Exploring the scope of nursing practices in the care of ECMO supported patients in Israel

Objectives: The growing implementation of extracorporeal membrane oxygenation (ECMO) for patients with COVID19 has led to increased involvement of nurses in treating ECMO-supported patients (ECMO-SP). In June 2021, the Israeli Ministry of Health;s Nursing Administration published the first director;s circular in the world to detail the nursing scope of practice in caring for ECMO-SP. This study aimed to examine how often nurses perform various activities while caring for adult ECMO-SP. Method(s): A cross-sectional study. A convenience sample consisted of 76 registered ICU nurses (mean age 41.3+/-8.7 years;71% female). A 20-item Nursing Activities in the Care of ECMO-SP instrument was developed based on the Israeli Ministry of Health;s procedure on Nursing Practice in the Care of ECMO-SP and a literature review. The instrument examined how often nurses perform various activities on a Likert scale ranging from 1 (Never) to 5 (Always). Exploratory and confirmatory factor analyses (EFA and CFA), as well as descriptive statistics and Pierson;s correlations were performed. Result(s): When examined in EFA and CFA, the instrument yielded acceptable fit indices. The instrument contains four subscales with the following mean +/- SD scores: Factor 1. Nursing care of ECMO-SP not related to the ECMO device (7 items, a=0.90), M+/-SD=4.66+/-0.61;Factor 2. Activities on the ECMO device during emergencies (5 items, a=0.82), M+/-SD=2.1+/-0.91;Factor 3. ECMO device calibrating and monitoring (4 items, a=0.72), M+/-SD=3.26+/-1.0;and Factor 4. Medication and blood administration through the ECMO device (4 items, a=0.73), M+/-SD=1.52+/-0.60. Of the 20 nursing activities, 10 (50%) were reported as "never" or "rarely" performed. Nine out of 20 items (45%) were reported as "very often" or "always" performed. Conclusion(s): Ten out of 20 (50%) activities while caring for ECMO-SP listed in the scope of practice as permissible for nurses to perform were reported as not performed at all or performed rarely. Policymakers need to act so that the activities listed in the nursing scope of practice are carried out by nurses in practice.

How Governor Directives Changed Health Workforce Flexibility in Response to the COVID-19 Pandemic.

OBJECTIVES: In times of heightened population health needs, the health workforce must respond quickly and efficiently, especially at the state level. We examined state governors' executive orders related to 2 key health workforce flexibility issues, scope of practice (SOP) and licensing, in response to the COVID-19 pandemic. METHODS: We conducted an in-depth document review of state governors' executive orders introduced in 2020 in all 50 states and the District of Columbia. We conducted a thematic content analysis of the executive order language using an inductive process and then categorized executive orders by profession (advanced practice registered nurses, physician assistants, and pharmacists) and degree of flexibility granted; for licensing, we indicated yes or no for easing or waiving cross-state regulatory barriers. RESULTS: We identified executive orders in 36 states containing explicit directives addressing SOP or out-of-state licensing, with those in 20 states easing regulatory barriers pertaining to both workforce issues. Seventeen states issued executive orders expanding SOP for advanced practice nurses and physician assistants, most commonly by completely waiving physician practice agreements, while those in 9 states expanded pharmacist SOP. Executive orders in 31 states and the District of Columbia eased or waived out-of-state licensing regulatory barriers, usually for all health care professionals. CONCLUSION: Governor directives issued through executive orders played an important role in expanding health workforce flexibility in the first year of the pandemic, especially in states with restrictive practice regulations prior to COVID-19. Future research should examine what effects these temporary flexibilities may have had on patient and practice outcomes or on permanent efforts to relax practice restrictions for health care professionals.

Analysis Of The Scope Of India's Virtual Court Hearings

With the increasing internet accessibility in India and the challenges posed by the Covid-19 pandemic, the practice of virtual court hearing has been accelerated in India. The virtual Court acts as an effective means to conduct Court proceedings, debarring geographical barriers and uplifting Courtroom functioning's productivity. Along with the practical applicability of virtual court hearings in India comes the glitches or challenges posed by the virtual hearing of matters. Nonetheless, the necessity of physical hearing of matters cannot be ignored. In pursuance of this, arguments in favor of reverting towards physical hearings after the pandemic situation ends are being posed before the Indian Judiciary, which negates the applicability of virtual courtrooms. Thereby, this article aims to analyze the applicability, necessity and efficacy of virtual court hearings and the challenges posed by Virtual Court hearings in India.Copyright © 2020 Ubiquity Press. All rights reserved.

Outpatient Child Life: Integrating play, coping strategies, and diagnosis education into a Pediatric Cystic Fibrosis Center

Background: A small Midwest cystic fibrosis (CF) center gained child life support in fall of 2016, but availability was limited due to sharing full-time equivalents (FTEs) between 31 outpatient subspecialty clinics. Child life involvementwas often restricted to immediate stressors (e.g., throat swabs, blood draws, first pulmonary function tests) in a reactive approach, but in the summer of 2020, the child life team added FTEs, increasing the ability for a primary child life specialist (CLS) to be more integrated into the clinic workflow. Partnering with the nurse care coordinators, a comprehensive, proactive approach to the integration of child life was formed, focusing on full scope of practice. Method(s): CFregistered nurse care coordinators collaborated with the CLSto discuss the goal of integration while understanding knownpatient stressors and optimal developmental and coping goals for patients younger than 19 and their siblings. We also determined ways to reduce disruption to clinic workflowwhile leveraging scheduling and increasing awareness of scope of practice of the interdisciplinary team, patients, and families. The CLS also obtained feedback from the family advisory committee engrained in clinic along with hosting a booth at the center's annual CF familyevent that targets caregivers of children with CF. Throughout each of these formative actions,(Figure Presented) Figure 1. : Child life integration protocol the primary focus was on collaboration with the interdisciplinary team, employing the full scope of practice of the CLS, mitigating logistical barriers, and optimizing patient experience and satisfaction. Result(s): The current plan (Figure 1) is based on identified time points where developmentally appropriate interventions and resources are implemented in a stepwise fashion, building upon itself. Interventions are individualized for each patient or family member based on coping and learning needs or developmental differences and are completed by the CLS based on professional judgment and after assessment and rapport is built. The scope of practice includes preparation for procedures or changes in the plan of care, procedural support, creation of coping plans for in-clinic and at-home care routines or events, educational activities and resources (e.g., making slime to learn about mucus, word searches about medications), therapeutic activities to support emotional processing of chronic illness, providing information on typical growth and development to caregivers, and facilitating developmentally appropriate transition-readiness goals through CF R.I.S.E. materials. During the COVID global pandemic, changes to outpatient clinic, including addition of virtual appointments, allowed the CLS to expand practice further. In these video appointments, teen patients appear to be more engaging and talkative, allowing the CLS to better assess coping, adherence, and transition readiness in a relaxed Table 1. Two-way table depicting concordance between substance use and mental health screening results at same encounter. General Anxiety Disorder (GAD7) and Patient Health Questionnaire (PHQ9) results were aggregated such that a positive screening result on either was compared with neither being positive.(Table Presented) environment more suited to their developmental needs. Based on the success of having video appointments with adolescent patients without caregivers present, the CLS and the registered nurse care coordinators agreed to include these moving forward. Conclusion(s): The integration of the CLS at full scope of practice benefits not only patients and families, but also the interdisciplinary team and clinic as a whole. By taking a proactive and preventative approach, coping and psychosocial concerns can be navigated throughout the developmental stages with greater stability and emotional safety for patients and their familiesCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

Organized Psychiatry Provides Strength and Value to Mental Health Professionals

The article discusses the impact of organized psychiatry on mental health professionals. Topics include results of the 2018 Survey of America's Physicians: Practice Patterns and Perspectives, complaints received each year by the American Psychiatric Association (APA) when its membership renewals reach members, and the struggle by specialty organizations to keep members active during these changing times.

The Current State of the Role of the Nephrology Registered Nurse in Home Dialysis Therapies and Future Implications

With an increased emphasis on home dialysis therapies (HDTs), and to ensure nephrology nurses have a voice in health policy discussions and decisions, the American Nephrology Nurses Association (ANNA) initiated the Home Dialysis Therapies Task Force. ANNA fully supports the increased utilization of HDTs and wants to ensure every individual has the option of HDT and deserves an RN in their care. Careful consideration must be given to the impact of legislative initiatives aimed at the nursing shortage and increasing the use of HDTs on delivery of safe care and RN practice. The HDT Task Force implemented a Think Tank to explore and delineate the role of nephrology RNs in HDT to ensure a safe and informed transition to HDT for individuals with kidney failure. The mission was to gather and analyze information on the role of the nephrology RN in HDTs, clarify RN-specific tasks versus tasks that may be delegated to support staff, and gather and gain insight into barriers to HDTs.

Voices of Pandemic Care: Perspectives from Pediatric Providers During the First SARS-CoV-2 Surge.

Pediatric providers were called on to care for adult patients well beyond their typical scope of practice during the first surge of the SARS-CoV-2 pandemic. Here, the authors share novel viewpoints and innovations from the perspective of providers, consultants, and families. The authors enumerate several of the challenges encountered, including those faced by leadership in supporting teams, balancing competing responsibilities to children while caring for critically ill adult patients, preserving the model of interdisciplinary care, maintaining communication with families, and finding meaning in work during this unprecedented crisis.

Pharmacist Administration of Long-Acting Injectable Antipsychotics to Community-Dwelling Patients: A Scoping Review.

Long-acting injectable antipsychotics (LAIAs) have demonstrated positive outcomes for people with serious mental illnesses. They are underused, and access to LAIAs can be challenging. Pharmacies could serve as suitable environments for LAIA injection by pharmacists. To map and characterize the literature regarding the administration of LAIAs by pharmacists, a scoping review was conducted. Electronic-database searches (e.g., PsycINFO, Ovid Medline, Scopus, and Embase) and others including ProQuest Dissertations & Theses Global and Google, were conducted. Citation lists and cited-reference searches were completed. Zotero was used as the reference-management database. Covidence was used for overall review management. Two authors independently screened articles and performed full-text abstractions. From all sources, 292 studies were imported, and 124 duplicates were removed. After screening, 13 studies were included for abstraction. Most articles were published in the US since 2010. Seven studies used database and survey methods, with adherence and patient satisfaction as the main patient-outcomes assessed. Reporting of pharmacists' and patients' perspectives surrounding LAIA administration was minimal and largely anecdotal. Financial analyses for services were also limited. The published literature surrounding pharmacist administration of LAIAs is limited, providing little-to-no guidance for the development and implementation of this service by others.

Federal pharmacist Paxlovid prescribing authority: A model policy or impediment to optimal care?

The U.S federal government leveraged emergency authority to allow pharmacists to prescribe Paxlovid (nirmatrelvir and ritonavir) during the COVID-19 pandemic. While heralded by pharmacy associations, the FDA framework included restrictions that arguably ran counter to clinical guidelines and evidence-based research and recommendations. These restrictions will limit the utility of pharmacist prescriptive authority for Paxlovid in practice. The experience of Paxlovid prescribing and a similar recent federal action illustrate the challenges inherent in federal oversight of pharmacist prescriptive authority. While initially more difficult to navigate for stakeholders, working with state legislatures and state boards of pharmacy has much stronger long-term potential to enable broad pharmacist prescriptive authority and benefit patient care. This commentary uses Idaho's pharmacist prescribing regulations as a comparison to the federal actions.

Characterisation of professional pharmacy association resources and recommendations on COVID-19 pandemic

Background: As one of the most accessible healthcare workers, pharmacists are at the frontlines during emergencies such as the COVID-19 pandemic. Professional pharmacy associations provide resources and recommendations for pharmacists on COVID-19. Yet, the extent and repository of resources are currently not categorised. Purpose(s): To identify COVID-19 resources for pharmacists provided by associations in the United States of America and the International Pharmaceutical Federation (FIP) and characterise these resources to better serve pharmacists' needs to combat the pandemic. Method(s): A review of 17 pharmacy association websites was conducted to identify available resources. Search terms included 'resource, policy and recommendation'. Specific criteria were applied to categorise results in six areas. Descriptive statistics were used for data analysis. Result(s): Of the 16 US pharmacy associations and the FIP websites, 94% provided COVID-19 resources, 53% developed policies, and 94% had specific recommendations. Those were characterised into 6 types of recommendations, including 94% on general recommendations, 65% on education/training, 53% on supply chain management/drug shortages, 47% on guidelines/protocols, 71% on scope of practice, and 24% on the emergence of tele-health. Conclusion(s): Whilst the majority of associations provide COVID-19 related resources on general recommendations, scope of practice, and education/training, there are opportunities for more specific areas on guidelines/protocols and telehealth. With the dynamic nature of COVID-19, it is important for pharmacists to stay updated to provide optimal care for diverse patients and populations while combating the current pandemic and beyond.

The State of Advanced Practice Registered Nursing in Alabama

Scope of practice for advanced practice registered nurses (APRNs) varies according to U.S. jurisdiction licensure requirements. Nineteen U.S. jurisdictions currently allow independent practice in all four APRN roles: certified nurse midwife (CNM), certified nurse practitioner (CNP), certified registered nurse anesthetist (CRNA), and clinical nurse specialist (CNS). Twenty-six U.S. jurisdictions allow full practice authority for CNPs. APRNs practicing in the remaining U.S. jurisdictions have varying practice restrictions, which are dictated by their state licensure laws. Alabama's scope and standards of practice restrict all APRN roles. During the initial months of the COVID-19 pandemic, Alabama was one of many U.S. jurisdictions that implemented emergency waivers, thereby expanding the scope of APRN practice and granting increased autonomy to APRNs while caring for more complex patients. Once the pandemic threat lessened, many U.S. jurisdictions, including Alabama, returned to pre-pandemic restrictive scope of practice regulations. Through empirical evidence, we conducted a review of APRN practice before, during, and after the pandemic. The literature included anecdotal reports of safe delivery of healthcare provided by APRNs working under the emergency waivers. The literature revealed that APRNs are prepared to practice to the full extent of their scope of practice and provide high-quality healthcare services to improve access to care. Alabama and other U.S. jurisdictions where APRN practice is restricted should advocate for legislative changes supporting APRN full practice authority commensurate with their educational training and certification. © 2023 National Council of State Boards of Nursing

Emergency Removal of Supervision Requirements for Psychiatric Mental Health Nurse Practitioners: A Mixed-Methods Survey.

OBJECTIVE: Physician supervision of nurse practitioners (NPs) was temporarily waived in Massachusetts in response to a state of emergency due to the COVID-19 pandemic. The authors examined the impact of the scope-of-practice changes and pandemic-related demands on psychiatric mental health NPs (PMHNPs) during the state's first COVID-19 surge. METHODS: A mixed-methods Web-based survey was conducted in May and June of 2020. Fisher's exact test was used to compare associations across certification types, and inductive content analysis was applied to open-ended responses. RESULTS: The survey response rate was 41% (N=389 of 958), consisting of 26 PMHNPs and 363 other NPs. Compared with other NPs, PMHNPs were significantly more likely to work in a telehealth setting (42% vs. 11%, p<0.001), to spend more time working during the initial surge (50% vs. 26%, p<0.05), and to believe that the waiver improved clinical work (52% vs. 25%, p<0.01). Content analysis of PMHNPs' open-ended responses identified four themes: the supervision waiver reduced burden on PMHNPs, collaboration and mentorship models persisted, the pandemic exacerbated the already high demand for psychiatric care, and telehealth helped meet the high demand for such care. CONCLUSIONS: PMHNPs may be more sensitive to the scope-of-practice changes and telehealth expansion than other NPs because of the constraints of the psychiatrist shortage and high relative uptake of telehealth in psychiatric care. The interactions of workforce supply, telehealth expansion, and scope-of-practice laws are important to consider in the development of policies to improve access to mental health care.

Pandemic Disruption in Residency Did Not Alter Trends in Intended Scope of Practice.

We found the intended scope of practice remained unchanged in graduating family medicine residents between pre-pandemic and pandemic period. Tracking these trends with later cohorts will fully assess the pandemics' impact on training so that residencies can adjust their education accordingly.

A Systematic Review of Surgical Simulation in Gender Affirmation Surgery

INTRODUCTION: The burgeoning field of gender affirmation surgery (GAS) is increasingly complex, challenging Plastic Surgeons to meet elevated functional and cosmetic standards. During the COVID-19 pandemic, remote learning provided for simulation training, offering residents procedural exposure before treating patients. As GAS continues to evolve and the pandemic quells, there will be an increasing demand for GAS with the expectation for surgeons to be masters of these techniques. This systematic review summarizes current simulation training models in GAS. METHOD(S): A systematic review was conducted using PRISMA-P guidelines through the following databases: PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane. Inclusion criteria were English language peer-reviewed articles about surgical simulation techniques or training related to GAS. Skills and techniques taught and assessed, model type, equipment, and cost for each article were ed from articles. RESULT(S): Of 1,650 articles, 10 met inclusion criteria. Simulations included cadavers (n = 2), synthetic benchtop/3-dimensionally printed models (n = 6), and augmented/virtual reality interfaces (n = 2). Most simulations involved chest reconstruction +/- augmentation (n = 6) followed by vaginal reconstruction +/- repair (n = 3). One simulation involved facial GAS. All models emphasized surgical technique and anatomy. CONCLUSION(S): The evolving field of GAS requires that trainees be knowledgeable on surgical techniques surrounding this scope of practice. Surgical simulations teach residents to master operative techniques while addressing the sensitive nature of GAS. Given the new emphasis on remote learning, surgical simulation infrastructure adjacent to clinical training may benefit trainees with practical considerations for complexity and cost.

The Changing Face of Dentistry: Perspectives on Trends in Practice Structure and Organization.

KNOWLEDGE TRANSFER STATEMENT: This perspective is intended to stimulate thoughts by clinicians, researchers, and educators about needed trends to the dental profession. With consideration of changes needed within the dental profession, improvements and implementation of diagnostic coding and value-based care could result in improved oral health for numerous Americans.

Social Work After Tehan: Reframing the Scope of Practice

This article describes the recent changes to Australian higher education funding in relation to social work education and practice in order to analyse the frames that situate their implementation. It documents various stakeholder responses to the proposed changes, demonstrating ways in which social work's scope of practice is susceptible to reframing by external forces. The analysis of stakeholder framings of social work in the unfolding chronology illustrates this vulnerability, identifying the alliances and compromises that underpinned the efforts to mitigate impacts of the proposed changes. This analysis reveals the need for social work to articulate its unique role across both sector and disciplinary boundaries, as both an academic discipline and a practice-based profession. IMPLICATIONS Recent changes to funding Australian higher education challenged the viability of social work education, with significant fee increases and reductions in Commonwealth contribution proposed. Advocacy in defence of social work education reframing social work as a branch of allied health succeeded, but no certainty regarding future funding arrangements for social work education was achieved. While the alliance with health did offer a protective frame for social work education funding, this was achieved at the cost of broader alliances within the human services sector.

Optimizing a team approach for successful accrual to and conduct of clinical trials in a community oncology practice

Background: Oncologists and advanced practice providers (APPs) routinely work as part of a team to provide quality cancer care in today's healthcare environment. However, this does not always translate into the realm of clinical research. It is estimated that only 2-8% of the adult oncology population enrolls in a clinical trial, with more than 20% of current trials failing to meet accrual goals. These numbers are projected to be even worse due to the impact of the COVID pandemic. Our Oncologist/APP team in conjunction with a clinical research coordinator (CRC) set out to develop a workflow to approach and offer clinical trials to patients in our practice with the goal of increasing clinical trial accrual and improving clinical trial conduct. Methods: Between 1/1/19-12/31/21, a community breast oncology focused practice in the Hawaii M/U NCORP implemented a plan with the goal to increase accrual to clinical trials. Building on the prior experience of both clinicians, the practice developed a comprehensive team approach between the Oncologist, APP, and CRC. This approach included four components: 1) Clinic workflow for clinical trial screening, introduction, and follow-up of potential participants;2) Shared clinical trial visits between MD & APP;3) Protocol reviews by MD who reviewed treatment protocols & APP who reviewed symptom management and cancer care delivery research (CCDR) protocols. All clinical trial reviews were discussed with CRC for coordination input;4) Protocol leadership between MD serving as local primary investigator (PI) on treatment trials, APP serving as local PI and/or site champion on symptom management and CCDR protocols. Results: From 2019- 2021, our practice was able to accrue over 23% of our patients to clinical trials in a community practice setting, despite the COVID-19 Pandemic. Of the 149 unique accruals during this period, 59% of accruals were interventional trials and 41% were observational trials. Clinical trial accrual was racially diverse and mirrored the patient population. During this period, there were minimal protocol deviations observed based on review of shadow charts on this group of clinical trial patients. Conclusions: Through this team approach, our practice has been successful in having a high rate of clinical trial accrual while maintaining excellent clinical trial conduct even during the pandemic. We believe our team approach that utilizes the APP to the full scope of practice along with CRC empowerment in addition to the engaged oncologist is key to our success. Oncology practices and healthcare systems must value and engage all potential members of the team to maximize their clinical trial ability and to continue to offer/ enroll patients in clinical trials as the standard of care.

INTERDISCIPLINARY STUDENT LEAD CALL CENTER TO SUPPORT SOCIAL NEEDS OF PATIENTS DIAGNOSED WITH COVID19

STATEMENT OF PROBLEM/QUESTION: Social risk factors (SRF), such as food insecurity, represent adverse social circumstances associated with poor health outcomes. The COVID-19 pandemic impacted impoverished communities by exacerbating existing SRF. Students and faculty at Boston University Medical Center (BUMC), an academic safety net hospital, and Boston University School of Social Work (BUSSW) partnered to develop an outreach call center (CC) to explore SRF of patients with COVID-19 and connect them with available social need resources. In this , the development and operations of the CC and descriptive data on the volume and type of outreach efforts will be presented. DESCRIPTION OF PROGRAM/INTERVENTION: Call Center (CC) Operation: An ambulatory RN performed SRF screening in patients diagnosed with COVID-19 and sent referrals to the CC. Then, students called patients and screened for SRF using the THRIVE screening tool, and used the THRIVE Directory, an online repository of resources, to provide information about organizations to support their social needs. Two weeks later, students called the patients to assess whether they received help and provided additional support as needed. MEASURES OF SUCCESS: Volume of outreach calls and type of outreach efforts were evaluated. Number of patients reached through the CC were tracked using Epic reports. Types of referrals were tracked using automated reports from the THRIVE Directory database. Finally, students completed surveys to reflect on their experiences and to evaluate the impact on skills to address social needs. FINDINGS TO DATE: Between 10/2020 and 03/2021, the CC served 312 patients and 478 referrals were made, with a mean of 1.53 referrals per patient. Patients were most often referred to the City of Boston Food Delivery (148 referrals). Patients were most often referred to Government programs (188), followed by BMC programs (133) and Local Non-Profits (70). The most common primary support area was Food. Preliminary results from students' surveys showed a positive impact in their skills to collaboratively address social needs. KEY LESSONS FOR DISSEMINATION: It was feasible to develop and implement an interdisciplinary social needs outreach workforce to support patients with COVID-19. Food was the most important driver of social need among BUMC patients. Our partnership with the City of Boston was key to effective assistance with food delivery, showing the importance of collaborative partnerships when developing outreach efforts to support patients with social needs. Finally, interdisciplinary outreach opportunities like the CC can be used to teach health professional students about the different scopes of practice and how to effectively collaborate with other disciplines when addressing patient health related social needs.

Increased self-reported pharmacist prescribing during the COVID-19 pandemic: Using the Theoretical Domains Framework to identify barriers and facilitators to prescribing.

BACKGROUND: Community pharmacists are positioned to improve access to medications through their ever-expanding role as prescribers, with this role becoming more pronounced during the COVID-19 pandemic. OBJECTIVES: Our research aimed to determine the extent of self-reported pharmacist prescribing pre-COVID-19 and during the COVID-19 pandemic, to identify barriers and facilitators to pharmacist prescribing, and to explore the relationship between these factors and self-reported prescribing activity. METHODS: A questionnaire based on the Theoretical Domains Framework (TDFv2) assessing self-reported prescribing was electronically distributed to all direct patient care pharmacists in NS (N = 1338) in July 2020. Wilcoxon signed-rank tests were used to examine temporal differences in self-reported prescribing activity. TDFv2 responses were descriptively reported as positive (agree/strongly agree), neutral (uncertain), and negative (strongly disagree/disagree) based on the 5-point Likert scale assessing barriers and facilitators to prescribing from March 2020 onward (i.e., 'during' COVID-19). Simple logistic regression was used to measure the relationship between TDFv2 domain responses and self-reported prescribing activity. RESULTS: A total of 190 pharmacists (14.2%) completed the survey. Over 98% of respondents reported prescribing at least once per month in any of the approved prescribing categories, with renewals being the most common activity reported. Since the pandemic, activity in several categories of prescribing significantly increased, including diagnosis supported by protocol (29.0% vs. 58.9%, p < 0.01), minor and common ailments (25.3% vs 34.7%, p = 0.03), preventative medicine (22.1% vs. 33.2%, p < 0.01). Amongst the TDFv2 domains, Beliefs about Consequences domain had the largest influence on prescribing activity (OR = 3.13, 95% CI 1.41-6.97, p < 0.01), with Social Influences (OR = 2.85, 95% CI 1.42-5.70, p < 0.01) being the next most influential. CONCLUSION: Self-reported prescribing by direct patient care community pharmacists in Nova Scotia increased during the COVID-19 pandemic, particularly for government-funded services. Key barriers to address, and facilitators to support pharmacist prescribing were identified and can be used to inform future interventions.