Biomedical subjects

Molly Courtenay

Publications and source records attributed to Molly Courtenay.

15 recordsLinked to original sources

PubMed2007

A review of the impact and effectiveness of nurse-led care in dermatology.

AIMS AND OBJECTIVES: To identify systematically, summarize and critically appraise the current evidence regarding the impact and effectiveness of nurse-led care in dermatology. BACKGROUND: A diverse range of nurse-led models of care exist in dermatology. Primary studies have been conducted evaluating these models, but review and synthesis of the findings from these studies have not been undertaken. METHOD: Systematic searches of CINAHL, MEDLINE, British Nursing Index (BNI) and the RCN Library Catalogue from 1990 until March 2005. The searches were supplemented by an extensive hand search of the literature through references identified from retrieved articles and by contact with experts in the field. RESULTS: Fourteen relevant publications were identified and included findings from both primary and secondary care. The evidence indicates that nurses are treating a number of dermatological conditions, primarily using treatment protocols, across a broad range of clinical settings. However, some nurses working in primary care, lack confidence to treat some of these conditions and the educational needs of these nurses are frequently unmet. A reduction in the severity of the condition and more effective use of topical therapies are benefits of nurse interventions on service delivery. Faster access to treatment, a reduction in referrals to the general practitioner or dermatologist and an increase in knowledge of their condition are benefits reported by patients. CONCLUSIONS: Findings of the review are generally positive. However, there are methodological weaknesses and under researched issues, e.g. cost effectiveness of nurse-led care and the prescription of medicines by nurses for patients with dermatological conditions that point to the need for further rigorous evaluation. RELEVANCE TO CLINICAL PRACTICE: Nurse-led care is an integral element of the dermatology service offered to patients. This review highlights the impact of this care and the issues that require consideration by those responsible for the development of nurse-led models of care in dermatology.

Dermatology↗

PubMed2006

Independent extended supplementary nurse prescribers, their prescribing practice and confidence to educate and assess prescribing students.

BACKGROUND: No other country in the world has such extended prescribing rights for nurses as the United Kingdom. Concerns surround the move of nursing towards a medical model of care, and the level of medical practice support required by trainee prescribers. AIM: To provide an overview of the nurses adopting the role of independent extended supplementary prescriber, their prescribing practice and confidence to educate and assess prescribing students. METHODS: A convenience sample of 1187 independent extended supplementary nurse prescribers were sent a questionnaire. Eight hundred and sixty eight completed questionnaires were returned. RESULTS: The majority (82%) of nurses worked in primary care. Eighty seven percent used independent extended prescribing and 35% supplementary prescribing. Most were qualified to degree level or higher and had over 10 years nursing experience. Seventy four percent felt confident to act as a mentor during the prescribing programme. More highly qualified nurses and those who had undertaken, or had access to continuing professional development, were statistically more likely to feel confident to adopt this role. CONCLUSION: Appropriately qualified nurse prescribers might be best placed to support trainee prescribers. Exploration of the low uptake of supplementary prescribing and access to continuing professional development is required.

Adult↗

PubMed2006

Independent extended and supplementary nurse prescribing practice in the UK: a national questionnaire survey.

BACKGROUND: Nurses are able to prescribe independently from a list of nearly 250 prescription only medicines for a range of over 100 medical conditions or, from the whole British National Formulary as a supplementary prescriber. There is some evidence available on the prescribing practices of district nurses and health visitors and early independent extended prescribers. Little or no attention has focussed on supplementary nurse prescribing. OBJECTIVE: To provide an overview of the prescribing practices of independent extended/supplementary nurse prescribers and the factors that facilitate or inhibit prescribing. DESIGN OF STUDY: National questionnaire survey. SETTING: United Kingdom. PARTICIPANTS AND METHOD: A convenience sample of 868 qualified independent extended/supplementary nurse prescribers self-completed a written questionnaire. RESULTS: A total of 756 (87%) used independent extended prescribing; 304 (35%) used supplementary prescribing to treat a range of chronic conditions (including asthma, diabetes and hypertension); 710 (82%) nurses worked in primary care. Nurses in general practice reported the largest number of reasons preventing prescribing. Reasons included the inability to computer generate prescriptions and to implement the Clinical Management Plan. Nurses in primary care reported more continuing professional development needs. These needs included update on prescribing policy and the treatment management of conditions. A total of 277 (32%) nurses were unable to access continuing professional development. CONCLUSION: Independent extended/supplementary nurse prescribers work predominantly in primary care and do prescribe medicines. These nurses are highly qualified and have many years clinical experience. Supplementary prescribing is used by a minority of nurses. Implementing the Clinical Management Plan is a barrier preventing the use of this mode of prescribing. The continuing professional development needs of independent extended/supplementary nurse prescribers are frequently unmet. It will become increasingly important that these needs are met once nurses are able to prescribe the full range of medicines included in the British National Formulary, limited only by their area of competence.

Adult↗

PubMed2006

Preparing nurses to prescribe medicines for patients with dermatological conditions.

BACKGROUND: From Spring 2006, independent extended nurse prescribers in the United Kingdom will be able to prescribe any licensed medicines except controlled drugs. Supplementary nurse prescribers are currently able to prescribe any medication. No other country in the world has such extended prescribing rights for nurses. Aspects of prescribing viewed positively by nurses include continuity of care, increased satisfaction, and the belief that patients receive improved information about prescriptions. There is some evidence, however, that nurses feel ill-prepared to prescribe due to poor understanding of pharmacology, physical assessment and diagnosis. AIM: This paper reports a study assessing the extent to which independent extended supplementary nurse prescribers feel prepared to prescribe medicines for patients with dermatological conditions. METHODS: A convenience sample of 1187 qualified independent extended supplementary nurse prescribers was sent a postal questionnaire. A total of 868 completed questionnaires was returned, and 638 of these nurses prescribed medicines for skin conditions. The data were collected in 2005. RESULTS: A total of 605 (94.8%) participants used independent extended prescribing and 234 (36.7%) supplementary prescribing. The majority were highly experienced and worked in primary care. In general, their prescribing programme had met their needs when prescribing medicines for patients with dermatological conditions. However, the needs of those who had undertaken a diploma-level module in dermatology and/or dermatology study days, and those working in both primary and secondary care, were met to a statistically significantly greater extent during the programme than for those nurses without this preparation, or those working in either primary or secondary care. CONCLUSION: Independent extended supplementary prescribing has extended the role that nurses in the United Kingdom are able to play in the management of skin disease. Specialist dermatology training is a prerequisite for nurses adopting this role. Further evaluative work on patient-focused outcomes, i.e. accessibility and convenience of care, and satisfaction with quality of care, is required.

Adult↗

PubMed2006

Attitudes towards, and information needs in relation to, supplementary nurse prescribing in the UK: an empirical study.

AIMS AND OBJECTIVES: The main aim of the study is to assess the views of people, who have not yet experienced nurse prescribing, to determine their level of confidence in nurse as opposed to doctor prescribing, effects on likely adherence and concerns that they might have. Additionally, the extent to which people would want nurses to provide an explanation for medicine choice and the type of information wanted was examined. BACKGROUND: Nurse prescribing has been successfully implemented in the UK in a number of healthcare settings. Existing research has not addressed effects on people's confidence and likely adherence, nor have people's information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction. METHODS: A convenience sample of 74 members of the general population self-completed a written questionnaire. RESULTS: In general, people would have confidence in the nurse having prescribed the best medicine and say that they would be very likely to take the medicine. Concerns identified did not specifically relate to the nurses' status. Support is provided for the importance of nurses providing a full explanation about medicines, and some indication about which categories of information should be included. Information about medication side effects was most wanted by participants. CONCLUSIONS: Independent and Supplementary Prescribing are pivotal to modernizing the NHS. The current study establishes people's initial views and concerns about nurse prescribing and assesses information needs. Support for initiating follow-on studies with particular patient groups is also provided. IMPLICATIONS FOR CLINICAL PRACTICE: People who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood. This should include information about medication side effects.

Adult↗

PubMed2004

Effectiveness of nurse prescribing: a review of the literature.

BACKGROUND: In the UK, the number of nurses able to prescribe medicines is rapidly increasing in line with Government policy directives. Whilst a number of research studies have been conducted on nurse prescribing, review and synthesis of the findings from these studies had not been undertaken. AIMS AND OBJECTIVES: The literature review was conducted to identify key findings about the impact and effectiveness of nurse prescribing as well as under-researched issues, in order to inform future research, education and practice in this area. METHODS: A review of the literature on the first phase of nurse prescribing (1993-2002) in the UK was undertaken using electronic databases and specified search terms; some hand searching and identification of grey literature was also carried out. RESULTS: Eighteen research-based publications were included in the review. Findings indicate that patients are generally satisfied with district nurses' and health visitors' prescribing in the first phase of nurse prescribing. Nurses who prescribe are also generally satisfied with their role, although some concerns about the adequacy of their pharmacological knowledge have been raised. There is some variation in the prescribing patterns of district nurses', health visitors' and practice nurses, and the limitations of the original Nurse Prescribers' Formulary (NPF) have been highlighted. Some preconditions for good nurse prescribing practice have begun to be identified. Some nurse prescribing outcomes - e.g. its impact on the prescribing practices of doctors, and the perspectives of certain patient groups - remain un-evaluated. Research into the first phase of nurse prescribing is inevitably confined to those with a district nurse and/or health visitor qualification who were prescribing from the original NPF, thus limiting conclusions that can be drawn for the current policy context. CONCLUSIONS: The review highlights that nurse prescribing has generally been evaluated positively to date; however, there are both methodological weaknesses and under-researched issues that point to the need for further research into this important policy initiative. RELEVANCE TO CLINICAL PRACTICE: The review focuses on a clinical issue central to current and future forms of health care practice. Findings from the review highlight both the impact of nurse prescribing and the prerequisites that require consideration by those responsible for the development of nurse prescribing in clinical practice.

Attitude of Health Personnel↗

PubMed2002

Nurse prescribing: implications for the life sciences in nursing curricula.

The development of new roles, over recent years, for health care professionals, has meant that the boundaries between the different occupations are no longer as clear as they were in the past. For example, the reduction in junior doctors' hours in the United Kingdom (UK), has meant that nurses have had the opportunity to expand their practice into a variety of areas which were once exclusively the responsibility of doctors. One area in which nurses (in the UK) have expanded their practice is prescribing. This paper commences with an overview of the development of nurse prescribing and highlights the important role of the life sciences in the education and training of nurse prescribers. The major findings from studies examining the teaching and learning of these sciences in nursing curricula are presented, and the implications for post-qualifying courses enabling nurses to prescribe, and pre-registration nurse education programmes are discussed.

Biological Science Disciplines↗

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