Journal of Qualitative Research in Health Sciences

Authors

1 Guilan University of Medical Sciences

2 Iran University of Medical Science

3 Tehran University of Medical Science

Abstract

Introduction: Presently, in many countries, certain groups of nurses are allowed to prescribe medicine. Despite the increasing attention of the world to nursing prescription and emphasis of the World Health Organization (WHO) on its implementation in regional countries, a review of literature indicated that there is no evidence of nursing prescription in Iran. Thus, this study aimed to assess the necessity of nursing prescription from the perspective of the Iranian nursing policymakers.

Method: This descriptive qualitative study was performed through interviews with 14 nursing policymakers. The participants were selected through purposive sampling method. Semi-structured interviews were used to collect data. Interviews were conducted after coordination with participants and in their workplace. All interviews were recorded using a digital voice recorder. Interviews were simultaneously transcribed verbatim and analyzed using conventional content analysis through inductive approach. The coding was performed using MAXQDA software. To achieve the accuracy and reliability of the data, the Lincoln and Guba authenticity criteria were used.

Results: Analysis of the recorded interviews resulted in the extraction of the 3 main categories of "the right to health and individual’s requirements", "the current situation of the clinical setting", and "nursing prescription outcomes".

Conclusion: The views and perspectives of nursing policymakers indicated that due individuals’ right to health and need for health care services, and also the positive outcomes that may result from nursing prescription, the necessity of its implementation is felt. However, there are challenges to its implementation that require the relevant authorities' efforts to resolve them.

Keywords

1. Delamaire M, Lafortune G. Nurses in Advanced Roles: A Description and Evaluation of Experiences in 12 Developed Countries. OECD Health Working Papers 2010; 54(5): 1-107. 2. Bhanbhro S, Drennan VM, Grant R, Harris R. Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature. BMC Health Services Research 2011; 11(330): 3-10. 3. Fittock A. Non-medical prescribing by nurses, optometrists, pharmacists, physiotherapists, podiatrists and radiographers. A quick guide for commissioners. National Prescribing Centre; 2010.pages 1-39. Available from: <www.npc.nhs.uk/non_medical/resources/NMP_QuickGuide.pdf>. 4. RCN Fact Sheet. Nurse Prescribing in the UK. Policy & International. 2012. Pages 1-5. Available from: <http://www.rcn.org.uk/__data/assets/pdf_file/0004/462370/15.12_NursePrescribing_in_the_UK_RCN_Factsheet.pdf> 5. Darvishpour A, Joolaee S, Cheraghi M.A. A meta-synthesis study of literature review and systematic review published in nurse prescribing. Med J Islam Repub Iran 2014, 28(77):1-12. 6. Cooper RJ, Anderson C, Avery T, Bissell P, Guillaume L, Hutchinson A, and et al. Nurse and pharmacist supplementary prescribing in the UK - A thematic review of the literature. Health policy 2008; 85(3): 277-292. 7. Hobson RJ. Investigation into early implementation of non medical prescribing in the UK. Thesis for the degree of Doctor of Philosophy. University of Bath. Department of Pharmacy and Pharmacology; 2008. pages 1-534. 8. Gielen SC, Dekker J, Francke AL, Mistiaen P, Kroezen M. The effects of nurse prescribing: a systematic review. Int J Nurs Stud. 2014; 51(7):1048-61. 9. Kroezen M, van Dijk L, Groenewegen PP, de Rond M, de Veer AJ, Francke AL. Neutral to positive views on the consequences of nurse prescribing: Results of a national survey among registered nurses, nurse specialists and physicians. Int J Nurs Stud. 2014; 51(4):539-48. 10. Hudson SA, Mc Anaw JJ, Johnson BJ. The Changing Roles of Pharmacists in Society. IeJSME 2007; 1(1): 22-34. 11. Bowskill D.The Integration of Nurse Prescribing: Case Studies in Primary and Secondary Care. [Ph.D. Thesis]. University of Nottingham; 2009. pages 1-250. Available at: <http://etheses.nottingham.ac.uk/1036> 12. Bradley E, Nolan P. Impact of nurse prescribing: a qualitative study. Journal of Advanced Nursing 2007; 59(2): 120–128. 13. Report on the fifth meeting of the Regional Advisory Panel on Nursing and consultation on advanced practice nursing and nurse prescribing: implications for regulation, nursing education and practice in the Eastern Mediterranean. Islamabad, Pakistan, 24–26 June 2001. Cairo, WHO Regional Office for the Eastern Mediterranean; 2002. Available from: <http://whqlibdoc.who.int/emro/2002/WHO-EM_NUR_348_E_L.pdf> 14. Khayati F, Saberi M. [Primary Health Care (PHC) an Ever Strategy for Health Equity Extension]. Journal of Health Administration 2009; 12(35):33-40. [Persian] Available from: < URL http://jha.iums.ac.ir/browse.php?a_code=A-10-3-217&slc_lang=fa&sid=1> 15. [Document of primary health care promotion policy]. Council of policy making and health reform; 2007. Pages 1-78. [Persian] Available from: < http://siasat.behdasht.gov.ir/uploads/291_1664_Primary_Health_Care_Services_Policy.pdf> 16. Elo S, Kyngas H. The qualitative content analysis process. Journal of Advanced Nursing; 2008, 62(1), pp. 107–115. 17. Holloway I, Wheeler S. Qualitative Research in Nursing and Healthcare.3rd ed. Oxford: Blackwell science; 2010. Pages 1-368. 18. Streubert HJ, Carpenter DR. Qualitative Research in Nursing, Advancing the Humanistic Imperative, third Edition. Philadelphia: Lippincott Company; 2003. Pages 1-501. 19. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2004; 24(2): 105-112. 20. Polit DF, Beck CT, Hungler BP. Essentials of Nursing Research: Methods, Appraisal, & Utilization. 5th ed. Philadelphia, Lippincott; 2001. Pages 1- 524. 21. [The map of development of the Iran health system, based on the Islamic Iranian model of progress]. Ministry of Health and Medical Education / policy- making Council; 2011. Pages 1-174. [Persian] Available from: < http://mediaserver.research.ac.ir/Repository/UploadSenderSubSystem/c6ded7f0-5540-4421-bbdb-b8d87cdadb75.pdf> 22. Shadpour K. [Health sector reform in Islamic Republic of Iran]. Hakim 2006; 9 (3): 1-18. [Persian] Available from: < URL http://hakim.hbi.ir/browse.php?a_code=A-10-5-16&slc_lang=fa&sid=1 23. Mistretta MJ. Differential effects of economic factors on specialist and family physician distribution in Illinois: a county-level analysis. J Rural Health 2007; 23(3): 215-21. 24. Seyedmajidi M, Motallebnejad M, Bijani A, Sabbagzadeh M. [Defining Effective Factors on Patients' Satisfaction Referring to Dental Faculty in Babol University of Medical Sciences: A Principle Step to Socially Accountable Medical Education]. Biannual Medical Education, Babol Univ Med Sci 2013; 1 (2):58-66. [Persian] 25. [Health reform program]. The secretariat of the national Headquarters of health reform program implementation; 2014. [Persian] Available from: < http://tahavol.behdasht.gov.ir> 26. [The World Health Report of 2000]. Economic studies office of Islamic Consultative Parliament. Research Department; 2004. Pages 1-65.[Persian] Available from: < http:// rc.majlis.ir/m/report/download/729070> 27. Kramer M, Maguire P, Schmalenberg CE, Andrews B, Burke R, Chmielewski L, et al. Excellence through evidence structures enabling clinical autonomy. The Journal of Nursing Administration (JONA) 2007; 37(1): 41-52. 28. Weston MJ. Strategies for Enhancing Autonomy and Control over Nursing Practice. OJIN: The Online Journal of Issues in Nursing 2010; 15(1). 29. Karagozoglu S. Level of autonomy of Turkish students in the final year of university baccalaureate degree in health related fields. Nurs Outlook 2008; 56(2): 70-77. 30. Kramer M, Schmalenberg C. The Practice of clinical autonomy in hospitals: 20 000 nurses tell their story. Critical Care Nurse 2008; 28(6): 58-71. 31. Lewis FM, Soule ES. Autonomy in nursing. Ishikawa Journal of Nursing 2006; 3(2): 1-6. 32. Bradley E, Nolan P. Addressing the concerns of the trainee nurse prescriber. Nursing Times 2006; 102(11): 36–39. 33. Carey N, Stenner K. Does non-medical prescribing make a difference to patients? Nursing Times2011; 107: early online publication. 34. Klein TA. Prescribing Competencies for Autonomous APRN Prescriptive Authority: What Do Nurse Prescribers Need to Know?. [Ph.D. Thesis]. Washington state university College of Nursing; 2011. Pages 1-124. 35. Cousins R, Donnell C. Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress. Fam Pract 2012; 29(2): 223-7. 36. Penz KL, Stewart NJ. Differences in autonomy and nurse -physician interaction among rural and small urban acute care registered nurses in Canada. Online Journal of Rural Nursing and Health Care 2008; 8(1): 39-53. 37. Carrigy A, O’Malley S, Begley C, Blunnie W, Bracken C, Byrne J, et al. Review of Nurses and Midwives in the Prescribing and Administration of Medicinal Products. Final Report of Bord Altranais; 2005.pages 1-3. 38. Miles K, Seitio O, Mc Gilvray M. Nurse prescribing in low-resource settings: professional considerations. International Nursing Review 2006; 53(4): 290–296. 39. Lockwood EB, Fealy GM. Nurse prescribing as an aspect of future role expansion: the views of Irish clinical nurse specialists. Journal of Nursing Management 2008; 16(7): 813–820. 40. Sketris I, Langille Ingram E, Lummis H. Optimal Prescribing and Medication Use in Canada: Challenges and Opportunities. Health Council Reports of Canada; 2007.pages 1-44. 41. Carey N, Stenner K, Courtenay M. How nurse prescribing is being used in diabetes services: views of nurses and team members. Journal of Nursing & Healthcare of Chronic Illnesses 2010; 2(1): 13-21. 42. Stenner K, Carey N, Courtenay M. Implementing nurse prescribing: a case study in diabetes. Journal of Advanced Nursing 2010; 66(3): 522–531. 43. Jabareen H M. Skill Mix Development in General Practice: A Mixed Method Study of Practice Nurses and General Practitioners. [Ph.D. Thesis]. Faculty of Medicine University of Glasgow; 2008. Pages 1-323. Available at: <http:// theses.gla.ac.uk/632/1/2008JabareenPhD.pdf> 44. Jones & Bartlett Learning. The Profession of Nursing. available at: <samples.jbpub.com/9781449649029/46066_CH01_6031.pdf > McMillan M. Nurse prescribing: adding value to the consumer experience. Aust Prescr 2007; 30: 2–3. Online available at: