Nurse Prescribing Practices: An International Systematic Review with Implications for Tanzania

Abstract

Background: The role of nurse prescribing is increasingly expanding worldwide as the nursing profession evolves.
Several factors have driven its introduction into healthcare systems, including improving community health, increasing
patients’ access to medicines, optimizing nurses’ knowledge and skills, enhancing healthcare accessibility, increasing
nurses’ autonomy, and reducing physicians’ workload.
Objectives: This review aims to discuss nurses’ roles in prescribing medicines from an international perspective and within
the Tanzanian context, including current practices, opportunities, strategies, and challenges.
Methods: Four electronic databases, including CINAHL, PubMed/Medline, Cochrane Library, and PsycINFO, were
searched to identify peer-reviewed articles published in English between January 2015 and July 2025. Studies were
selected using predefined inclusion criteria and appraised using the Mixed Methods Appraisal Tool (MMAT) version 2018.
Results: Fourteen publications out of 4,217 retrieved articles were included in this study. Findings indicate that nurses
can prescribe medications depending on country legislation and educational qualifications. In some countries, nurse/
midwife specialists prescribe medicines without additional training because prescribing education is incorporated into
their curricula. In Tanzania, nurses’ prescribing roles remain unclear, as legislation does not authorize nurses to prescribe
independently without physician involvement. Furthermore, physician resistance and limited systems supporting continuity
of non-physician prescribing and patient experience monitoring were identified as major challenges to implementing
nurse prescribing.
Conclusion: Nurses’ authority to prescribe medicines varies across countries, depending on legislation and healthcare
systems. Many countries implementing nurse prescribing provides additional educational programs to support the role.
Legal implementation of nurse prescribing in Tanzania may provide important healthcare benefits