Registered nurse prescriber role in Ontario: barriers and facilitators of role implementation.

Abstract

Aim: This study explored registered nurse (RN) prescribers' perspectives on educational preparation and identified barriers and facilitators to successful role adoption.

Background: Registered nurse (RN) prescribing was introduced in Ontario in 2023 to improve access to care and optimize the nursing scope of practice. While educational programmes were developed rapidly, little is known about RN prescribers' experiences with role implementation and workplace integration.

Purpose: This study explored RN prescribers' perspectives on educational preparation and identified barriers and facilitators to successful role adoption.

Methods: A mixed-methods design was used. A cross-sectional survey of 52 RN prescribers who completed a College of Nurses of Ontario-approved prescribing programme captured demographic data and employment experiences. Quantitative analysis included descriptive statistics, bivariate tests, and hierarchical regression. Fifteen participants completed semi-structured interviews, which were analysed thematically.

Results: Quantitative findings indicated generally positive employment experiences, with higher satisfaction associated with supportive colleagues and management. Unrealistic employer expectations and lack of familiarity with RN prescribing scope were identified as barriers. Qualitative analysis revealed four themes: (1) value of prior RN experience, with most participants recommending 2-5 years before prescribing; (2) mentorship as a catalyst for role transition, and physician mentorship was most common; (3) colleague support and organizational culture as critical facilitators; and (4) role clarity and system-level barriers. Participants emphasized that although education prepared them to prescribe, workplace readiness and clear role expectations were essential for building confidence and ensuring safe practice.

Conclusion: Successful implementation of RN prescribing requires more than education; structured mentorship, supportive organizational culture, and standardized policies are vital. These findings inform strategies to strengthen RN prescribing integration and improve access to care.