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Perceptions and practice of concordance in nurses' prescribing consultations: findings from a national questionnaire survey and case studies of practice in England.
Int J Nurs Stud. 2007 Jan; 44(1):9-18.IJ

Abstract

BACKGROUND

The number of nurses able to independently prescribe medicines in England is increasing. Patient adherence to prescribed medicines remains a significant problem [Department of Health, 2000. Pharmacy in the Future: Implementing the NHS Plan. A Programme for Pharmacy in the NHS. Stationary Office, London]. Concordance-a partnership approach to medicine consultations-is advocated as an effective solution [Medicines Partnership, 2003. Project Evaluation Toolkit. Medicines Partnership, London].

OBJECTIVES

To investigate whether nurses were practising the principles of concordance within their prescribing interactions.

DESIGN

Phase (i) postal questionnaire survey. Phase (ii): case studies of practice.

SETTINGS

Phase (i) primary and secondary care trusts throughout England in which nurse prescribers were practicing. Phase (ii) six general practice settings; one community midwifery service; one specialist community palliative care service; one secondary care ophthalmology unit; one NHS walk-in centre.

PARTICIPANTS

Phase (i) a random sample of 246 nurses registered as independent nurse prescribers with the Nursing and Midwifery Council in 2002/2003. Phase (ii) purposively selected sample of 14 nurse prescribers who participated in Phase (i) of the study; a total of 208 purposively selected patients completed self-administered questionnaires.

METHODS

Phase (i) postal questionnaires. Phase (ii) structured non-participant observation of 118 nurse prescribing consultations; 115 post-consultation patient questionnaires; 93-patient postal questionnaires.

RESULTS

99% of the nurses in the national survey stated they were practising the principles of concordance. The majority of patients surveyed also reported experiencing concordance in practice. Observation of practice revealed that although some principles of concordance were regularly integrated into nurses' practice, other principles were less often in evidence. Some evidence from both observation of practice and patient questionnaires suggested that a professionally determined 'compliance' agenda may still be partially operating in practice.

CONCLUSIONS

Most nurses believe they are practicing concordance in their prescribing consultations. The majority of patients also reported that they had experienced some of the principles of concordance in practice. Observation of practice highlighted that the shift from a professionally determined compliance agenda to the integration of concordance into nurses' prescribing consultations had not yet taken place.

Authors+Show Affiliations

School of Nursing & Midwifery, University of Southampton, Building 67, Highfield, Southampton SO17 1BJ, England. sml@soton.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16359677

Citation

Latter, Sue, et al. "Perceptions and Practice of Concordance in Nurses' Prescribing Consultations: Findings From a National Questionnaire Survey and Case Studies of Practice in England." International Journal of Nursing Studies, vol. 44, no. 1, 2007, pp. 9-18.
Latter S, Maben J, Myall M, et al. Perceptions and practice of concordance in nurses' prescribing consultations: findings from a national questionnaire survey and case studies of practice in England. Int J Nurs Stud. 2007;44(1):9-18.
Latter, S., Maben, J., Myall, M., & Young, A. (2007). Perceptions and practice of concordance in nurses' prescribing consultations: findings from a national questionnaire survey and case studies of practice in England. International Journal of Nursing Studies, 44(1), 9-18.
Latter S, et al. Perceptions and Practice of Concordance in Nurses' Prescribing Consultations: Findings From a National Questionnaire Survey and Case Studies of Practice in England. Int J Nurs Stud. 2007;44(1):9-18. PubMed PMID: 16359677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Perceptions and practice of concordance in nurses' prescribing consultations: findings from a national questionnaire survey and case studies of practice in England. AU - Latter,Sue, AU - Maben,Jill, AU - Myall,Michelle, AU - Young,Amanda, Y1 - 2005/12/15/ PY - 2005/07/18/received PY - 2005/12/20/pubmed PY - 2007/3/3/medline PY - 2005/12/20/entrez SP - 9 EP - 18 JF - International journal of nursing studies JO - Int J Nurs Stud VL - 44 IS - 1 N2 - BACKGROUND: The number of nurses able to independently prescribe medicines in England is increasing. Patient adherence to prescribed medicines remains a significant problem [Department of Health, 2000. Pharmacy in the Future: Implementing the NHS Plan. A Programme for Pharmacy in the NHS. Stationary Office, London]. Concordance-a partnership approach to medicine consultations-is advocated as an effective solution [Medicines Partnership, 2003. Project Evaluation Toolkit. Medicines Partnership, London]. OBJECTIVES: To investigate whether nurses were practising the principles of concordance within their prescribing interactions. DESIGN: Phase (i) postal questionnaire survey. Phase (ii): case studies of practice. SETTINGS: Phase (i) primary and secondary care trusts throughout England in which nurse prescribers were practicing. Phase (ii) six general practice settings; one community midwifery service; one specialist community palliative care service; one secondary care ophthalmology unit; one NHS walk-in centre. PARTICIPANTS: Phase (i) a random sample of 246 nurses registered as independent nurse prescribers with the Nursing and Midwifery Council in 2002/2003. Phase (ii) purposively selected sample of 14 nurse prescribers who participated in Phase (i) of the study; a total of 208 purposively selected patients completed self-administered questionnaires. METHODS: Phase (i) postal questionnaires. Phase (ii) structured non-participant observation of 118 nurse prescribing consultations; 115 post-consultation patient questionnaires; 93-patient postal questionnaires. RESULTS: 99% of the nurses in the national survey stated they were practising the principles of concordance. The majority of patients surveyed also reported experiencing concordance in practice. Observation of practice revealed that although some principles of concordance were regularly integrated into nurses' practice, other principles were less often in evidence. Some evidence from both observation of practice and patient questionnaires suggested that a professionally determined 'compliance' agenda may still be partially operating in practice. CONCLUSIONS: Most nurses believe they are practicing concordance in their prescribing consultations. The majority of patients also reported that they had experienced some of the principles of concordance in practice. Observation of practice highlighted that the shift from a professionally determined compliance agenda to the integration of concordance into nurses' prescribing consultations had not yet taken place. SN - 0020-7489 UR - https://www.unboundmedicine.com/medline/citation/16359677/Perceptions_and_practice_of_concordance_in_nurses'_prescribing_consultations:_findings_from_a_national_questionnaire_survey_and_case_studies_of_practice_in_England_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-7489(05)00209-9 DB - PRIME DP - Unbound Medicine ER -