Implementation of nurse prescribing in diabetes

‘Few current problems’ were reported by nurses prescribing for patients with diabetes and their colleagues in this case study, and initial implementation problems had been resolved. Diabetes services were ‘primed’ to assimilate nurse prescribing.

The interviews, with nurse prescribers, administrative staff, physicians and non-prescribing nurses, revealed some interesting findings. Discontinuing the extended formulary in 2006 had ‘a profound effect’: because these nurses could now prescribe insulin and oral hypoglycaemic agents independently, the preferred mode switched from supplementary to independent prescribing. This allowed nurses to make better use of their prescribing qualification. The authors suggest that supplementary prescribing may be less useful in the management of long-term conditions than was originally thought.

In this case study, prescribing was found to fit into pre-existing structures, which meant that it could be seen as improving efficiency without requiring major changes – this may have smoothed the road to implementation. Success also depends on organizational support, good relationships between professionals, and acceptance of the prescribing role.Â

Stenner K, Carey N and Courtenay M. Implementing nurse prescribing: a case study in diabetes. J Advanced Nursing 2010; 66(3): 522-531.