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The prescribing needs of community practitioner nurse prescribers: a qualitative investigation using the theoretical domains framework and COM-B

Chater, Angel M., Williams, Jane and Courtenay, Molly 2019. The prescribing needs of community practitioner nurse prescribers: a qualitative investigation using the theoretical domains framework and COM-B. Journal of Advanced Nursing 75 (11) , pp. 2952-2968. 10.1111/jan.14170
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Aim With several qualified community practitioner nurse prescribers (CPNPs) not prescribing, this research aimed to understand what influences this behaviour. Design A qualitative research design. Methods Semi‐structured interviews, based on the theoretical domains framework (TDF) were conducted with 20 CPNPs. Data collection took place between March‐July 2018 and continued until data saturation was reached. Results Nine themes inductively explained prescribing behaviour: 1) ‘Knowledge and experience’; 2) ‘Consultation and communication skills’; 3) ‘Professional confidence and identity’; 4) ‘Wanting the best outcome’; 5) ‘NHS versus patient cost’; 6) ‘Emotion‐led decisions’; 7) ‘Time allocation’; 8) ‘Formulary access’ and 9) ‘Supporting environment for patient‐centred care’. Themes were then deductively mapped to the TDF and COM‐B. Conclusion There is an ongoing need to support community practitioner nurse prescribers’ ‘Capability’ to prescribe in terms of knowledge and aquired skills; ‘Opportunity’ to make prescribing easier, such as access to a wider and up to date nurse formulary alongside effective clinical support; and ‘Motivation’ to feel confident in prescribing behaviour, highlighting positive patient outcomes while reducing perceived issues such as cost and non‐adherence. Impact Findings show that Capability, Opportunity and Motivation all influence the decision to prescribe. Those responsible for professional regulation and training should ensure community practitioner nurse prescribers have access to the relevant knowledge, skills and formulary to facilitate their prescribing behaviour. Professional confidence and identity as a prescriber should be encouraged, with acknowledgment of influences such as cost and emotion. An environment that allows for patient‐centred care and the best outcome should be supported, this may mean increasing time allocated to consultations.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Healthcare Sciences
Publisher: Wiley
ISSN: 0309-2402
Date of First Compliant Deposit: 6 August 2019
Date of Acceptance: 5 August 2019
Last Modified: 15 Jun 2020 10:00

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