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Presentation modality: poster
Nursing care research and long term conditions




REF.: 033
Country: United Kingdom

The use of cognitive continuum theory and patient scenarios to explore nurse prescribers' pharmacological knowledge and decision making
Maxine Offredy
1, Sally Kendall2, Claire Goodman2
(1) Doctor, (2) Professor. University of Hertfordshire, CRIPPAC, College Lane, Hatfield (UK)

Mail delivery: University of Hertfordshire, CRIPPAC, College Lane, Hatfield, Herts AL10 9AB (UK)

Rev Paraninfo digital, 2007: 2

How to cite this document

Offredy, Maxine; Kendall, Sally; Goodman, Claire. The use of cognitive continuun theory and patient scenarios to explore nurse prescribers' pharmacological knowledge and decision making. Rev Paraninfo Digital, 2007; 2. In: <http://www.index-f.com/para/n2/033.php> Consulted 11 de Agosto del 2022



Introduction: Nurses have been involved in prescribing in England since 1996, and to date over 41,000 nurses are registered with the Nursing and Midwifery Council as prescribers. The majority of evaluative research on nurse prescribing is descriptive and relies on self report and assessment of patient satisfaction. Few studies have tested the pharmacological knowledge base of nurse prescribers and how practitioners make their prescribing decisions. This study explores and tests nurse prescribers� pharmacological knowledge and decision making. Semi-structured interviews with nurse prescribers using patient scenarios were used as proxy methods of assessment of how nurses made their prescribing decisions.
Methods: Two primary care trusts in the southeast of England were the settings for this study. Purposive sampling of 25 participants to ensure there was a mixed group of prescribers was used to enable detailed exploration of the research objectives and to obtain in-depth understanding of the complex activities involved in nurse prescribing. Interviews and case scenarios were the methods employed. The use of Cognitive Continuum Theory guided the analysis.
Results: The majority of participants were unable to identify the issues involved in all the scenarios; they also failed to provide an acceptable solution to the problem, suggesting that they would refer the patient to the general practitioner. A similar number described themselves as �very confident� while seven participants felt that they were �not confident� in dealing with medication issues, four of whom were practising prescribing.
Conclusions: The effects of social and institutional factors are important in the decision making process. The lack of appropriate pharmacological knowledge coupled with lack of confidence in prescribing was demonstrated. The scenarios used in this study indicate that nurses are perhaps knowledgeable in their small area of practice but flounder outside this. Further research could be conducted with a larger sample and with more scenarios to explore the decision making and the pharmacological knowledge base of nurse prescribers, particularly in the light of government policy to extend prescribing rights to non-medical prescribers, including pharmacists.
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