Readiness of Polish palliative care nurses to expand authority for independent nurse prescribing (INP)

Introduction
The aims of the study were to assess the current use of prescribing rights by palliative care nurses in Poland, explore their attitudes toward expanding independent prescribing, identify perceived needs regarding specific drug groups, and examine barriers and opportunities for implementation.

Material and methods
A survey was conducted using a proprietary questionnaire as the research tool. The target population included registered nurses working in palliative care settings across Poland. Participants were recruited via professional networks and invited to complete an online questionnaire distributed through ICT channels. The survey collected data on demographics, educational attainment, self-assessed clinical competence, and attitudes toward prescribing specific drug groups. Data were collected within three months, yielding 144 fully completed responses.

Results
The diagnostic survey examined 144 palliative care nurses. The group of drugs that nurses with a bachelor’s degree (BSN) and master’s degree in nursing (MSN) do not want to prescribe were antidepressants. Nurse specialists (NS) indicated the need to expand the catalog of drugs for INP to include benzodiazepines and sleep medications from the group “Z” (Z-drugs). Palliative care nurses also indicated the necessity to expand INP of strong opioids. Attitudes toward INP of medications were related to nurses’ education levels.

Conclusions
Bolstering palliative care nurses’ clinical competencies through targeted education and formal INP authorization can enhance patient access to symptom management and reduce bottlenecks in medication delivery. Empowering nurses with independent prescribing privileges, particularly for controlled drugs, such as opioids and anxiolytics, has the potential to decrease hospital admissions, shorten lengths of stay, limit re-admissions, and lower overall healthcare costs. Nurses themselves recognize extended prescribing rights as essential for optimizing interdisciplinary palliative care delivery.