Benefits and challenges of nurse prescribing.

BACKGROUND: Since 1999, all health visitors and district nurses in the United Kingdom (UK) have received additional education to permit their registration as independent prescribers from a limited list of medicinal products. Little research has investigated how more than 20 000 health visitor and district nurse prescribers have implemented their new role since the evaluation of the pilot sites.

AIMS: The aims of the study were to describe prescribing practices of health visitors and district nurses, the factors (contextual and professional) which enable and facilitate nurse prescribing, and views about the Nurse Prescribers' Formulary.

METHOD: A mail survey was conducted of all health visitors and district nurses working in three trusts in southern England. A 74% response rate was achieved (n = 91).

FINDINGS: Most respondents prescribed less than three times a week, with district nurses prescribing significantly more than health visitors (P
LIMITATIONS: The survey was conducted in three primary care trusts in southern England, which may be unrepresentative of trusts elsewhere in UK.

CONCLUSIONS: The level of reported prescribing by health visitors and district nurses in this study indicates that they are not acting as substitute prescribers for general practitioners of the products in the limited formulary. Implementation of a major role change such as nurse prescribing requires a number of conditions, including adequate education/preparation, a formulary that meets practitioners' needs, and acceptance by the practitioners themselves.