McHugh, Áine M.
(2022)
An Examination of the Nurse/Midwife Prescribing
Programme in Ireland: Confidence, Accuracy,
Seeking Advice and working within the Scope of
Practice.
PhD thesis, National University of Ireland Maynooth.
Abstract
The purpose of this study is to explore the impact of the nurse/midwife
prescribing programme on nurse/midwife prescribers and measuring the
confidence, accuracy, advice seeking behaviour and scope of practice of the
participants. A concurrent mixed method approach was used. Data were
gathered from 28 qualified nurses and midwives in Ireland, 14 of whom were
registered nurse/midwife prescribers and 14 of whom were undertaking the
prescribing programme, using semi- structured interviews, and testing the
participants with validated clinical scenarios. Relevant literature was also
reviewed which revealed tensions between views of medicine and nursing,
issues of power and knowledge, and differences between positivist and post-
positivist views of research methodology.
The qualitative analysis of the data using MAX QDA to manage the data
resulted in the identification of themes including, aspects of the programme
which were more useful to the nurse/midwife prescribers; the effect the
nurse/midwife prescribing programme had on their clinical practice and their
thinking; how has the programme influenced or changed their view of
prescribing practices; how they used the nurse/midwife prescribing decision
making framework developed by An Bord Altranais; how did the
nurse/midwife prescribing programme prepare them for their role as a
nurse/midwife prescriber in Ireland and the changes that are required to the
nurse/midwife prescribing programme in Ireland. The quantitative element of
the study found high levels of confidence and accuracy among nurse/midwife
prescribers, a willingness to seek advice from medical and nursing colleagues
and it emerged that participants had good awareness of the limits of their
scope of practice.
The study found that nurse/midwife prescribing was perceived by the
participants to have changed their practice in terms of caring for the whole
patient and their awareness of potential dangers in prescribing such as
polypharmacy. Also, the study found that the prescribing programme was
effective in preparing the nurse/midwife prescribers, and that being a
nurse/midwife prescriber produced efficiencies in patient care as well as
quality enhancement in that care. The study revealed frustrations with the
governance system particularly the monitoring system that seemed to
incentivize prescriptions. Finally, the study highlighted the pedagogical
implications of this study for nurse/midwife prescribing education and how
real-world learning through simulation, cooperative learning, and
interdisciplinary education, could enhance learning, increase safety, and
ultimately lead to better patient outcomes.
| Item Type: |
Thesis
(PhD)
|
| Keywords: |
Examination; Nurse/Midwife Prescribing
Programme; Ireland; Confidence; Accuracy;
Seeking Advice; Practice; |
| Academic Unit: |
Faculty of Social Sciences > Education |
| Item ID: |
15841 |
| Depositing User: |
IR eTheses
|
| Date Deposited: |
13 Apr 2022 14:12 |
| URI: |
|
| Use Licence: |
This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available
here |
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