Nurse prescribing in primary care in Spain: legal framework, historical characteristics and relationship to perceived professional identity

Abstract

To identify the extent of nurse prescription and determine specific medications and/or health-care supplies routinely prescribed by primary care nurses in Spain in a changing legal context. To explore nurse perceptions of legalized nurse prescription’s relationship to professional identity. Although the Spanish public has similar confidence in nurses and physicians, professional identity remains a concern for nurses. Nurse prescription has a confusing history in Spain but is increasingly common elsewhere, and may enhance nursing’s professional profile. A cross-sectional survey reporting the occurrence of nurse prescription in one province in Spain and primary care nurses’ perceptions of nurse prescription and professional identity in this province. The response rate was 69.6% (87 nurses). Frequent nurse-prescribed medications were vaccinations (63.1%), topical antiseptics (60.7%) and antipyretics(44.8%); health-care supplies included supplies for diabetes (51.8%), wound care dressings (44.2%) and incontinence (26.7%). Respondents indicated that nurse prescription positively contributes to the profession and to its development.Conclusion Nurse prescribing exists in primary care in Spain, and formal legalization is in progress but awaits a consensus formulary. Nurses indicated that full legalization would increase professional autonomy and contribute positively to the profession, as an example of how policy can have an impact on practice.Implications for nursing management Spain’s experience with inconclusive shifts in the legal status of nurse prescribing may contribute to the discussion in countries where this professional practice is not yet established.