Naidoo M, Filmalter C J, Cordier W
Department of Pharmacology, School of Medicine, Faculty of Health Science, University of Pretoria, Hatfield, South Africa.
Department of Nursing Science, School of Healthcare Sciences, Faculty of Health Science, University of Pretoria, Hatfield, South Africa.
Int J Ment Health Nurs. 2025 Jul;34(4):e70101. doi: 10.1111/inm.70101.
Mental healthcare service access in South Africa is currently strained due to, among others, shortages of specialised mental healthcare professionals. The National Strategic Plan for HIV, TB and STIs (2023-2028) recommends enabling nurses to diagnose, prescribe and dispense neuropsychiatric medication for promoting mental health services. The aim was to explore and describe the existing practices, strengths and challenges for nurses prescribing neuropsychiatric medication globally through a scoping and document review. A standardised search was conducted across PubMed, CINAHL and EBSCOHost electronic databases. An online Google search was conducted across governmental legislative and regulatory websites. The Joanna Briggs Institute scoping review framework was followed using relevant MeSH terms and free-text words. South African governmental and parastatal documentation relating to relevant regulatory frameworks affecting such prescribing authorisation in South Africa was analysed following Bowen (2009) guidelines. Of 817 citations identified, 20 reports were included. The included reports originated mostly from developed countries, with only one from South Africa. Patients and healthcare professionals were mostly positive towards including the prescription of neuropsychiatric medication in the nursing care model. Prescription of Schedule 5 and 6 controlled substances by nurses is already authorised in the USA and UK. In South Africa, nurses are not yet permitted and will require amendments to the legislative framework that guides nursing practice. Nurses can prescribe neuropsychiatric medications in certain developed countries; however, contextual research is necessary to ascertain whether South African stakeholders will support such an authorisation. Educational and interprofessional concerns will need to be thoroughly assessed to ensure that appropriate competencies are obtained, ensuring the boundaries of the scope of practice. Investigation of potential professional overlap of responsibilities and perceptional biases, as well as transformation of educational platforms, will be needed should such a recommendation come to pass. Furthermore, legislative changes will be required to authorise the prescription of neuropsychiatric medications.
南非的精神卫生保健服务目前面临压力，原因包括专业精神卫生保健专业人员短缺等。《2023 - 2028年艾滋病毒、结核病和性传播感染国家战略计划》建议让护士能够诊断、开处方和配发神经精神药物，以促进精神卫生服务。目的是通过范围界定和文献综述，探索和描述全球护士开具神经精神药物的现有做法、优势和挑战。在PubMed、CINAHL和EBSCOHost电子数据库中进行了标准化搜索。在政府立法和监管网站上进行了在线谷歌搜索。遵循乔安娜·布里格斯研究所的范围界定综述框架，使用相关医学主题词和自由文本词。按照鲍恩（2009年）的指导方针，分析了与影响南非此类处方授权的相关监管框架有关的南非政府和半官方文件。在识别出的817条引文中，纳入了20份报告。纳入的报告大多来自发达国家，只有一份来自南非。患者和医疗保健专业人员大多对在护理模式中纳入神经精神药物处方持积极态度。在美国和英国，护士开具第5类和第6类管制物质的处方已经获得授权。在南非，护士尚不被允许开具此类处方，需要对指导护理实践的立法框架进行修订。在某些发达国家，护士可以开具神经精神药物；然而，需要进行背景研究，以确定南非的利益相关者是否会支持这种授权。需要全面评估教育和跨专业问题，以确保获得适当的能力，明确执业范围的界限。如果这一建议得以通过，将需要调查潜在的职责专业重叠和认知偏见，以及教育平台的变革。此外，还需要进行立法变革，以授权开具神经精神药物处方。
