Safety and quality of nurse independent prescribing: a national study of experiences of education, continuing professional development clinical governance.

AIM To determine the adequacy of initial nurse independent prescribing education and identify continuing professional development and clinical governance strategies in place for non-medical prescribing. BACKGROUND In 2006, new legislation in England enabled nurses with an independent prescribing qualification to prescribe, within their competence. In 2006, non-medical prescribing policies released by the Department of Health outlined the recommendations for education, continuing professional development and governance of non-medical prescribing; however, there was no evidence on a national scale about the extent of implementation and effectiveness of these strategies. DESIGN National surveys of: (i) nurse independent prescribers; and (ii) non-medical prescribing leaders in England. METHODS Questionnaire surveys (August 2008-February 2009) covering educational preparation, prescribing practice (nurse independent prescribers) and structures/processes for support and governance (non-medical prescribing leaders). RESULTS Response rates were 65% (976 prescribers) and 52% (87 leaders). Most nurses felt their prescribing course met their learning needs and stated course outcomes and that they had adequate development and support for prescribing to maintain patient safety. Some types of community nurse prescribers had less access to support and development. The prescribing leaders reported lacking systems to ensure continuity of non-medical prescribing and monitoring patient experience. CONCLUSION Educational programmes of preparation for nurse prescribing were reported to be operating satisfactorily and providing fit-for-purpose preparation for the expansion to the scope of nurse independent prescribing. Most clinical governance and risk management strategies for prescribing were in place in primary and secondary care.