Wilkinson Jill, Carryer Jenny, Adams Jeffery
School of Nursing, Massey University, Wellington, New Zealand.
J Clin Nurs. 2014 Aug;23(15-16):2355-65. doi: 10.1111/jocn.12517. Epub 2013 Dec 20.
To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing.
Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines.
The study was a process and outcome clinical programme evaluation.
The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively.
Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team.
These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended.
Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care. As novice prescribers, nurses need to be well prepared educationally and have access to supportive clinical supervision.
评估糖尿病专科护士处方项目，以确定糖尿病专科护士开处方是否安全有效，并为注册护士处方的实施和推广提供参考。
许多国家的注册护士能够开处方，但在新西兰，在糖尿病专科护士项目之前，执业护士是唯一能开处方的护士。新规定允许护士开具有限数量的处方药。
该研究是一项过程和结果的临床项目评估。
该项目于2011年4月至9月进行，涉及四个地区的12名糖尿病专科护士。定量数据收集自糖尿病专科护士为该项目维护的临床记录（1274名患者和3402次处方事件）、与利益相关者的调查（全科医生，n = 30；团队成员，n = 19；患者，n = 89）以及患者笔记（n = 117）和处方（n = 227）的审核，定性数据收集自与项目参与者（n = 18）和患者（n = 19）的访谈。所有数据均进行描述性分析。
糖尿病专科护士开处方被确定为安全、高质量且恰当。它为糖尿病专科服务的有效性带来了重要益处，患者可以接受，并且得到了更广泛医疗团队的支持。
这些发现与国际文献中关于护士在一系列不同实践领域开处方的报道一致。如果要扩展处方模式，建议明确教育和能力要求以及为护士持续监督提供资源。
糖尿病专科护士开处方通过提供更及时的服务改善了用药途径。护士对自己的工作更满意，因为他们可以独立提供完整的护理过程。作为新手开处方者，护士需要在教育上做好充分准备，并获得支持性的临床监督。
