Dutch Travel Health Nurses: Prepared to Prescribe?

Authors

  • Femke W. Overbosch MD,

    Corresponding author
    1. Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, The Netherlands
    • National Coordination Centre for Traveler's Health Advice (LCR), Amsterdam, The Netherlands
    Search for more papers by this author
  • Susan C. Koeman RN,

    1. National Coordination Centre for Traveler's Health Advice (LCR), Amsterdam, The Netherlands
    Search for more papers by this author
  • Anneke van den Hoek MD, PhD,

    1. Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, The Netherlands
    2. Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Amsterdam, The Netherlands
    Search for more papers by this author
  • Gerard J.B. Sonder MD, PhD

    1. National Coordination Centre for Traveler's Health Advice (LCR), Amsterdam, The Netherlands
    2. Department of Infectious Diseases, Public Health Service (GGD), Amsterdam, The Netherlands
    3. Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Amsterdam, The Netherlands
    Search for more papers by this author

  • This paper was presented as oral communication at the Northern European Conference on Travel Medicine, Dublin, Ireland (June 6–8, 2012).

Corresponding Author: Femke W. Overbosch, MD, National Coordination Centre for Traveler's Health Advice (LCR), Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands. E-mail: foverbosch@ggd.amsterdam.nl

Abstract

Background

In travel medicine, as in other specialties, independent prescribing of medication has traditionally been the domain of practitioners like physicians, dentists, and midwives. However, a 2011 ruling in the Netherlands expands independent prescribing and introduces supplementary prescribing by nurses, with expected implementation over the next few years. As specialist nurses will not be eligible for independent prescribing, this study addresses supplementary prescribing, specifically by travel health nurses. Such nurses will work in partnership with an independent prescriber, usually a physician. After the physician evaluates a patient's condition and needs, the nurse may prescribe from an open or limited formulary. This supplementary approach seems appropriate in travel medicine, which is highly protocolized. A questionnaire survey was conducted to assess whether travel health nurses themselves aspire and feel competent to prescribe, and what training they might need.

Methods

All travel health nurses in the Netherlands received a questionnaire seeking their anonymous response.

Results

The response rate was 58%. Self-reported compliance with protocols and quality criteria was high; 82% of respondents aspire to prescribe and 77% feel competent to prescribe. Of the latter, 22% indicated that ongoing access to a doctor would remain important, and 14% preferred to prescribe under certain conditions like a restricted number of medicines. The reason most frequently given for not feeling competent was the need for additional education before obtaining prescribing rights (40%). Aspiration to prescribe was the only significant predictor for feeling competent to prescribe (odds ratios: 6.8; 95% confidence intervals: 3.5–13). Of all the responding nurses, 95% reported one or more educational needs related to prescribing, particularly in pharmacology.

Conclusions

Most Dutch travel health nurses aspire to prescribe and feel competent for the supplementary approach, but require further education before the approach is implemented in travel medicine.

Ancillary