Following the completion of a nurse prescribing course, nurses are now able to prescribe certain medications in the Republic of Ireland. This new initiative follows the example of the USA, Canada, Sweden, New Zealand, Australia and most recently the United Kingdom (Buchan, 1999). The government¿s decision to introduce nurse prescribing was supported by international evidence that showed that: (i) nurses are safe prescribers; (ii) patient compliance with nurse prescribing is high; (iii) patients view nurse prescribing favourably due to good communication between the nurse prescriber and patient; (iv) nurse prescribing can save time and is cost effective (While et al., 2004, Brown et al., 1995).
This study examined nurses¿ perceptions and beliefs regarding medication adherence and their ability to influence same in this new role. The study employed a cross-sectional questionnaire design across two cohorts of a nurse prescribing course. Nurses completed the Jefferson Scale of Physician Empathy-Healthcare professions (JSPE-H) version and a questionnaire assessing perceived skills and attitudes towards medication adherence at the completion of their prescribing course in the Republic of Ireland.
A total of 38 nurses (92% female) with a mean age of 39 years completed the questionnaires. Fifty eight percent of participants were educated to a BSc or MSc level and mean number of years qualified was 18 years. Fifty-one percent of nurses completing the course believed that adherence to medication would be a problem for patients and all agreed that encouraging adherence would be part of their role as prescriber. Nurses generally felt confident in this role with 90% believing they were good at counselling patients; 87% believing they could influence patient¿s adherence to medication; and 63% feeling confident in prescribing for patients. The mean JSPE-H score was 114. Empathy was significantly associated with confidence in counselling patients about their medication (r=-0.47, p<001), diagnosing patients conditions (r=-0.37, p<0.05) and prescribing for patients (r=0.43, p<0.05).
The nurses partaking in this study generally perceived themselves to be confident and competent prescribers who can have a positive impact on patient adherence to medication. Empathy was positively associated with confidence in the prescriber role highlighting the importance of this skill in the treatment process. Future studies will be well placed examining the transfer of skills from the classroom to the clinical setting.
References:
1) Buchan J. Determining skill-mix: lessons from an international review. Human Resources for Health Development Journal. (1999); 3: 80-90.
2) Brown SA and Grimes DE. A meta-analysis of nurse practitioners and nurse midwives in primary care. Nurse Response. (1995);44:332-339
3) While EA and Biggs K. Benefits and challenges of nurse prescribing, Journal of Advanced Nursing. (2004); 45 (6):559¿567.