Influences on community nurse prescribing

The factors that community nurses consider when prescribing were discussed during semi-structured interviews with a purposive sample of 21 nurses. The interviews were analysed using the framework method to identify key themes. For district nurses, the need to facilitate patient concordance was an important influence, while for health visitors it was responding to patient pressures to prescribe. Some nurses were reluctant to prescribe for patients that were very old/young, already receiving several items from their GP or without a GP diagnosis. The limited time available in clinics prevented some prescribing but the time available during home visits permitted a comprehensive patient assessment and a full explanation in the use of the product. The high priority nurses place on achieving concordance is important when determining the effectiveness of their prescribing. However, extended clinical roles could be undermined if there is a failure to manage patient pressure to prescribe.