Voorschrijven van medicijnen door verpleegkundigen

Summary

Nurse prescribing
A study on task substitution and professional jurisdictions
Marieke Kroezen

Nurses prescribe appropriately and in comparable ways to physicians. Yet the conditions under which nurses prescribe medicines vary considerably across Western European and Anglo-Saxon countries, from countries where nurses prescribe independently to countries in which prescribing by nurses is only allowed under strict conditions and the supervision of physicians. This means that in some countries, such as the United Kingdom, nurses share (full) legal jurisdiction over prescribing with the medical professionals. However, in most other countries, the legal jurisdiction over prescribing remains predominantly within the medical profession. In the Netherlands, some categories of specialized registered nurses (with a Bachelor’s degree) have limited legal prescribing rights, whereas nurse specialists (with a Master’s degree in Advanced Nursing Practice) have quite extensive prescribing rights. Dutch nurse specialists are allowed to prescribe any medicine within their specialism and competence. However, there is great diversity in the extent to and the way in which nurse specialists’ legal prescriptive authority has been implemented in everyday practice. Often, nurse specialists prescribe according to delimited protocols or following consultation with medical specialists. Hence, nurse specialists’ legal authority over prescribing is much broader than their jurisdictional control over prescribing in daily practice. As prescribing by nurses is still evolving in the Netherlands, prescriptive authority on the work floor will presumably change and crystallize over the years to come. Although it has been shown that nurse prescribing is safe and patients are generally satisfied with nurse prescribing, adjustments in nurse prescribing education, financing and implementation in everyday practice can yield further improvements in the future years.