Nursing Online – July 2008

Prescribing an expanded nurse role

There is growing recognition that part of the solution to the pressures we are experiencing in the health sector is for nurses to provide a wider range of services to patients, including prescribing. Nurse prescribing has existed in the UK since 2003 following pilot and demonstration nurse prescribing programs that commenced in 1998. These nurse prescribing initiatives in both community and hospital settings have resulted in substantial savings due to more efficient use of doctors’ and nurses’ time, increased access to appropriate medication leading to reduced length of stay and, in community settings, prevention of readmissions.

Evaluation of extended formulary independent nurse prescribing
University of Southampton School of Nursing and Midwifery on behalf of Department of Health, UK

This study aims to provide an evaluation of the expansion of independent nurse prescribing to inform future developments for prescribing in nursing and other health professions. This national research found that independent nurse prescribing was viewed positively by patients, doctors and nurses themselves, with patients citing accessibility as a major advantage when obtaining their medicine from a nurse rather than a doctor. The research, carried out by the University of Southampton, evaluated the first two years of extended formulary nurse prescribing and used a national survey, observation of prescribing nurses and the views of stakeholders in its assessment.

Effects of nurse prescribing of medication: a systematic review
Lotti M. Van Ruth, Patriek Mistiaen, Anneke L. Francke

Nurse prescribing is being implemented increasingly. This article reviews the literature on the effects of it. Eleven databases and six websites were searched. Twenty-three studies were included. All but two studies had a high risk of bias. The findings were that nurses sometimes differ from physicians in the number of patients they prescribe or in the choice of type of medication. Clinical parameters were the same or better for treatment by nurses; perceived quality of care by nurses is similar or better. The article concludes that the effects of nurse prescribing seem positive, although the high risk of bias in the studies means they must be regarded with caution.

Non-physician prescribing in the UK benefits patients with diabetes
Molly Courtenay, PhD, MS, BS, RN

The national service framework for diabetes within the UK’s Department of Health focuses on structured, proactive care to support people with diabetes in managing their condition. This framework emphasises the role of the nurse in service delivery for patients with diabetes. It is evident that nurse specialists in diabetes care have a role to play with regard to the management of medicines. For a number of years, nurses have been adjusting insulin dosages or oral hypoglycaemic medication, and so have, in effect, been making prescribing decisions.

Extending independent nurse prescribing within the NHS in England: a guide for implementation
(2nd Edition – February 2004) Department of Health, UK

This document provides some practical insights into how nurse prescribing has been implemented in the UK as well as an overview of the principal areas, knowledge and competencies required to underpin the practice of prescribing.