Enhancing Nurse Prescribing Education in Iran: Challenges and Potential Solutions

Researchers from Tarbiat Modares University and Shahid Beheshti University explore integrating nurse prescribing training into Iran's nursing education, identifying challenges and potential solutions through qualitative analysis and curriculum comparison with John Hopkins University. They recommend curriculum modifications and pilot studies to enhance nurse prescribing capabilities in Iran.

A study conducted by researchers from Tarbiat Modares University and Shahid Beheshti University of Medical Sciences, explores the potential for integrating nurse prescribing training into Iran's nursing education system. This research, authored by Aazam Soltaninejad, Fatemeh Alhani, and Maryam Rassouli, is divided into two phases: a qualitative content analysis followed by a comparative analysis of nursing curricula.

Exploring Challenges in Nursing Education

In the first phase, 20 participants, including 16 nurses, three physicians, and one clinical pharmacist, were interviewed to gather insights into the current state of nursing education and the feasibility of nurse prescribing training. The qualitative analysis identified two main themes: challenges in nursing education and the potential for nurse prescribing training development. The challenges included inadequate knowledge in essential courses such as pharmacology, pathophysiology, and health assessment, insufficient educational infrastructure, and the need for continuous professional development. Participants highlighted the necessity for nurses to have advanced clinical skills and knowledge, including proficiency in the English language to stay updated with global medical standards.

Identifying Knowledge Gaps

The nurses reported that their current education does not sufficiently cover the advanced science courses necessary for safe and effective prescribing practices. Additionally, the educational infrastructure was found to be lacking, with a shortage of trained faculty members and inadequate continuous professional education programs. The qualitative phase revealed that nurses' basic scientific knowledge is insufficient for nurse prescribing development. Nurses must be well-versed in anatomy, pathology, physiology, pathophysiology, and pharmacology to make informed decisions regarding patient treatment. Participants emphasized that the pharmacology knowledge of nursing students and registered nurses is superficial, posing a threat to patient safety if nurses were to prescribe medications without additional training. The study also found that nurses' health assessment knowledge and skills are inadequate for effective prescribing. Proper treatment requires comprehensive physical and psychological health assessment skills, which are currently insufficiently covered in nursing curricula. The participants also highlighted the gap between theoretical knowledge and practical skills, indicating that nursing students do not acquire the necessary professional knowledge and skills upon graduation.

Enhancing Continuous Professional Development

The study further identified issues with the motivation of nurses for continuous professional development. Full-time work schedules, high workloads, and a lack of effective continuous education programs contribute to the lack of motivation among nurses to pursue further professional development. The participants called for improvements in the content, execution method, and timing of continuous education programs to make them more relevant and effective in nursing practice. In the second phase, the researchers compared the nursing curricula in Iran with those of John Hopkins University (JHU) to identify gaps and potential areas for improvement. The comparison revealed that Iranian curricula lack adequate courses in key areas such as pharmacology, pathophysiology, and health assessment. In contrast, JHU's nursing curricula include comprehensive courses in these areas, along with additional courses in clinical judgment and diagnosis, which are crucial for preparing nurses to prescribe safely and effectively.

Integrating Advanced Training

The study suggests that integrating these courses into Iranian nursing curricula and adopting an interprofessional approach involving pharmacists and doctors could enhance nurse prescribing training in Iran. The researchers also compared the last revised master's curricula in medical-surgical nursing, adult critical care nursing, pediatric critical care nursing, and community health nursing in Iran with those of JHU. They found that the credit hours for key courses in JHU's curricula are higher than those in Iranian curricula. Additionally, JHU's curricula include courses in advanced pharmacology, advanced health assessment, and symptom management, which are not present in Iranian curricula. The study recommends modifying the existing master's curricula in Iran to include these essential courses and adopting an interprofessional education model to support nurse prescribing training.

Leveraging Existing Potentials

Despite the challenges, the study identifies significant potentials for developing nurse prescribing training in Iran. The existence of advanced nursing roles in community health and critical care settings provides a foundation for implementing nurse prescribing training. The study suggests that modifying the current nursing curricula, utilizing the prepared structures such as nursing home care and experienced nurses in intensive care units, and involving physicians and pharmacists in the training process could help overcome the challenges and develop nurse prescribing training in Iran. The researchers recommend conducting pilot studies to evaluate the outcomes of integrating nurse prescribing training into continuous education and formal curricula such as the Master of Science in community health nursing or critical care nursing. These pilot studies would help assess the feasibility and effectiveness of nurse prescribing training in practice and provide valuable insights for further development. Overall, the research highlights the need for educational and managerial policies to support the development of nurse prescribing in Iran. By addressing the identified challenges and leveraging the existing potentials, nurse prescribing training could help address the country's healthcare challenges, particularly in underserved areas where access to medical professionals is limited.