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Evaluating prescribing competencies and standards used in nurse independent prescribers’ prescribing consultations: An observation study of practice in England

Evaluating prescribing competencies and standards used in nurse independent prescribers’ prescribing consultations: An observation study of practice in England
Evaluating prescribing competencies and standards used in nurse independent prescribers’ prescribing consultations: An observation study of practice in England
Background: Independent prescribing of medicines by nurses is widely considered to be part of advanced nursing practice, and occurs within an episode of patient care that can be completed independently by a nurse. Nurse prescribers therefore require the competencies necessary to manage a consultation—such as history taking and diagnostic skills—and subsequently need to decide on any appropriate medicine to be prescribed. Safe prescribing should also involve an accurate, legible and comprehensive written prescription and documentation of the consultation in the patient’s records. However, the extent to which nurse independent prescribers use prescribing competencies and standards in practice had not been researched prior to this study.
Aim: To describe the frequency with which nurses use a range of prescribing competencies in their prescribing consultations, in order to provide a measure of the quality and safety of nurses’ independent prescribing practices.
Design and methods: Across 10 case study sites, 118 nurse independent prescribers’ prescribing consultations were analysed using non-participant observation and a structured checklist of prescribing competencies. Documentary analysis was also undertaken of a) prescriptions written (n =132) by nurses and b) the record of the prescribing episode in patient records (n =118).
Sample and setting: 118 prescribing consultations of 14 purposively selected nurse independent prescribers working in primary and secondary care trust case study sites in England.
Findings: Nurse independent prescribers were issuing a prescription every 2.82 consultations; nurses used a range of assessment and diagnosis competencies in prescribing consultations, but some were employed more consistently than others; nurses almost universally wrote full and accurate prescription scripts for their patients; nurses recorded each of their prescribing consultations, but some details of the consultation and the prescription issued were not always consistently recorded in the patient records.
Conclusion: The findings from this observation study provide evidence about the quality and safety of nurses’ prescribing consultations in England.
advanced nursing practice, advanced clinical skills, non-medical prescribing, nurse independent prescribing, medication management
1361-4096
7-26
Latter, S.
83f100a4-95ec-4f2e-99a5-186095de2f3b
Maben, J.
482f92f0-6339-42dd-9ee5-3fbc08d1e6f0
Myall, M.
0604ba0f-75c2-4783-9afe-aa54bf81513f
Young, A.
6bb7aa9c-776b-4bdd-be4e-cf67abd05652
Baileff, A.
ed1badbf-2876-4a47-ba53-9507e44add0c
Latter, S.
83f100a4-95ec-4f2e-99a5-186095de2f3b
Maben, J.
482f92f0-6339-42dd-9ee5-3fbc08d1e6f0
Myall, M.
0604ba0f-75c2-4783-9afe-aa54bf81513f
Young, A.
6bb7aa9c-776b-4bdd-be4e-cf67abd05652
Baileff, A.
ed1badbf-2876-4a47-ba53-9507e44add0c

Latter, S., Maben, J., Myall, M., Young, A. and Baileff, A. (2007) Evaluating prescribing competencies and standards used in nurse independent prescribers’ prescribing consultations: An observation study of practice in England. Nursing Times Research, 12 (1), 7-26. (doi:10.1177/1744987106073949).

Record type: Article

Abstract

Background: Independent prescribing of medicines by nurses is widely considered to be part of advanced nursing practice, and occurs within an episode of patient care that can be completed independently by a nurse. Nurse prescribers therefore require the competencies necessary to manage a consultation—such as history taking and diagnostic skills—and subsequently need to decide on any appropriate medicine to be prescribed. Safe prescribing should also involve an accurate, legible and comprehensive written prescription and documentation of the consultation in the patient’s records. However, the extent to which nurse independent prescribers use prescribing competencies and standards in practice had not been researched prior to this study.
Aim: To describe the frequency with which nurses use a range of prescribing competencies in their prescribing consultations, in order to provide a measure of the quality and safety of nurses’ independent prescribing practices.
Design and methods: Across 10 case study sites, 118 nurse independent prescribers’ prescribing consultations were analysed using non-participant observation and a structured checklist of prescribing competencies. Documentary analysis was also undertaken of a) prescriptions written (n =132) by nurses and b) the record of the prescribing episode in patient records (n =118).
Sample and setting: 118 prescribing consultations of 14 purposively selected nurse independent prescribers working in primary and secondary care trust case study sites in England.
Findings: Nurse independent prescribers were issuing a prescription every 2.82 consultations; nurses used a range of assessment and diagnosis competencies in prescribing consultations, but some were employed more consistently than others; nurses almost universally wrote full and accurate prescription scripts for their patients; nurses recorded each of their prescribing consultations, but some details of the consultation and the prescription issued were not always consistently recorded in the patient records.
Conclusion: The findings from this observation study provide evidence about the quality and safety of nurses’ prescribing consultations in England.

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More information

Published date: January 2007
Keywords: advanced nursing practice, advanced clinical skills, non-medical prescribing, nurse independent prescribing, medication management
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 43851
URI: http://eprints.soton.ac.uk/id/eprint/43851
ISSN: 1361-4096
PURE UUID: 5d1faa81-2ba0-4758-9174-2eee178e7618
ORCID for S. Latter: ORCID iD orcid.org/0000-0003-0973-0512
ORCID for M. Myall: ORCID iD orcid.org/0000-0001-8733-7412
ORCID for A. Young: ORCID iD orcid.org/0000-0002-1486-5561

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Date deposited: 31 Jan 2007
Last modified: 10 Dec 2019 01:49

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Contributors

Author: S. Latter ORCID iD
Author: J. Maben
Author: M. Myall ORCID iD
Author: A. Young ORCID iD
Author: A. Baileff

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