Safety and quality of nurse independent prescribing: a national study of experiences of education, continuing professional development clinical governance

Abstract

Aim. To determine the adequacy of initial nurse independent prescribingeducation and identify continuing professional development and clinicalgovernance strategies in place for non-medical prescribing.Background. In 2006, new legislation in England enabled nurses with anindependent prescribing qualification to prescribe, within their competence. In 2006,non-medical prescribing policies released by the Department of Health outlinedthe recommendations for education, continuing professional development andgovernance of non-medical prescribing; however, there was no evidence on a nationalscale about the exte nt of implementation and effectiveness of these strategies.Design. National surveys of: (i) nurse independent prescribers; and (ii) non-medical prescribing leaders in England.Methods. Questionnaire surveys (August 2008–February 2009) coveringeducational preparation, prescribing practice (nurse independent prescribers) andstructures/processes for support and governance (non-medical prescribing leaders).Results. Response rates were 65% (976 prescribers) and 52% (87 leaders). Mostnurses felt their prescribing course met their learning needs and stated courseoutcomes and that they had adequate development and support for prescribing tomaintain patient safety. Some types of community nurse prescribers had less accessto support and development. The prescribing leaders reported lacking systems toensure continuity of non-medical prescribing and monitoring patient experience.Conclusion. Educational programmes of preparation for nurse prescribing werereported to be operating satisfactorily and providing fit-for-purpose preparationfor the expansion to the scope of nurse independent prescribing. Most clinicalgovernance and risk management strategies for prescribing were in place inprimary and secondary care.