IntroductionMedical prescribing, in terms of both education and practice, has been extensively researched but this has not been the case with nurse prescribing (Coombes, Mitchell, & Stowasser, 2008; Franson, Dubois, de Kam, Burggraaf, & Cohen, 2009; Garbutt et al., 2006; Gwee, 2009). One reason for this is that internationally, prescriptive authority differs between countries, and hence the educational preparation for nurses to prescribe also varies. This has detracted from consistent research into the educational preparation and practice of nurse prescribing despite the fact that registered nurse prescribing is well established in some countries, notably the United Kingdom and is generally regarded positively (Latter et al., 2010).This article describes the pedagogical underpinnings of one of the first postgraduate programmes developed for nurse practitioners to gain prescriptive authority. Nurses intending to become nurse practitioner prescribers were interviewed to gain an understanding of their experiences of undertaking these postgraduate prescribing programmes.BackgroundNurse prescribing in New Zealand: A brief historyIn New Zealand, the nurse practitioner role was introLim, duced to improve patient access to health care services (National Health Committee, 2000). The introduction of the nurse practitioner role also represented a significant advance for professional nursing and positioned nurses to practice autonomously. Autonomous practice for nurse practitioners includes performing comprehensive health assessments, clinical diagnosis and prescribing treatments. The introduction of nurse prescribing in New Zealand has developed concurrently with the role of the nurse practitioner (Nursing Council of New Zealand, 2005). Since 1999, nurse practitioners in New Zealand can prescribe as long as they have completed the necessary educational preparation (Lim, Honey, & Kilpatrick, 2007).Prescriptive authority in New Zealand is outlined in the Medicines Act of 1981 and in the Medicines Regulation of 1984. Under the Act, health professionals with prescriptive authority (authorised prescribers) can prescribe all medicines from Part 1A or Part 1B of the Schedule 1 of the Medicines Regulations. Three health professional groups were authorised prescribers (doctors, dentists and midwives) until 1999 (Medicines Amendment Act 1999) when prescriptive authority for nurses was considered by the New Zealand government and the legislation was amended.Educational preparation for prescribing was included in the undergraduate programme for doctors, dentists and midwives, which was not the case for nurses. Therefore the term, designated prescribers, was added in the amendments to the Act. Unlike authorised prescribers, designated prescribers are required to undergo additional education in pharmacology and therapeutics to become prescribers. Since 1999, further amendments to the Act (in 2011) extended prescriptive authority to pharmacists and diabetes nurse specialists, so that pharmacists, diabetes nurse specialists and nurse practitioners could become designated prescribers. The extension was further refined in 2013 (Medicines Amendment Act 2013), when nurse practitioner prescribers gained the same prescriptive authority as doctors, dentists and midwives as authorised prescribers, and a new category of prescribers called delegated prescribers was added to the Act. There are now three levels of prescriptive authority in New Zealand: authorised, designated and delegated. These legislative changes bring challenges and potential for confusion to nurse prescribing roles.Educational preparation of nurses for prescribing has always been considered in the changes to the legislation. Educational preparation includes knowledge of applied biological sciences, advanced assessment and diagnoses, pharmacology and therapeutics, alongside a prescribing practicum where the knowledge is applied within a clinical context. …
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