Improving Nurse Practitioner Practice through Rational Prescribing

Nurse practitioners (NPs) are often influenced by external factors that may lead to inappropriate or suboptimal prescribing choices. The movement of evidence-based practice and the World Health Association's promotion of rational prescribing that began in the 1970s are part of a global initiative to reduce inappropriate prescribing and improve patient care. This article conceptualizes rational prescribing and reviews the efficacy of strategies in current use to improve prescribing practices. The ethical role of NPs is explored, and we identify the primary role of NPs as an obligation to educate patients to make informed decisions that are efficacious and cost effective. NPs have a fiduciary duty to the patient to make choices in the best interest of the patient, but this duty must be balanced with their professional duty to the wider community and to the common good of the global society.