Background: Non-medical prescribing is a new skill in midwifery practice. Information is needed on whether this is an activity that is feasible, appropriate, meaningful and effective.
Aim: To report on the determinants of midwife prescribing behaviour to inform midwifery practice.
Method: A mixed-methods review using an integrated approach combining methodologically diverse data into a single mixed-methods synthesis. A systematic search of the literature was conducted. Data were categorised according the feasibility-appropriateness-meaningfulness-effectiveness (FAME) scale and thematised according the attitude, social-influence, self-efficacy (ASE) model. A thematic analysis, a Bayesian descriptive analysis and Bayesian Pearson correlations of the FAME-categories and ASE-themes were performed.
Findings: Seven studies showing moderate to good quality were included for synthesis. The FAME categories feasibility and
appropriateness tended to affect the utility of midwife prescribing; meaningfulness and effectiveness were related to non-utility
of prescribing. There were weak to moderate correlations between the FAME categories and the ASE themes social influence, intention, barriers and supportive factors and perceived knowledge (r-.41 to -.34 and r.37 to .56). ASE themes showed a strong negative correlation between attitude and self-efficacy (r-.70); weak positive correlations between attitude and social influence (r.31) and perceived knowledge (r.30); a weak positive correlation between self-efficacy and social influence (r.30), and a weak negative correlation with intention (r-.31); a moderate negative correlation between social influence and barriers/ supportive factors (r-.50); a weak negative correlation between barriers/supportive factors and perceived
Conclusion: Prescribing fits the midwife’s professional role and maternity services and is enhanced by the midwife’s willingness
and supportive practice. Prescribing requires collaborative practice, meaningful relationships with women, (applied) knowledge,
expertise, and theoretical, practical and logistic support in the clinical area.
Implications: Midwives who consider prescribing or who are autonomous prescribers should be aware of their role and position
as autonomous prescriber. They should reflect on their willingness to prescribe, self-efficacy, perceived knowledge, their cognitive
beliefs about prescribing and the effect of prescribing on women in their care.
Kuipers, Y. (2019, November). Non-medical prescribing behaviour in midwifery practice: a mixed-methods review. Poster presented at ESPACOMP Congress, Porto, Portugal