Background:
Demand for high quality cancer care at Sunshine Coast Health (SCH) has driven expansion of the Nurse Practitioner (NP) and NP candidate (NPC) workforce in oncology. NPCs cannot prescribe until endorsed as NPs and there is limited evidence or training to support safe NPC prescribing. In 2024, SCH implemented a supervised prescribing pilot to build NPC competence and confidence.
Aims:
To describe a supervised prescribing model that supports competent and confident NP/NPC prescribing in oncology.
Methods:
A pilot model was implemented for two oncology NPCs, with a retrospective audit of the August to November 2024 period. The model was endorsed by executive, pharmacy and medicines and safety committees. NPCs completed electronic prescriber training and documented patient demographics, medication details, outcomes of proposed orders, and escalation processes. Pre- and post-pilot surveys were completed by NPCs and oncology clinicians.
Results:
Across the 3-month period, 29 medications were prescribed; 27 orders were accepted and 2 rejected with no clinical incidents or RiskMan reports. NPCs reported increased confidence and prescribing competence and described the model as a valuable learning opportunity that improved clinic time management. Supervising clinicians reported that supervised prescribing under close oversight better prepared NPCs for endorsement requirements and improved perceived efficacy and patient safety.
Conclusion
This supervised prescribing model was feasible, safe and acceptable at a service level, with strong support from executives, pharmacists and clinicians. It provides a practical pathway to a competent and confident NPC by completion of candidacy and has been approved for ongoing use in Cancer Care, with potential expansion to non-cancer NPCs and broader implementation across Queensland Health.