Influences on Nurse Prescriber’s Decision- - Making: A Phenomenological Study

Background

Prescribing is not merely the accurate writing of a prescription, but the application of theory related to assessment, examination, diagnostics and associated decision-making strategies. Despite the popularity of nurse prescribing and its reported benefits, which have been widely studied within the UK, there is limited research into the factors that influence nurse prescribers’ decision-making and the implications of those decisions on their subsequent prescribing practice.

Aim

The study was designed to explore the lived experience of nurse prescribers and understand how their perception of their own competence and scope of practice influences their prescribing decision-making.

Methods
Interpretive phenomenological analysis is used to interpret, semi-structured interviews and vignette discussions undertaken with nine NIPs from community and acute care settings within the West Midlands.

Findings

Decisions made about prescribing options, are effectively driven by individual levels of confidence, yet profoundly shaped by local arrangements. The x variation in local governance, suggests there is inconsistency in approach to formulary development or expansion based on prescribers’ scope of practice. These contributory factors when combined with variable individual knowledge and diagnostic ability result in inconsistent prescribing practice.

Conclusion

A conceptual model based on influences on nurse prescribers’ decision-making is presented.