Abstract

To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). Qualitative study conducted through semi-structured in-depth interviews. Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.

Highlights

  • Effective team communication and clear definitions of roles are two of the fundamental prerequisites for effective collaboration among nurses, physicians and pharmacists to deliver high quality care and better meet patients’ needs [1, 2]

  • Shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in pharmaceutical care (PC)

  • European nurses have an active role in PC

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Summary

Introduction

Effective team communication and clear definitions of roles are two of the fundamental prerequisites for effective collaboration among nurses, physicians and pharmacists to deliver high quality care and better meet patients’ needs [1, 2]. In this study PC is defined as ‘Healthcare professionals’ contribution to the care of individuals in order to optimize medicines use and improve health outcomes’. This definition is based on the definition of the Pharmaceutical Care Network Europe (PCNE) [8], which, was limited to the contribution of pharmacists, as well as the original definition of Hepler and Strand in 1990 [9]. The need for interprofessional collaboration in PC is broadly recognised [3, 10,11,12,13,14]

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