Nurses’ role in medical prescription: Systematic review

Abstract

Aim: To identify and describe the role of non-prescribing nurses in medical prescription, through a critical synthesis of all the studies published worldwide answering this question. Background: Medical prescription is a prerogative of the physician. Yet, the final decision for prescribing is most often the conjunction of different factors and actors. What could be the role of non-prescribing nurses in medical prescription? Design: A systematic literature review. Methods: A literature search of the databases, the Ovid MEDLINE database, PubMed, Web of Science, Cochrane, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), was done to identify studies that describe the nurse's role in medical prescription up to May 2017. A quality assessment of relevant studies was performed. Results: Four studies were included in this review. The overall methodological quality of the studies was intermediate (score: 8.5 of 12). Analyses of the included articles show the nurses have an essential role in the administration of medications and in the follow-up of the drug consequences. In addition, nurses tend to share the decision regarding prescribing with the doctors through an inter-professional collaborative approach. Nurses do not have sufficient knowledge about pharmacology and drug management. Conclusions: Our systematic review emphasizes the importance of multidisciplinary collaboration between nurses and other health professionals in acute care settings. The strong involvement of nurses could provide a dialogue to strengthen best practice. Improving the nurses' knowledge and their skills are likely to enhance the optimization of treatment. Relevance to Clinical Practice: The current literature suggests a refinement of pharmacological knowledge among nurses and effective nurse-doctor interactions to guide the best medical prescribing.

The expansion of the role of nurse prescribing in intensive care units in the healthcare system of Iran: a qualitative content analysis

“…When prescribing medications, physicians make decisions not only based on their expertise and knowledge but also under the influence of nurses [ 28 ]. The nature of communications in ICUs is better than that of other units, and effective physician-nurse cooperation is necessary and should be strengthened for optimal treatment of patients [ 29 ]. This relationship is an appropriate facilitator, and nurses play a key role in creating interprofessional cooperation [ 30 ].…”

Facilitators and barriers to the clinical administration of herbal medicine in Ghana: a qualitative study

“…The current study explored the facilitators and barriers to the clinical administration of herbal medicine. The nurses mentioned that doctors’ prescription will make it easy to administer herbal medicine in the future [ 13 , 40 ]. However the study by [ 40 ] was concerned with nurses serving orthodox medication.…”

“…The nurses mentioned that doctors’ prescription will make it easy to administer herbal medicine in the future [ 13 , 40 ]. However the study by [ 40 ] was concerned with nurses serving orthodox medication. Participants in the present study were optimistic about them not having the sole right to serve herbal medication [ 40 ].…”

“…However the study by [ 40 ] was concerned with nurses serving orthodox medication. Participants in the present study were optimistic about them not having the sole right to serve herbal medication [ 40 ]. This could be attributed to the professional background of the majority of the participants which currently does not permit them to prescribe medicatons in Ghana.…”

“…The nurses expectation of doctors’ prescription of herbal medicine was directed towards conventional doctors which could be related to familiarity as well as drug prescription being reported as a responsibility of medical doctors [ 41 ]. This might contribute to why the nurses thought they could only make suggestions to the doctors [ 40 ]. It is important for policy makers to consider including mainstream healthcare doctors in policies regarding prescription of herbal medicine in hospitals.…”