Epilepsy specialist nurse prescribing practice in the United Kingdom: A national questionnaire survey

Abstract

Recent advances in legislation have enabled nurses in the United Kingdom (UK) to become Nurse Independent and Supplementary Prescribers (NISP). The NISP can assess, diagnose and independently prescribe any licensed medicine within their area of competence. This change has meant the number of nurse prescribers in disease specific areas has increased. This study set out to assess the number of Epilepsy Specialist Nurses (ESNs) prescribing and the context in which they do so. A draft questionnaire was developed and piloted with 10 ESNs. Minor changes to improve data collection were made. In April 2009 all known ESNs were invited via letter to complete the questionnaire. One month later a follow up reminder was mailed to all ESNs to encourage participation. Data was analyzed using percentages and cross tabulation. Completed questionnaires were returned by 29 nurse prescribers. Twenty ESNs were working as independent nurse prescribers, 6 as supplementary nurse prescribers and 3 as both. Prescribing practice demonstrated that 21 (72%) signed prescriptions, 28 (97%) made recommendations to other prescribers, 14 (48%) prescribed or amended ward/in patient drug prescriptions and 10 (34%) used clinical management plans. The medications prescribed by ESNs included anti-epilepsy medication, folic acid, vitamin K, anti-depressants, steroids, rescue medication and the contraceptive pill. Most ESNs wrote a prescription for a new drug at least once a week whilst most nurses titrated medication daily. Nurse prescribers held higher academic qualifications and had worked in the field of epilepsy for years. Epilepsy specialist nurse prescribing enabled a holistic approach to patient care. This paper identified the need for ESNs to update annually and audit their prescribing practice.