Healthcare services

Batey and Holland (1985) found the nurse practitioners provided effective management of medications for 85. 7% of all patients who presented for primary care issues independent of physician involvement. Patients believe that nurse practitioners would make better prescribing decisions than physicians because of the practice of holistic medicine (Nolan 2004). The holistic approach to a nurse practitioners approach to prescribing is believed to also consider medication compliance and health maintenance issues (Nolan 2004).

Patients also believe that a nurse practitioner monitors medications closer than physicians because of the ease of accessibility (Nolan 2004). The nurse practitioner profession is growing during a period of time when the demand for healthcare services is increasing and the production of new physicians from medical schools are unchanged (Cipher, Hooker, & Guerra 2006). Nurse practitioners will have a more cautious approach to prescribing medications and have a higher consultation rate for less frequently prescribed medications and for less common illnesses encountered (Batey & Holland 1985).

Nurse practitioners saw more primary care patients in rural areas than physicians and prescribed more medications (Cipher, Hooker, & Guerra 2006). Nurse practitioners along with physician assistants are slowly becoming a principle provider of care for people in rural areas and as the number of providers increase the prescribing practices are expected to continue to expand (Cipher, Hooker, & Guerra 2006). Nurse practitioner prescribing offers more patient education on medication administration to patients because of the extra time provided during an office visit (Nolan 2004).

Practice Implications of Prescribing Nurse practitioners provide a broad range of primary care services in rural and urban areas and medication prescribing and dispensing are important aspects of healthcare delivery (Cipher, Hooker, & Guerra 2006). Nurse practitioner prescribing is increasing in significance and policies need to be changed and developed to create prescriptive independence to enable efficient delivery of healthcare services (Cipher, Hooker, & Guerra 2006).

Nurse practitioners who do not have prescriptive authority for schedule II-V medications report a lack of expertise as a prominent barrier to autonomy (Kaplan, Brown, Andrilla & Hart 2006). Nurse practitioners who have schedule II-V prescriptive authority report patient drug seeking behavior as the most difficult barrier to overcome in medication prescribing (Kaplan, Brown, Andrilla, & Hart 2006). The development of prescriptive authority for nurse practitioners has created an interest for the pharmaceutical industry.

Prescriptive authority by nurse practitioners has developed unintended consequences of ethical dilemmas which are propagated by the pharmaceutical industry (Nolan 2004). There are distinct benefits of pharmaceutical influence on nurse practitioner prescribing because of the patient information and financial support provided (Nolan 2004). Other benefits available to the prescribing nurse practitioner are the education seminars provided by the pharmaceutical industry (Nolan 2004).

These educational presentations supplied by the pharmaceutical industry need to be screened carefully for a the presence of a hidden sales agenda which would unduly influence prescribing habits not in the best interests of patient care (Nolan 2004). The fear of litigation is present as the nurse practitioner profession seeks to increase the prescriptive authority the members have (Nolan 2004). Current literature demonstrates that despite the barriers nurse practitioners prescribing produce better patient outcomes (Nolan 2004).

Prescriptive authority has not been shown to increase job satisfaction for nurse practitioners due to the barriers still present (Nolan 2004). Internal barriers to the expansion of nurse practitioner prescribing authority include the education, expertise, professional attitudes, and values (Kaplan, Brown, Andrilla, & Hart 2006). These internal barriers develop from socialization, communication with colleagues, normal community practice, and personal characteristics (Kaplan, Brown, Andrilla, & Hart 2006).

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