Summary

The extended independent and supplementary nurse prescribing programme implemented in 2003 is anticipated to have the potential to improve patient care by enabling faster access to medicine for people with chronic conditions such as Diabetes. Diabetes mellitus is a progressive, life–long, chronic condition which affects an estimated 1.4 million people in the UK and inevitably requires medication to control symptoms and prevent complications associated with the disease.

The supplementary prescribing option of nurse prescribing is an opportunity for Diabetes Specialist Nurses (DSN) to provide timely and appropriate clinical management for patients with diabetes within an agreed management plan. The clinical management plan (CMP) is a patient specific document and can only be implemented to enable supplementary nurse prescribing upon agreement by the individual patient, the independent prescriber (doctor or dentist and supplementary prescriber (nurse or pharmacist). The CMP allows the DSN to manage the treatment of the patient by modifying diabetes therapies tailored to the needs of the individual to achieve treatment goals. The use of a patient specific CMP compliments the National service Framework for diabetes requirement that all patients have a care plan. Involving the patient by seeking agreement to implement the CMP may improve concordance and compliance with therapies and treatment decisions.

Monitoring diabetes control is essential from diagnosis as the information received provides valuable feedback as to the effectiveness of therapies. Comprehensive diabetes education should be tailored to empower the patient with knowledge and skills to manage this chronic condition regardless of treatment regimes.

Consideration should always be given to the type of diabetes, the potential effects on lifestyle and treatment options available today.

Nursing Times 2004; 100(4): 49–69.

Morgan R. An audit of asthma care. Practice Nurse 2004; 27(2): 30–34.