Nurse Supplementary Prescribing Research Articles

Stakeholder views on the impact of nurse prescribing on dermatology services

To explore stakeholder views on the impact of nurse prescribing on dermatology services. Nurse led care enhances the services that dermatology patients receive. Research indicates that care delivered by nurse prescribers can improve efficiency and access to medicines. There is no evidence exploring the impact of nurse prescribing on the configuration of dermatology services. Case study. A collective case study of 10 practice settings across England where nurses prescribed medicines for dermatology patients. A thematic analysis of semi-structured interview data collected during 2006 and 2007. Participants were qualified nurse prescribers, administrative staff, doctors and non-nurse prescribers. Nurse prescribing was reported to support and facilitate the modernisation of dermatology services. It enabled nurses to make effective use of their knowledge and skills, overcome delays in treatment and provide faster access to medicines. However several organisational issues restricted the success of the initiative. Nurse prescribing is successfully being used to support and deliver a range of services to dermatology patients. Stakeholders reported that both patients and staff had benefited by the adoption of this role by nurses. However issues over support and access to CPD and capacity of the workforce were identified as potential barriers which could affect the contribution of nurse prescribing to dermatology patients. Nurse prescribing contributes to the services provided to dermatology patients; Nurse supplementary prescribing contributes to the ability of dermatology nurse specialists to work in teams and prescribe complex medicines; Provision of adequate support and strategic planning are essential if the impact of nurse prescribing is to be fully realised.

An exploration of the continuing professional development needs of nurse independent prescribers and nurse supplementary prescribers who prescribe medicines for patients with diabetes

Nurse Independent and Nurse Supplementary Prescribing has extended the role that nurses in the UK have in the management of care for patients with diabetes. Concerns surround nurses' pharmacological knowledge and provision of continuing professional development to meet the needs of nurse prescribers. To examine the continuing professional development needs of nurses who prescribe medicines to patients with diabetes. A questionnaire survey. The NMC database was used to randomly select and distribute questionnaires to 1992 registered Nurse Independent/Nurse Supplementary Prescribers. One thousand and four hundred questionnaires were returned. Medicines for patients with diabetes were prescribed by 439 respondents. This paper reports on the findings of these 439 nurses. The majority (63%) of nurses worked in general practice. Over 80% reported continuing professional development was available and that they had accessed it to support their prescribing role. Over 40% of nurses had continuing professional development needs in the areas of prescribing policy, pharmacology for diabetes and the management and treatment of diabetes related conditions. Senior nurses reported fewer continuing professional development needs. Access and provision of continuing professional development for nurse prescribers has improved since the initial implementation of nurse prescribing. However, nurse's pharmacological knowledge and the provision of continuing professional development continue to be an area of concern which warrant further investigation. Previous concerns have been identified about the provision of continuing professional development to meet the needs of nurse prescribers. Pharmacological knowledge is still the greatest continuing professional development requirement of nurses who prescribe for patients with diabetes. Education providers may wish to consider developing the content of continuing professional development programmes to meet these needs.

Nurse supplementary prescribing for patients with diabetes: a national questionnaire survey

To examine the prescribing practices of nurse supplementary prescribing in diabetes. Nurses in several roles are involved in the management of medicines for patients with diabetes. Nurse prescribing should help optimise these roles. Nurses in the UK have virtually the same independent prescribing rights as doctors. There is little or no evidence on the extent to which nurse supplementary prescribing is used, or the impact and activity of nurse supplementary prescribing for patients with diabetes. Survey. A random sample of 214 nurse supplementary prescribers self-completed a written questionnaire. The majority of nurses held an academic qualification at degree level or higher, had a wealth of clinical experience, worked full-time, were based in primary care and worked in general practice. The majority of nurses prescribed between one and five items a week. Oral anti-diabetic drugs, hypertension and lipid-regulating drugs and insulins were the products most often prescribed. Over 85% had undertaken specialist training in diabetes prior to undertaking the prescribing programme. Supplementary prescribing provides a practical and useful framework within which to prescribe medicines for patients with diabetes and its associated complications. Specialist diabetes training is a necessary prerequisite for nurses prescribing in this area. It is evident that there is still a place for supplementary prescribing. * Recent legislative changes mean that nurses can now independently prescribe practically any drug. * Nurses in general practice appear to prescribe most frequently as a nurse supplementary prescriber for patients with diabetes. * Nurse supplementary prescribers are likely to use this mode of prescribing to deliver medicines to patients with diabetes. * Over two-thirds prescribe for common but serious complications of diabetes, e.g. hypertension, hyperlipidaemia and cardiovascular disease.

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Service delivery by nurse prescribers for diabetes care

The overall aim of the research was to provide a national evaluation of Nurse Independent and Nurse Supplementary Prescribing in diabetes in the UK. A key component was to examine service provision by nurse prescribers for patients with diabetes.The NMC database was used to randomly select and distribute questionnaires to 1992 registered Nurse Independent/Nurse Supplementary Prescribers. 1400 questionnaires were returned. Medicines for patients withdiabetes were prescribed by 439 respondents. This paper reports on the findings of these 439 nurses. The majority (63%) of nurses worked in general practice. Over 90% of services were provided to patients in the community. Over 30% made treatment alterations over the telephone to patients they had not met. Nurses with specialist training in diabetes viewed themselves as more competent than nurses without (P=0.000). Nurses who reported higher levels of competence were more likely to make treatment alterations over the telephone (P=0.000). Nurse independent and nurse supplementary prescribers working in a variety of roles are actively involved in the delivery of services to patients with diabetes. This care is predominantly provided in the community. It is evident from our findings that nurse's competence affects their scope of professional practice in the management of these patients.

A qualitative study on the impact of legislation on prescribing of controlled drugs by nurses

This qualitative research explores the views of 26 qualified Nurse Independent and Nurse Supplementary Prescribers on the adoption of the role of prescribing for patients in pain, and how the legislation on prescribing controlled drugs has had an impact on practice. This level of prescribing, and the impact of legislation have varied according to the context in which the nurses worked. Practice was affected in the hospital setting where there was confusion over definitions of pain types. Nurses working with chronic pain patients in outpatient settings tended to make recommendations rather than prescribe medication. The findings of this study inevitably have implications for the Home Office consultation on the prescription of controlled drugs by Nurse Independent Prescribers.

Comparing nurses' and doctors' views of nurse prescribing: a questionnaire survey

Nurses have successfully adopted the role of prescriber in numerous health care settings in the UK. Existing research has not addressed how Nurse Independent and Nurse Supplementary Prescribers compare with doctors in terms of the perceived advantages and disadvantages of nurse prescribing, nor has the perceived importance of nurses providing patients with an explanation about their medicines been established. The current study utilized a random sample of 31 qualified Nurse Independent and Nurse Supplementary Prescribers and 30 general practitioners who self-completed a written questionnaire in an independent groups design. The study establishes nurses' and doctors' perceptions of the advantages and disadvantages of independent and supplementary nurse prescribing and provides some indication of the importance that nurses and doctors place on nurses providing an explanation about medicines, and the categories of information perceived to be important.

Delivering the choice agenda as a framework to manage adverse effects: a mental health nurse perspective on prescribing psychiatric medication

The article describes the clinical management of a patient referred, with a diagnosis of schizophrenia, who experienced adverse effects associated with an elevated prolactin level. A reflective model was adopted to inform the new learning which emerged from the clinical scenario. It highlights that Mental Health Nurse Supplementary Prescribers need to develop a prescribing value base underpinned by choice in addition to advanced technical skills to manage unhelpful effects of medication.

A guide to working with the pharmaceutical industry

The introduction of Nurse Independent Prescribing and Nurse Supplementary Prescribing means that over 10 000 nurses across the UK have virtually the same prescribing rights as doctors. Nurses are therefore faced with the challenges of working with the pharmaceutical industry. Such challenges include the extent to which promotional material can be relied upon, the acceptability with regards to the provision of free samples, hospitality, gifts, and the sponsorship of meetings. The Association of the British Pharmaceutical Industry (ABPI) Code of Practice for the Pharmaceutical Industry sets out how pharmaceutical companies are permitted to promote medicines to health professionals and others. It also covers the provision of information about prescription-only medicines to the public.

Mental health nurse supplementary prescribing: mapping progress 1 year after implementation

Aims and MethodA postal questionnaire survey was conducted of the directors of nursing of all mental health NHS trusts in England, in order to examine current activities and attitudes regarding nurse supplementary prescribing (NSP) in psychiatric settings.ResultsFifty-four per cent of nurse directors returned the questionnaire. They perceived that NSP was an important means for improving patient care and treatment, particularly in community settings. In their opinion, psychiatrists were generally not opposed to its introduction. To date, relatively few mental health nurses have received training in NSP.Clinical ImplicationsDirectors of nursing have positive views and experiences of NSP. Widespread implementation of NSP is likely to occur over the next few years and psychiatrists will need to consider how this will impact on their role.