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To identify barriers and facilitators to nurse prescribing implementation through a synthesis of qualitative studies.
The roles of healthcare professionals are expanding in response to the growing demand for access to high-quality healthcare services. Advanced practice nurses are a global trend, and nurse prescribing is a crucial feature of advanced practice nurses that can meet the needs of growing healthcare services. The development and promotion of nurse prescribing varies significantly across countries, and it is essential to identify the factors influencing the implementation of nurse prescribing.
A systematic search of PubMed, Web of Science, Embase, Cochrane Library, CINAHL, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wan Fang and Weipu database was conducted to retrieve literature on barriers and facilitators related to the implementation of nurse prescribing. We searched records from inception to 29 March 2025. Two researchers independently performed literature screening, literature evaluation, data extraction and synthesis. Literature screening and data extraction adhered to the predefined inclusion and exclusion criteria. Literature quality was evaluated using the JBI Checklist for Qualitative Research. The results were synthesised using the thematic synthesis approach. Information was extracted using the Consolidated Framework for Implementation Research (CFIR) in a deductive way, and barriers and facilitators to the implementation were categorised based on the CFIR. Report rigour assessed via ENTREQ.
The synthesis of 14 included papers identified 18 thematic categories, yielding two key findings. The main barriers identified included failure to anticipate the cost of nurse prescribing, legal constraints, social pressures, poor organisational structure, insufficient prescribing education, lack of competence of nurses leading to psychological changes, opposition and lack of cooperation of team members, and insufficient planning of nurse prescribing. Facilitating factors included prescribing experience, resource and labor conservation, cost reduction, resources, nurses' prescribing training, leadership support, patients' needs, nursing professional development, nurses' competence, and team cooperation and support.
Identifying barriers and facilitators to nurse prescribing is critical for informing policy-making and clinical prescribing practices. The results offers practical guidance to develop strategic plans that enhance implementation and adoption of nurse prescribing.
Nurse prescribing improves patient access while mitigating healthcare strain. By streamlining medication delivery and optimising resource use in overburdened systems, this model strengthens patient-centered care while allowing physician specialisation in complex cases. This workforce innovation enhances team-based care and ensures continuity for vulnerable populations.
This paper identifies barriers and facilitators, offering policymakers, healthcare administrators, and educators actionable insights to enable nurse role expansion, reduce physician workload, and enhance outcomes through holistic care.
No patient or public contribution.
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