Nurse prescribing ‘supports and enhances’ established diabetes services, according to the conclusion of this case study of nine English settings in which nurses prescribe for people with diabetes.
Semi-structured interviews with nurse prescribers and other team members (administrative staff, doctors and non-prescribing nurses) revealed that the specialist nurses tended to treat patients with poorly controlled diabetes whereas nurses in general practice usually cared for patients with better controlled diabetes and prescribed a wider range of medicines for diabetes and related co-morbidities. Scope of practice and levels of responsibility varied, with nurses in one general practice setting taking responsibility for the whole of diabetes care with little input from the GPs, whereas one diabetes specialist nurse had been prevented from prescribing for inpatients.
Nurse prescribing was seen as facilitating change rather than causing it, with the shift of diabetes services to the community perceived as the main driver for change. It did, however, provide the flexibility and impetus to consider different ways of working: nurses in general practice were introducing a single review process in which patients with diabetes and co-morbidities had all their conditions reviewed at the same time. Prescribing by nurses was seen as helping to provide a more streamlined, responsive service, with good teamworking being important, for example in sharing information about new medicines.
Carey N, Stenner K and Courtenay M. How nurse prescribing is being used in diabetes services: views of nurses and team members. J Nursing Healthcare Chronic Illness 2010; 2(1): 13-21.