An evaluation of a specialist nurse prescriber on diabetes in‐patient service delivery

Abstract

The aim of this study was to evaluate the impact of a diabetes specialist nurse (DSN) prescriber on insulin and oral hypoglycaemic agent medication errors, length of hospital stay, and patients' ability to self‐manage their diabetes whilst in hospital. The setting was six wards in a single United Kingdom district general hospital trust. The standard in‐patient care of a convenience sample of diabetic patients treated with insulin and/or oral hypoglycaemic agents was evaluated before (n = 187) and after (n = 265) the intervention of a DSN prescriber. Prospective data were collected in order to measure insulin and oral hypoglycaemic medication errors, and length of stay (i.e. primary outcome measures). A secondary outcome, the extent to which patients felt able to manage their care, was measured using a self‐report questionnaire. The results showed that the median number of insulin and oral hypoglycaemic agent medication errors was lower in the intervention group (four vs six, p<0.01). The median length of stay was less for patients in the intervention group (seven vs nine days, p<0.05). In all, 61% (59/96) of patients in the pre‐intervention group, compared with 71% (90/126) of patients in the intervention group (p = 0.118), reported that they were able to manage their diabetes during their hospital stay. It was concluded that a DSN prescriber reduced prescribing errors. This reduction had some effect on length of stay. The cost saving was at least sufficient to self‐finance the cost of a DSN prescriber post. Copyright © 2007 John Wiley & Sons.

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