Nurse prescribing roles in acute care: an evaluative case study

Area of Science:

• Nursing Practice
• Healthcare Policy
• Patient Safety

Background:

• Limited data existed on nurse prescribing in acute care settings.
• Concerns were raised by some physicians regarding patient safety.
• Nurse prescribing aimed to facilitate doctor-nurse substitution in episodic care.

Purpose of the Study:

• To evaluate the implementation of nurse prescribing in an English acute care hospital.
• To assess the impact and effectiveness of nurse prescribing in this setting.

Main Methods:

• A mixed-methods single-case study design was employed.
• Data collection included semi-structured interviews, non-participant observation of consultations, and patient questionnaire surveys.
• The study involved 18 hospital staff, 47 patients across 52 consultations, and 122 surveyed patients (61% response rate).

Main Results:

• Nurse prescribing enhanced patient service delivery and optimized staff skill deployment.
• Both nurse prescribers and colleagues reported positive perceptions of role changes and patient care impact.
• Patients expressed statistically significant higher satisfaction with medication information received from nurse prescribers compared to doctors.

Conclusions:

• Nurses and doctors demonstrated equivalent care provision in prescribing roles.
• Key enablers for embedding nurse prescribing roles included shared vision, local champions, action learning, and peer support.