NPSA to be abolished
August 4, 2010
The government is planning to abolish the National Patient Safety Agency (NPSA), according to plans it has set out in its review of arm’s-length bodies (see here).
Its functions will be divided among different bodies, with the work related to reporting and learning from serious patient safety incidents moving to the new NHS Commissioning Board, and the National Research Ethics Service being considered as part of a review of research regulation. The Health Protection Agency and National Treatment Agency for Substance Misuse are also to be abolished, with their functions transferring to the new public health service.
Matt Griffiths, ANP committee member and visiting professor of prescribing and medicines management at the University of the West of England, is concerned about these plans: “Medication safety is a huge, huge issue and should be high-profile - it needs to be considered as a whole. Enforcement and policy making should be informed by research, and it is vital that the expertise is on board to reduce the large number of medication-related hospital admissions and incidents each year”.
Professionalism and ethics
July 25, 2010
In this article, the author discusses what professionalism means in the context of advanced nursing practice, and discusses the nature of conscientious objection, for example in the area of reproductive medicine and abortion. As nursing practice extends, along with technological and medical advances, non-medical prescribers may find themselves faced with new ethical dilemmas.
Another issue is that of conflict of interest, particularly between professionals and any private interest whose income depends on the professionals’ approval or prescription of their product - so including but not limited to the pharmaceutical industry. The author says that non-medical prescribers need a better understanding of the Association of the British Pharmaceutical Industry (ABPI) Code of Practice, and that perhaps there should be active policing of the Code and publication of case details. The article also points out how many drug trials, and how much nursing and medical education, are funded by the pharmaceutical industry and the impact this has. There is accumulating evidence that does not support the industry’s stance that education is the true intent of its programmes, argues the author, who says that there is now a body of thought that policies and guidelines are needed in this area.
Nurse prescribing extends beyond the therapeutic alliance into areas of research, human rights, policy, promoting change, financial issues and ethics. The author concludes by urging the Nursing and Midwifery Council (NMC) to set the highest standards, provide robust guidance for practitioners and show that it is willing to stand up to private industry.
Young A. Professionalism and ethical issues in nurse prescribing. Nurse Prescribing 2010; 8(6): 284-289.
Practice nurses and prescribing
July 25, 2010
What is the experience of prescribing for practice nurses, how do they feel about it, and what has its impact been on their role? These were some of the issues explored in a small, qualitative study using semi-structured interviews with eight prescribing practice nurses. Their experiences were mainly positive, but some tensions with medical colleagues in particular remain.
Many or all of the nurses felt that there were benefits for patient care through prescribing, that there were misunderstandings among practice staff about their role, that it is both ‘imperative and intuitive’ to follow appropriate guidance, that their role had changed as a result of prescribing, and that they were unwilling to prescribe outside their competence or boundaries. Some felt that workload had increased. It emerged during the interviews that minor illness is increasingly being incorporated into the role of these nurses. Although some GPs welcomed the change and were supportive, others were less happy about it and lacked understanding about the nurse prescriber’s role and competency.
The authors make some recommendations: all staff working with prescribing nurses should get full explanations of the circumstances in which they can prescribe; after the initial mentoring period, doctors or experienced nurse prescribers should provide a further period of mentoring and supervision, to further mutual respect and understanding; and a continued learning or system of monitoring could be introduced to help nurse prescribers demonstrate their credibility - as nurses’ roles extend, something like the GP performance monitoring system may become more appropriate. Clearly, as the authors point out, this is a small study and further work is needed.
Daughtry J. and Hayter M. A qualitative study of practice nurses’ prescribing experiences. Practice Nursing 2010; 21(6): 310-314.
New CKS topics
July 25, 2010
New topics on polycythaemia/erythrocytosis and post-traumatic stress disorder have been added to the Clinical Knowledge Summaries (CKS) website.
National approach pays off in Ireland
July 14, 2010
Two articles about the implementation of nurse and midwife prescribing in Ireland have highlighted the importance of a structured, national approach. One [1] describes the national processes used and argues that the “critical success factor” was “the introduction of a standardised approach applied in a systematic manner by each health service provider….”. Another [2] describes how one aspect of the national framework used to support the initiative, the national nurse and midwife prescribing minimum dataset, was developed - and how its reports can be used to examine the prescribing activity of nurse prescribers in Ireland.
[1] Adams E et al. Prescribing in Ireland: the National Implementation Framework. Nurse Prescribing 2010; 8(4): 182-188.
[2] Adams E et al. Nurse and midwife prescribing in Ireland: the Minimum Dataset. Nurse Prescribing 2010; 8(5): 234-241.
Categories
Recent Posts
- NPSA to be abolished
- Professionalism and ethics
- Practice nurses and prescribing
- New CKS topics
- National approach pays off in Ireland
- CDs: Another question asked in Lords
- Patients ‘confident’ about nurse prescribing
- Push for non-medical prescribing in Wales
- Insulin safety guidance issued
- Prescribing book - July publication
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