurses into an individual course is small.…”

Nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature

“…Nevertheless, a number of recurring themes could be discerned, such as the views of nurses, doctors and other parties involved concerning nurse prescribing [45,47,51,53,81,94,108,109,115,121,139], prescribing behaviours of nurses [36,43,124,126,128,129,131,137], and nurse prescribing in relation to specific diseases [38,44,84,89,91-93,101,108,116,125] - most notably concerning nurse prescribing in mental health care [21,32,39,67,76,83,100,102,104-106,132,135]. Also, a number of publications focussed on the history and evolution of (nurse) prescribing of medicines, but these remained relatively limited [5,6,46,48,49,75,90,96,103,142].…”

“…Australia, Canada, Ireland, New Zealand, Sweden, the United Kingdom and the United States of America. While nurse prescribing has been in place in the USA since the 1960s [5,6,30,107,115,123,128,134,135,138], it is a relatively new phenomenon in most other countries. Table 2 presents an overview of the (expected) year of introduction of nurse prescribing in Western European and Anglo-Saxon countries.…”

“…In the Netherlands, the aim of task reallocation in the health care sector and more particularly the undesirable situation in which nurses prescribe medicines on an illegal basis, have been the main driving force behind the introduction of nurse prescribing [117,118]. The objective of creating quicker and more efficient patient access to medicines has also been highly influential in the introduction process of nurse prescribing internationally, especially within the UK and Ireland [21,25,26,29,31,32,34-37,39,42,46,47,51,52,55,58,61,62,64,67,69,76,82-84,87,89,90,94,100,102,104,106,112,114][116,120,128,132,135-137,140]. Another important force in this process has been the aim to make better use of nurses' skills and knowledge, and to improve the use of both health professionals' and patients' time [5,6,23,26,30,34,37,39,41,42,44,46,47,51,52,55,56,60,64,66-69,73-76,79,84,86,87,89,90,92,93,100,102,103,106,109][115-118,124,125,130,…”

“…Whereas these seem to have been the main drivers behind the introduction of nurse prescribing in the UK and Ireland, forces originating from within the health professions appear to have prevailed in other countries. In Australia, Canada, New Zealand, Sweden and the USA nurses were granted prescribing rights in order to reduce the workload of doctors and physicians, address the shortage of physicians - partly resulting from the growing specialisation of health professionals - and meet the medication needs of patients in remote areas who were often suffering as a result of a shortage of physicians [5,6,22,28,30,33,34,41,51,59,61,85,85,86,107,120-122,124,125,127,128,131,135,138]. Moreover, prescriptive authority for nurses in Canada, New Zealand and the USA followed the development of advanced practice nurse (APN) roles [5,61,74,124], which clearly connects their prescribing privileges with internal developments within the nursing profession.…”