Non-prescribing diabetes nurse specialist views of nurse prescribing in diabetes health
Hazel Philips, RN, MN, Diabetes Nurse Specialist, Hutt Valley DHB, Wellington, NZ
Jill Wilkinson, RN, PhD, Senior Lecturer, School of Nursing, Massey University, Wellington, NZ
Reference: Philips, H., & Wilkinson, J. (2015). Non-prescribing diabetes nurse specialist views of nurse prescribing in diabetes health. Nursing Praxis in New Zealand, 31(1), 5-17.
In 2011 a project to trial diabetes nurse specialist prescribing was implemented. Twelve diabetes nurse specialists took part in the project located in four sites throughout New Zealand. Evaluation of the project found diabetes nurse specialist prescribing to be safe, of high quality and appropriate. Consequently, a staged roll-out of prescribing to and approval for another 15 diabetes nurse specialists has taken place. Against that background, and with the aim of informing future workforce planning, this paper presents the results of a survey of non-prescribing diabetes nurse specialists views of nurse prescribing. Members of the diabetes nurse specialist section of the New Zealand Nurses Organisation completed an online survey between May and June 2012 (n=92). All data were analysed descriptively. The results indicate that standing orders are not always adequate and that prescribing is recognised as a natural progression for nurses; 72.8% indicated interest in becoming a prescriber; 57.6% met the postgraduate study requirements and 35.9% had altered study plans to meet the requirements. A statistically significant relationship exists between being accredited as 'specialist' with the New Zealand Nurses Organisation (n=39) and the intention to become a prescriber (p=.029). Diabetes nurse specialists agree that prescribing improves access to diabetes services, diabetes management, continuity and quality of care, the use of diabetes nurse specialist time and skills, team dynamics, and reduces delays for patients. Concerns include ongoing access to the required medical supervision. The study implications are that diabetes nurse specialists are ready to become prescribers and more are needed to meet the needs of an increasing number of people with diabetes. Resources for the necessary medical supervision need to be included in future workforce planning if diabetes nurse specialist prescribing is to remain viable and continue to make a positive impact on the health of people with diabetes.
Diabetes nurse specialist; diabetes nurse prescriber; designated prescriber; registered nurse; workforce planning