Recent Research About Nursing, June 2014

Jun 17, 2014, 9:00 AM

This is part of the June 2014 issue of Sharing Nursing’s Knowledge.

Research Compares Nurse and Physician Prescription Practices

A newly published systematic review of more than four decades of research on nurse prescribing finds that in the U.S. states and foreign countries in which nurses are allowed to prescribe, their prescription practices are similar to those of physicians, but their patients report higher satisfaction with their care and are more likely to return for follow-up visits.

The review was conducted by a team of researchers in the Netherlands—one of several countries in which nurses may prescribe. The team screened all studies they could find on the subject dating back to 1974, finally identifying 35 studies that met their criteria, including 13 from the United States, 12 from the United Kingdom, five from the Netherlands, two from Canada, two from Norway, and one from Colombia. The studies’ methods and specific topics varied, but the team conducting the review identified a number of trends in the research. They wrote:

  • “Our findings suggest that nurses prescribe for a wide range of patients and in comparable ways to physicians. Overall, nurses appear to prescribe for just as many patients as physicians do, nurses prescribe comparable numbers of medicines per patient visit and there appear to be few differences between nurses and physicians in the type and dose of medication prescribed and in clinical outcomes.
  • “Studies comparing the total number of medicines prescribed by nurses and doctors show mixed results ... depending on therapy type and the type of medication being prescribed.
  • “Patients were generally more or equally satisfied with the care provided by nurses compared to the traditional care provided by physicians.
  • “[N]urses generally appear to spend more time with patients than physicians do and to give more or the same amount of information to patients. ...
  • “While there appear to be no differences between nurses and physicians in referrals to secondary care, patients cared for by nurses seem to make more return visits than patients cared for by physicians.”

“[I]t appears that nurse prescribing is of similar quality to physician prescribing,” the research team concludes, “and worries about whether nurses have the competence to prescribe appear to be unfounded.”

Read an abstract of the study, published in the International Journal of Nursing Studies.

Nurses More Likely to Rate Patients’ Pain Higher, Administer Opioids

New research finds that nurses are more likely than doctors to rate patients’ pain as severe enough to warrant the use of opioid analgesics.

In a study published in the May 2014 issue of the International Journal of Nursing Studies, a group of nine researchers tested 80 physicians (44 men and 36 women) and 113 nurses (10 men and 103 women), using a brief written description of the symptoms of a fictional patient suffering from long-term back pain. They also showed subjects 20-second videos of several computer-animated patients who were identifiable by gender, age, and race.

The researchers then asked the health care professionals to rate their patients’ pain and to decide whether they would administer opioid analgesics. They write, “We found meaningful differences in how health care professionals make decisions about pain assessment and treatment in general, as well as differences in their pain management decisions across patient demographic groups. ... [N]urses were more willing to administer opioid analgesics than were physicians.”

They also identified differences by patient. “Health care professionals rated pain higher and were more likely to treat male and African American virtual human patients with opioids than they were female and Caucasian virtual human patients,” the researchers say. “Health care professionals were also more willing to rate pain higher for older than for younger adults.”

According to the researchers, the differences between the professions could not be accounted for by gender. Female and male physicians rated patients’ pain and their need for opioids similarly.

Read an abstract of the study.

More Coverage of Recent Research About Nursing on the Human Capital Blog

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CDC Study: Nurses, Physician Assistants More Likely to Provide Education in Chronic Disease Management than Doctors

When It Comes to Cost and Quality of Hospital Care, Nurse Tenure and Teamwork Count

New Survey: In an Evolving Profession, Nurses Are Satisfied and Staying the Course

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.