An evaluation of the appropriateness and safety of nurse and midwife prescribing in Ireland.

Hdl Handle:
http://hdl.handle.net/10147/247611
Title:
An evaluation of the appropriateness and safety of nurse and midwife prescribing in Ireland.
Authors:
Naughton, Corina; Drennan, Jonathan; Hyde, Abbey; Allen, Deirdre; O'Boyle, Kathleen; Felle, Patrick; Butler, Michelle
Affiliation:
School of Nursing, Midwifery and Health Systems, University College Dublin (UCD), Belfield, Dublin, Ireland.
Citation:
An evaluation of the appropriateness and safety of nurse and midwife prescribing in Ireland. 2012: J Adv Nurs
Journal:
Journal of advanced nursing
Issue Date:
19-Sep-2012
URI:
http://hdl.handle.net/10147/247611
DOI:
10.1111/jan.12004
PubMed ID:
22989189
Additional Links:
http://onlinelibrary.wiley.com/doi/10.1111/jan.12004/full
Abstract:
AIM: To evaluate the clinical appropriateness and safety of nurse and midwife prescribing practice. BACKGROUND: The number of countries introducing nurse and midwife prescribing is increasing; however, concerns over patient safety remain. DESIGN: A multi-site documentation evaluation was conducted using purposeful and random sampling. The sample included 142 patients' records and 208 medications prescribed by 25 Registered Nurse Prescribers. METHODS: Data were extracted from patient and prescription records between March-May 2009. Two expert reviewers applied the modified Medication Appropriate Index tool (8 criteria) to each drug. The percentage of appropriate or inappropriate responses for each criterion was reported. Reviewer concordance was measured using the Cohen's kappa statistic (inter-rater reliability). RESULTS: Nurse or midwife prescribers from eight hospitals working in seventeen different areas of practice were included. The reviewers judged that 95-96% of medicines prescribed were indicated and effective for the diagnosed condition. Criteria relating to dosage, directions, drug-drugs or disease-condition interaction, and duplication of therapy were judged appropriate in 87-92% of prescriptions. Duration of therapy received the lowest value at 76%. Overall, reviewers indicated that between 69 (reviewer 2)-80% (reviewer 1) of prescribing decisions met all eight criteria. CONCLUSION: The majority of nurse and midwife prescribing decisions were deemed safe and clinically appropriate. However, risk of inappropriate prescribing with the potential for drug errors was detected. Continuing education and evaluation of prescribing practice, especially related to drug and condition interactions, is required to maximize appropriate and safe prescribing.
Item Type:
Article
Language:
en
ISSN:
1365-2648

Full metadata record

DC FieldValue Language
dc.contributor.authorNaughton, Corinaen_GB
dc.contributor.authorDrennan, Jonathanen_GB
dc.contributor.authorHyde, Abbeyen_GB
dc.contributor.authorAllen, Deirdreen_GB
dc.contributor.authorO'Boyle, Kathleenen_GB
dc.contributor.authorFelle, Patricken_GB
dc.contributor.authorButler, Michelleen_GB
dc.date.accessioned2012-10-08T14:02:00Z-
dc.date.available2012-10-08T14:02:00Z-
dc.date.issued2012-09-19-
dc.identifier.citationAn evaluation of the appropriateness and safety of nurse and midwife prescribing in Ireland. 2012: J Adv Nursen_GB
dc.identifier.issn1365-2648-
dc.identifier.pmid22989189-
dc.identifier.doi10.1111/jan.12004-
dc.identifier.urihttp://hdl.handle.net/10147/247611-
dc.description.abstractAIM: To evaluate the clinical appropriateness and safety of nurse and midwife prescribing practice. BACKGROUND: The number of countries introducing nurse and midwife prescribing is increasing; however, concerns over patient safety remain. DESIGN: A multi-site documentation evaluation was conducted using purposeful and random sampling. The sample included 142 patients' records and 208 medications prescribed by 25 Registered Nurse Prescribers. METHODS: Data were extracted from patient and prescription records between March-May 2009. Two expert reviewers applied the modified Medication Appropriate Index tool (8 criteria) to each drug. The percentage of appropriate or inappropriate responses for each criterion was reported. Reviewer concordance was measured using the Cohen's kappa statistic (inter-rater reliability). RESULTS: Nurse or midwife prescribers from eight hospitals working in seventeen different areas of practice were included. The reviewers judged that 95-96% of medicines prescribed were indicated and effective for the diagnosed condition. Criteria relating to dosage, directions, drug-drugs or disease-condition interaction, and duplication of therapy were judged appropriate in 87-92% of prescriptions. Duration of therapy received the lowest value at 76%. Overall, reviewers indicated that between 69 (reviewer 2)-80% (reviewer 1) of prescribing decisions met all eight criteria. CONCLUSION: The majority of nurse and midwife prescribing decisions were deemed safe and clinically appropriate. However, risk of inappropriate prescribing with the potential for drug errors was detected. Continuing education and evaluation of prescribing practice, especially related to drug and condition interactions, is required to maximize appropriate and safe prescribing.-
dc.languageENG-
dc.language.isoenen
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/jan.12004/fullen_GB
dc.rightsArchived with thanks to Journal of advanced nursingen_GB
dc.titleAn evaluation of the appropriateness and safety of nurse and midwife prescribing in Ireland.en_GB
dc.typeArticleen
dc.contributor.departmentSchool of Nursing, Midwifery and Health Systems, University College Dublin (UCD), Belfield, Dublin, Ireland.en_GB
dc.identifier.journalJournal of advanced nursingen_GB

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