Prevalence and Perspective of Nurses Prescribing Medicines: A Cross-sectional Mixed-method Study in Bhutan

Abstract Background: Nurses prescribing medicines is a global phenomenon, albeit with inconsistent regulations and policies. Although there are no clear policies on the nurses prescribing authority, anecdotal evidence indicates the prescribing behaviour among nurses in Bhutan. Aim: In this study, we aimed to examine the prevalence and perspective of nurses prescribing medicines in Bhutan. Materials and Methods: A cross-sectional mixed-method study was conducted by surveying 312 registered nurses. Demographic data obtained through convenient sampling technique were statistically tested using logistic regression to identify the predictors of nurses prescribing medicines. The qualitative data gathered through in-depth interviews were analysed using thematic analysis. Results: The prevalence of nurses prescribing medicines in Bhutan was 61.2%. Clinical experiences of 1–10 years (adjusted odds ratio [AOR]: 4.98 [95% confidence interval (CI): 1.37–18.13]), work area (AOR: 2.91 [95% CI: 1.31–6.45]), department (AOR: 12.84 [95% CI: 5.19–31.71]), hospital support (AOR: 0.17 [95% CI: 0.06–0.47]) and sensitisation program (AOR: 2.35 [95% CI: 1.18–4.67]), and confidence in prescribing (AOR: 3.54 [95% CI: 1.70–7.38]) were significantly associated with nurses prescribing medicines in Bhutan. Qualitative data revealed an acute shortage of doctors as a fundamental reason why nurses illegally prescribe medicines. Conclusion: A high prevalence of nurses prescribing medicines was found in this study. This raises a serious concern as it might lead to grave consequences not only for the service recipients but also for the nurses. We recommend addressing the shortage of doctors on an urgent basis to prevent illegal prescribing incidents in the country.