Nurse prescriber–patient consultations: a case study in dermatology

Courtenay, Molly; Carey, Nicola; Stenner, Karen

doi:10.1111/j.1365-2648.2009.04974.x

Cited by 35 publications

(44 citation statements)

References 22 publications

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“…A similar multimethod study was conducted on nurse prescribing for patients with diabetes (Courtenay et al 2009b) . Findings that the majority of patients highly rated all aspects of nurse communication, such as: listening, showing concern, explaining condition or treatment, giving information about medications and answering queries were congruent with previous work (Courtenay et al 2009a, Latter et al 2007). In observations of videotaped consultations, nurses consistently demonstrated use of listening skills, were sensitive to patient concerns, planned for future needs and provided instructions to patients about their medication.…”

supporting

confidence: 71%

“…Positive patient evaluation of nurse prescriber communication skills in relation to listening and providing information on treatment have been reported previously using questionnaire methods (Latter et al 2007, Courtenay et al 2009a). This study has provided a detailed exploration of these benefits from the point of view of patients.…”

Section: Discussionmentioning

confidence: 66%

“…Two mixed method case studies of nurse prescribing (Courtenay et al 2009a, Latter et al 2007) report inconsistencies during observations of nurse-patient consultations in the extent to which nurses provided information about side-effects and the risks and benefits of treatment options. The authors argue that these are necessary prerequisites for informed choice.…”

mentioning

confidence: 99%

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Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views

Stenner

Courtenay

Carey

2011

International Journal of Nursing Studies

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supporting

confidence: 71%

Section: Discussionmentioning

confidence: 66%

mentioning

confidence: 99%

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Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views

Stenner

Courtenay

Carey

2011

International Journal of Nursing Studies

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“…Improved access to medicines and increased service efficiency are benefits attributed to NMP by patients, NMPs, doctors and other stakeholders [10,15,16]. Nurses and pharmacists have been shown to be competent at assessing patients, producing appropriate prescriptions, and providing patients with information and advice about treatment and side effects [10,17,18]. Adopting the prescribing role is reported to increase job satisfaction, improve inter-professional collaboration and encourage flexible team working [10,19].…”

Section: Introductionmentioning

confidence: 99%

Non medical prescribing leads views on their role and the implementation of non medical prescribing from a multi-organisational perspective

Courtenay

Carey

Stenner

2011

BMC Health Serv Res

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BackgroundIn the United Kingdom, non-medical prescribing (NMP) has been identified as one way to improve healthcare quality and efficiency. Healthcare organisations are charged with overseeing the clinical governance of NMP and guidance recommends the identification of a lead director to be responsible for its implementation. While over twelve million items are prescribed each year by the 50,000 qualified NMPs its uptake is inconsistent. Several studies have explored the barriers to NMP at a practice level, however little is known about the role the NMP lead and the implementation of NMP from an organisational perspective. The aim of this research was to explore the role of the organisational NMP lead across a range of practice settings within one Strategic Health Authority (SHA) and consider the development of NMP from a multi-organisational perspective.MethodsSemi-structured telephone interviews with 28 NMP leads across one SHA were undertaken by a trained qualitative researcher. Interviews addressed the purpose of the role and difficulties encountered; audiotapes were transcribed, coded and themes were identified.ResultsThe NMP lead role comprised of four main functions; communication, coordinating, clinical governance and support. Factors hampering progress in overseeing the safe development of NMP included lack of clarity about the NMP lead role and responsibilities, strategic support and a lack of protected time. The extent to which clinical governance systems were in place across organisations was inconsistent. Where a strategic approach to its development was adopted, fewer barriers were encountered and NMP was more likely to become embedded within organisations.ConclusionsThe significant contribution that NMP leads play in embedding NMP within organisations should be acknowledged by clearer national guidance for this role and its responsibilities. Greater standardisation and consistency is required of clinical governance systems if quality and safety is to be ensured given the expanding development of NMP. The extent to which NMP is in place worldwide differs. However, our findings will be of interest to policymakers in other countries involved in the development and implementation of this role.

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“…However, the effectiveness of supplementary prescribing has been difficult to ascertain. Recent case studies of nurse prescribers (both supplementary and independent) working in non mental health settings [22,23] suggest that staff perceive that prescribing has helped them to provide more streamlined packages of care, involve patients more in prescribing decisions, be more responsive to patient needs, and to work more holistically. Specifically Courtenay et al [23] reported that nurse prescribers in dermatology services felt able to spend longer in consultations discussing medicines, and were able to make prescribing decisions that were better tailored towards their patients' lives.…”

Section: Introductionmentioning

confidence: 99%

A comparison of the clinical effectiveness and costs of mental health nurse supplementary prescribing and independent medical prescribing: a post-test control group study

Norman

Coster

McCrone

et al. 2010

BMC Health Serv Res

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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.

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Nurse prescriber–patient consultations: a case study in dermatology

Cited by 35 publications

References 22 publications

Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views

Consultations between nurse prescribers and patients with diabetes in primary care: A qualitative study of patient views

Non medical prescribing leads views on their role and the implementation of non medical prescribing from a multi-organisational perspective

A comparison of the clinical effectiveness and costs of mental health nurse supplementary prescribing and independent medical prescribing: a post-test control group study

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