Nurse prescribing

1. Nurse prescribing Karen Hoare Nurse Practitioner / Lecturer Dept. of General Practice and Primary Health Care School of Nursing University of Auckland Greenstone Family Clinic

3. Nurse prescribing in the UK • Recommended by the RCN in 1980 • The Cumberlege report 1986 • The Crown report 1989 – District Nurses and Health Visitors • Eight pilot sites in 1994 • Improved client care • Enabled nurses to make decisions • Furthered the development of evidence-based practice • 1999 widespread District Nurse and Health Visitor prescribing

4. International nurse prescribing • USA Paediatric Nurse Practitioners 1965 • Sweden – District Nurses 1994 ‘A nurse who takes an advanced degree in nursing does not become more like a doctor but becomes instead a better nurse.’ Aidroos (2002) Nurse prescribing in the UK. Lancet 360, 1608.

5. New Zealand 2005 ‘A threat to the standard of healthcare’ ‘Prescribing is probably the most dangerous activity that the medical degree confers on doctors’ Moller P. Begg E. (2005) Independent nurse prescribing in New Zealand. http://www.nzma.org.nz/journal/118-1225/1724 Hoare, K. Nurse prescribing: safety and accountability. (2006) http://www.nzma.org.nz/journal/119-1230/1892

6. Different types of prescribing • Independent – autonomous NP registered with Nursing Council with a defined scope of practice • Supplementary prescribing (UK) in partnership with doctors via patient group directives following a clinical management plan • Designated prescribers (NZ) April 2011 – 4 demonstration sites -Hawke’s Bay, Mid Central Health, Auckland and Hutt Valley DHB

7. Safe prescribing • Differential diagnosis • Boundaries • NPC competencies • Up to date • Guidelines • PHARMAC • Medsafe • MIMS • OTC medications. • Concordance. • Check for allergies. • Date, name, DOB, age (if child <12 years), address, signature, PIN. • Drug, dose, strength, amount, frequency, route. • Record and review

8. Training and competency assessment • Prior to administering Amoxycillin under Standing Order, registered nursing staff are required to have: • An annual review of competency in administration of this Standing Order by Karen Hoare, Nurse Practitioner / Dr Bruce Arroll. • Read material safety data sheet in data sheet folder. • Reviewed the Nursing Council of New Zealand’s ‘Code of Conduct’.

9. The following existing documents and references are related to Amoxycillin

10. Conclusion • Provision of essential medicines • High need for children and young people • Nurses are cautious • Follow the guidelines • Know what you are doing • MAKE A DIFFERENCE!