Abstract:This study explored the views of mental health service users regarding the concept of nurse prescribing, an area that to date has not been examined in any significant way. A qualitative approach was used to gather data from a series of focus groups made up of service users within the Avon and Wiltshire Mental Health Partnership NHS Trust area. Content analysis was used to analyse data from each focus group and four major themes were identified from the relevant component categories. This study identifies that … Show more
“…Thus, the study represents an advance on expert opinion papers, and adds to previous research on the views of staff [13,14] and patients [24,25] towards nurse prescribing as a policy initiative.…”
BackgroundSupplementary prescribing for mental health nurses was first introduced in the UK in 2003. Since then, a number of studies have reported stakeholders' perceptions of the success of the initiative. However, there has been little experimental research conducted into its effectiveness. This paper reports findings from the first known study to compare the cost and clinical impact of mental health nurse supplementary prescribing to independent medical prescribing.MethodsA post-test control group experimental design was used to compare the treatment costs, clinical outcomes and satisfaction of patients in receipt of mental health nurse supplementary prescribing with a matched group of patients in receipt of independent prescribing from consultant psychiatrists. The sample comprised 45 patients in receipt of mental health nurse supplementary prescribing for a minimum of six months and a matched group (by age, gender, diagnosis, and chronicity) of patients prescribed for by psychiatrists.ResultsThere were no significant differences between patients in the nurse supplementary prescribers' group and the independent prescribers' group in terms of medication adherence, health status, side effects, and satisfaction with overall care. Total costs per patient for service use were £803 higher for the nurse prescribers' group but this difference was not significant (95% confidence interval -£1341 to £3020).ConclusionsNo significant differences were found between the health and social outcomes of patients in the mental health nurse supplementary prescribers' group, and those prescribed for by the independent medical prescribers. The cost appraisal also showed that there was no significant difference in the costs of the two types of prescribing, although the pattern of resources used differed between patients in the two prescriber groups. The results suggest that mental health nurse supplementary prescribers can deliver similar health benefits to patients as consultant psychiatrists without any significant difference in patients' service utilisation costs.
“…Thus, the study represents an advance on expert opinion papers, and adds to previous research on the views of staff [13,14] and patients [24,25] towards nurse prescribing as a policy initiative.…”
BackgroundSupplementary prescribing for mental health nurses was first introduced in the UK in 2003. Since then, a number of studies have reported stakeholders' perceptions of the success of the initiative. However, there has been little experimental research conducted into its effectiveness. This paper reports findings from the first known study to compare the cost and clinical impact of mental health nurse supplementary prescribing to independent medical prescribing.MethodsA post-test control group experimental design was used to compare the treatment costs, clinical outcomes and satisfaction of patients in receipt of mental health nurse supplementary prescribing with a matched group of patients in receipt of independent prescribing from consultant psychiatrists. The sample comprised 45 patients in receipt of mental health nurse supplementary prescribing for a minimum of six months and a matched group (by age, gender, diagnosis, and chronicity) of patients prescribed for by psychiatrists.ResultsThere were no significant differences between patients in the nurse supplementary prescribers' group and the independent prescribers' group in terms of medication adherence, health status, side effects, and satisfaction with overall care. Total costs per patient for service use were £803 higher for the nurse prescribers' group but this difference was not significant (95% confidence interval -£1341 to £3020).ConclusionsNo significant differences were found between the health and social outcomes of patients in the mental health nurse supplementary prescribers' group, and those prescribed for by the independent medical prescribers. The cost appraisal also showed that there was no significant difference in the costs of the two types of prescribing, although the pattern of resources used differed between patients in the two prescriber groups. The results suggest that mental health nurse supplementary prescribers can deliver similar health benefits to patients as consultant psychiatrists without any significant difference in patients' service utilisation costs.
“…In the following excerpt, the rapport developed between the nurse and patient resulted in the patient having faith in the capabilities of the nurse prescriber:The nurse knows the patient, whereas I see my psychiatrist once in a blue moon…(the nurse) knows people's habits and mannerisms anyway. (C) (Harrison , p. 80)…”
Section: Resultsmentioning
confidence: 99%
“…The nurse knows the patient, whereas I see my psychiatrist once in a blue moon…(the nurse) knows people's habits and mannerisms anyway. (C) (Harrison , p. 80)…”
Section: Resultsmentioning
confidence: 99%
“…This was voiced from the perspective of differing salaries paid for doctors and nurses, and the choice to extend the scope of practice of nurses as a cost‐saving measure:There might be a hidden agenda, as nurses are more cost‐efficient…it's my suspicious mind, having nurses do (prescribing) instead of psychiatrists. (C) (Harrison , p. 83)…”
Section: Resultsmentioning
confidence: 99%
“…There might be a hidden agenda, as nurses are more cost‐efficient…it's my suspicious mind, having nurses do (prescribing) instead of psychiatrists. (C) (Harrison , p. 83)…”
The aim of the present qualitative, systematic review was to identify and summarize qualitative research that focussed on mental health nurse prescribing, synthesize findings, and outline key themes discerned. In November 2016, a systematic search was conducted for primary studies of the electronic databases PubMed, Excerpta Medica, (Embase), Cumulative Index to Nursing and Allied Health Literature, Scopus, and PsycINFO. Of the 101 papers identified through the search strategy, 12 qualitative studies met the review inclusion criteria. These studies included perspectives from nurses, doctors, and patients/clients regarding their attitudes about, and experiences of, nurse prescribing. Three themes emerged from the review: (i) patient-centred care; (ii) professional role; and (iii) professional support. Nurse prescribers embrace a patient-centred approach, providing timely and effective medication management. Adequate education and continuing professional development inclusive of clinical supervision enable competency development in nurse prescribing, supportive professional relationships, and patient safety. Further research is necessary to establish safety and demonstrate enhanced clinical outcomes from mental health nurse prescribing.
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