Continence is an area that requires many community nurses to prescribe from the Nurse Practitioner’s Formulary to promote good patient care and appropriate service delivery. Recently in West Berkshire, with the full support of GPs, the continence advisory service has taken over the non-medical prescribing of all continence products, with the aim of providing a safe, cost-effective and timely service. This initiative is aimed at changing the way continence prescriptions are issued to patients. This second article of a two-part series, as well as featuring a case report looking at the management of a patient with multiple sclerosis (MS) and bladder dysfunction, looks at the importance of holistic assessment to ensure appropriate catheter provision in line with prescribing principles.
Continence is an area that requires many community nurses to prescribe from the Nurse Practitioner’s Formulary to promote good patient care and appropriate service delivery. Recently in west Berkshire, with the full support of GPs, the continence advisory service has taken over the non-medical prescribing of all continence products, with the aim of providing a safe, cost-effective and timely service. This initiative is aimed at changing the way continence prescriptions are issued to patients. As well as examining the problems of bladder dysfunction in people with multiple sclerosis (MS), this first article of a two-part series, looks at the background to MS and bladder problems, as well as focusing on treatments such as clean intermittent self-catheterisation (CISC). The second part of the series will feature a case study looking at the management of a patient with MS and bladder dysfunction.
The prescribing of medication is by far the most common form of medical intervention. However, it has been shown that up to 50% of medicines are not taken as prescribed, that medication-related problems can occur, and that up to 7% of hospital admissions can be due to adverse drug reactions. A new approach termed 'medicines optimisation' has been developed that is intended to focus attention on outcomes rather than process in relation to improving quality, the benefits, and value patients receive from their use of medicines. This article describes the role that community nurses can play in achieving the ambitions of the medicines optimisation agenda.
Ongoing developments in the prescribing agenda such as the new competency framework and the widening of professional responsibility within this field, are just part of other major changes taking place in health and social care today. The advantages for nurses of working in this new and rapidly evolving healthenvironment include the possibility of greater role flexibility, increased employability in multi-sectoral teams and the opportunity to run their own commissioned services. For managers, there is the possibility of providing a whole therapeutic package of care from each employee, with the distinct advantage of reducing the cost of relying on locum staff and brought-in prescribing services. This article outlines the common competency framework for prescribing, which provides a focus for the development of skill and knowledge and aims to ensure that standards are upheld across care services.
Anita Fatchett, Associate Senior Lecturer Nursing at Leeds Metropolitan University
Andrew McEwan, Non-Medical Prescribing Lead at Leeds Metropolitan University
Peter Pridmore attempts to link theory to practice using ethical principles and the UKCC's codes
Vicki May describes a small study which investigated the readiness of district nurses to prescribe.
Matt Griffiths discusses the current educational provision for nurse prescribers. Matt Griffiths RGN, FAETC, A&E Cert, is a Senior Lecturer - Nurse Prescribing at the School of Health Studies, Homerton College, Cambridge. Matt Griffiths has been working as an activist for the RCN for the past year, advising on prescribing and medicines management. He will shortly be taking up a part-time joint secondment with Dr Molly Courtenay as advisor on nurse prescribing to the RCN. Article accepted for publication: February 2003
Irene Cooke gives an overview of nurse prescribing in relation to wound management.
Irene Cooke, RGN, SCM, DN, MPH, BSc (Hons), Non-Medical Prescriber, PGCHE is a Senior Lecturer/Pathway Leader in District Nursing, University of Chester.
Article accepted for publication: January 2007
Olabisi Oshinbolu reflects on a prescribing intervention undertaken as a student district nurse at London South Bank University.
Olabisi Oshinbolu is a District Nurse at Newham Primary Care Trust.
Article accepted for publication: December 2006
