Carey Nicola, Courtenay Molly, James June, Hills Mimi, Roland Jonathan
School of Health & Social Care, University of Reading, Reading, UK.
J Clin Nurs. 2008 Jun;17(12):1635-44. doi: 10.1111/j.1365-2702.2007.02197.x.
To evaluate the impact of a Diabetes Specialist Nurse prescriber on insulin and oral hypoglycaemic agent medication errors and length of stay.
The National Health Service has committed to a 40% reduction in the number of drug errors in the use of prescribed medicines. Drug errors in diabetes care are a common cause of significant morbidity and complications. Nurse prescribing creates an opportunity for nurses to improve care for these patients.
A quasi-experiment using six wards in a single hospital trust.
Inpatient care of a convenience sample of patients with diabetes was evaluated before (n = 27) and after (n = 29) the intervention of a Diabetes Specialist Nurse prescriber. Prospective data were collected to measure insulin and oral hypoglycaemic medication errors and length of stay.
There was a significant reduction in the total number of errors between the pre-intervention and intervention group (mean reduction 21 errors) (p = 0.016). The median length of stay was reduced by three days. The total number of errors and length of stay were affected by admission category (p = 0.0004).
A medicines management intervention, provided by a Diabetes Specialist Nurse prescriber, had a positive effect on the system of delivering medicines to patients with diabetes and significantly reduced the number of errors. This reduction had some effect on length of stay. The cost saving was sufficient to finance a Diabetes Specialist Nurse prescriber post.
(i) Errors frequently occur in the prescription and administration of medicines to patients with diabetes. (ii) The education of healthcare professionals is a factor contributing to these errors. (iii) Nurse prescribing provides a new system by which to educate patients and staff about their medicines. (iv) A Diabetes Specialist Nurse prescriber can reduce insulin and OHA MEs. This reduction had some effect on LOS.
评估糖尿病专科护士开处方者对胰岛素和口服降糖药用药错误及住院时间的影响。
国民医疗服务体系致力于将处方药使用中的用药错误数量减少40%。糖尿病护理中的用药错误是导致严重发病和并发症的常见原因。护士开处方为护士改善对这些患者的护理创造了机会。
在一家医院信托机构的六个病房进行的准实验。
对糖尿病患者便利样本的住院护理在糖尿病专科护士开处方者干预前（n = 27）和干预后（n = 29）进行评估。收集前瞻性数据以测量胰岛素和口服降糖药用药错误及住院时间。
干预前组和干预后组之间的错误总数显著减少（平均减少21个错误）（p = 0.016）。住院时间中位数减少了三天。错误总数和住院时间受入院类别影响（p = 0.0004）。
由糖尿病专科护士开处方者提供的药物管理干预对向糖尿病患者给药的系统产生了积极影响，并显著减少了错误数量。这种减少对住院时间有一定影响。节省的成本足以资助一个糖尿病专科护士开处方者的岗位。
（i）给糖尿病患者开处方和用药时经常出现错误。（ii）医护人员的教育是导致这些错误的一个因素。（iii）护士开处方提供了一个新系统，通过该系统可以就药物对患者和工作人员进行教育。（iv）糖尿病专科护士开处方者可以减少胰岛素和口服降糖药的用药错误。这种减少对住院时间有一定影响。
