Explore Registered Nurse Prescribing. March 10, 2010

Transcription

1 Explore Registered Nurse Prescribing March 10, 2010 Canadian Nurses Association, 2009

2 Diane Wilson Maté Director, Policy Development and Regulation, College of Registered Nurses of Manitoba Lisa Ashley Nurse Consultant, Nursing Policy, Canadian Nurses Association

3 History U.K more than 55,000 RNs are qualified to prescribe nationally Drivers: increase in complex and special needs, workforce supply, waiting list targets Ireland 2007 Currently 104 Registered Nurse Prescribers Drivers: changing health environment, increased political will

4 Prescribing in U.K. and Ireland Independent authorization, in writing, of the dispensing, supply and administration of a named medicinal product for a specific patient.

5 One Story Matt Griffiths is a registered nurse independent prescriber Matt works in a walk-in centre and out-ofhours care. Matt completes full episodes of care for up to 50 patients per week. Patients would have previously had to wait for a prescription signed by a doctor.

6 Internationally RNs can legally prescribe medication in several countries. RN prescribing in other countries is proving beneficial for professionals, the health-care system, and patients.

7 Regulation in U.K. and Ireland Prescribing is an expansion of a registered nurse s scope of practice, beyond the competence an individual practitioner possesses at the point of registration. Developed tools i.e. Decision-Making Frameworks and Practice Standards

8 Legal / Nursing Association RN prescribers in Ireland prescribe controlled drugs independently are subject to conditions for drugs for pain relief in hospital, palliative care, midwifery, and neonatal care in hospital law does not allow for nurses to prescribe unlicensed medicines RN prescribers in U.K. ensure have professional indemnity

9 Education minimum 3 years post-registration clinical experience ability to study at degree level support from employer / access to medical prescriber attendance in university course (attendance at class, self-directed learning and clinical practice)

10 Employers in U.K. and Ireland Structures need to be in place a local written policy a collaborative practice agreement (Ireland) must meet site selection criteria in order to participate

11 Front line RN Perspective Critical to have RN champions in management No backlash from physicians Facilitates the RN role RN prescribing rights has decreased wait times in outpatient departments

12 Other Health Professionals Buy-in from the individual physician and pharmacist in the practice setting is critical Concerns included: patient safety disparity in training between the medical profession and other health-care professionals

13 Evaluation in England University of Southampton National survey of 246 registered nurse prescribers RN prescribers have very effective prescribing decisions patient return visits reduced patients adhered to treatment programs improved uptake of medicines and better patient outcomes

14 Evaluation in Ireland 2009 University College of Dublin Patients and parents: highly satisfied with the care they received from RN prescribers received comprehensive education and advice from the RN prescriber on the medication prescribed more than 90% indicated that wait times were reduced

15 Questions? Diane Wilson Maté Lisa Ashley

16 References U.K. Department of Health and Social Security (1986). Neighborhood nursing: A focus for care [from Report of the Community Nursing Review (The Cumberlege Report)]. London: Her Majesty's Stationery Office. An Bord Altranais. (2000). Review of scope of practice for nursing and midwifery: Final report. Dublin: Author. Retrieved October 31, 2009, from Carroll, Mella (1998). Report of the Commission on Nursing: A blueprint for the future [Part 1]. Dublin: Government of Ireland. Retrieved October 31, 2009, from Courtenay, M., Carey, N., & Burke, J. (1986). Independent extended and supplementary nurse prescribing practice in the UK: A national questionnaire survey. International Journal of Nursing Studies 44(7),

17 References Drennan, J., Naughton, C., Allen, D., Hyde, A., Felle, P., O Boyle, K., et al. (2009). National independent evaluation of the nurse and midwife prescribing initiative. Dublin: University College Dublin. International Council of Nurses (ICN). (November 17-19, 2007). Proceedings of the 8th Meeting of the ICN Credentialing Forum. [Forum held at the Royal College of Nursing, London, U.K.] London: Author. Irish Medicines Board (Miscellaneous Provisions) Act Dublin: Department of Health and Children. Retrieved October 31, 2009, from

18 FOR INFORMATION: Lisa Ashley RN CCHN(C), BScN, MEd Nurse Consultant Canadian Nurses Association