Legal nurse prescribing of medicines in Western European and Anglo-Saxon countries: a systematic review of the literature.

Background: A growing number of countries introduces some form of nurse prescribing (NP), offering potential benefits in terms of improving patients’ access to medicines and better use of health professionals skills. International reviews concerning the practice of NP are scarce and lack a systematic- and theoretical approach. As a further growth of NP is anticipated, this study aims to provide a complete picture of NP internationally and the ensuing renegotiations between the nursing and medical professions over the jurisdiction of prescribing, so as to inform further developments. Methods: A systematic review of the NP literature was performed without limits as to date of publication or country. After a comprehensive search of six literature databases and eight websites, a three stage inclusion process consisting of initial sifting, more detailed selection and checking full-text publications, was performed independently by two reviewers. Data were synthesized using narrative and tabular methods. Results: Preliminary results show that educational, ractical- organizational and legal conditions are in place in all countries that realized NP. Yet the precise filling in of these conditions varies considerably, and a variety of jurisdictional settlements between the nursing and medical professions concerning the task of prescribing can be discerned. Conclusions: These preliminary results show that the practice of NP varies considerably among countries, from situations where nurses prescribe independently to situations in which prescribing by nurses is only allowed under strict conditions and close supervision of physicians. Insight into these different forms of NP organization internationally might aid future NP initiatives