Factors influencing effective independent nurse prescribing.

AIM To identify some of the factors influencing effective independent nurse prescribing within a surgical high-dependency unit. METHOD An audit methodology was used to record the personal prescribing practice of a critical care nurse following the completion of a course in independent and supplementary prescribing. RESULTS The main factors influencing effective independent nurse prescribing were identified as limitations of the Nurse Prescribers' Formulary; lack of depth and breadth of experience in clinical and diagnostic reasoning; insufficient opportunities to enable reflection in practice and case-based learning; and variation in prescribing practice among individual clinicians. CONCLUSION In the acute setting, the limitations imposed by the Nurse Prescribers' Formulory reduced the number of medicines that would otherwise have been prescribed, amended or discontinued. The recommendation from the Committee on Safety of Medicines that suitably qualified and trained nurses should be able to prescribe any medicine from the BNF is therefore wholly welcomed.