Griffith R and Tengnah C. Consent to examination and treatment 3: knowledge of risks. Nurse Prescribing 2004; 2(6): 244–246.

Summary

1. Approximately 160 nurses and pharmacists are currently enrolled on a ‘All Wales’ Supplementary Prescribing training course

2. The course is multi-professional and requires 15 days attendance plus additional self-directed learning utilising ‘All Wales’ distance learning materials

3. Each designated supervising medical practitioner must attend a one day training event in preparation for the role

4. Those in training come from a broad spectrum of nursing and pharmacy practice which will enable the value of supplementary Prescribing to be tested in a range of situations

Summary Some of the best-known consultation models derived from general practice are briefly described and discussed in terms of their relevance for nurse and pharmacist prescribers. The communication skills needed by the nurse prescriber are also considered, along with an introduction to the concept of the patient's health belief system. Some of the literature that compares nurse and GP consultations is also looked at, as is the concept of diagnosis by nurses. Concordance with medication and consultations with pharmacists are also mentioned.

Summary

Prescribers face a range of ethical dilemmas in their everyday practice. In this article, the principles-based approach to biomedical ethics developed by Beauchamp and Childress is outlined, with a particular focus on ‘respect for autonomy’. It is argued that the purpose of ethical reflection is to deepen and enrich more general reflection about clinical practice, rather than to provide definitive answers to dilemmas in prescribing.

Jones M. Case report. Nurse prescribing: a case study in policy influence. J Nursing Mgmt 2004; 12: 266–272.

Topol A. Pharmacokinetics and pharmacodynamics, general principles: Prescribing Nurse 2004; Spring: 12–17.

Summary This article sets out to review recent research studies pertaining to the drug treatment of oropharyngeal candidiasis in infants. The main aims of treatment programmes are to resolve signs and symptoms of the infection; and minimise drug induced resistance, with minimal adverse side effects. A search for clinical evidence using Medline, Nursing Index and Embase between 1995 and 2003, produces no systemic reviews, no placebo controlled trials only three random control trials for the treatment of oropharyngeal candidiasis in infants. Three independent randomised control trials with samples of infants with oropharyngeal candidiasis (who were not immuno-compromised), compare the three main drug treatments of choice for infants, i.e. miconazole gel, clotrimazole (nystatin) suspension, and fluconazole suspension. The randomised trial of these infants found that miconazole gel had a significantly higher cure rate compared with nystatin suspension. At day 12 of the trial there was a 99% cure rate with the use of miconazole gel (25 mg QDS) compared to only a cure rate of 54% with nystatin suspension (100 000 IU QDS) (P> < 0.0001). The evidence from these studies suggest that miconazole gel (25 mg QDS) is the drug of choice for health visitors treating infants with oropharangeal candidiasis, as it is a safe and effective and cost effective treatment regime from birth.

Summary

Skin cancer represents a significant health problem in the white adult population. Nurses have a responsibility in health promotion and disease prevention for patients at risk of developing the most common form of skin cancer, the basal cell carcinoma (BCC).

BCC is managed using a combination of primary and secondary disease prevention strategies. These are education and screening of at-risk individuals in the community. Self-screening within the home, as well as opportunistic screening by health professionals, is deemed the most cost-effective strategy in the UK. Nurses, therefore, have a responsibility to educate patients about sun awareness, sun protection and early recognition of cancerous or pre-cancerous lesions. A number of treatment options are available for basal cell carcinoma with the decision to treat based on clinical appearance, histological examination, previous medical history and patient choice. Nurse, through the use of patient group directions and prescribing, can help to ensure the most appropriate treatment for individual patients.

Summary

There are many responsibilities and challenges organisations need to address to ensure the selection of nurses for extended/supplementary prescribing occurs within an environment which guarantees success and fits the long-term objectives of the organisation in terms of role re-design and service delivery. As a local lead it is important to recognise the challenges influencing the development, implementation and effectiveness of nurse prescribing. This article considers some of those challenges and shares the experience of Coventry Teaching Primary Care Trust. The article provides some food for thought for nurses wanting to become prescribers, organisations and Higher Educational Institutes.

Jain A. Extracts from ‘BestTreatments’: Treating nicotine addiction. British Medical Journal 2003; 327: 1394–1395.

Lawton S. Nurse-led care: the role of nurses in eczema clinics. Nurse Prescribing 2004; 2(6): 239–243.

Baird A. Supplementary prescribing: one general practice's experience of implementation. Nurse Prescribing 2004; 2(2): 72–75.

Gagan M. Keeping things under control: drug supply. Supplementary Prescribing in Practice 2004; 1(2): 8.

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

Pearce L. Writer's block. Nursing Standard 2004; 18(46): 14–17.

Avery A et al. Doctors' views on supervising nurse prescribers. Prescriber 5 September 2004; 56–61 (download here [1]; accessed 5/10).

Baird A. Recent developments in prescribing. Journal of Community Nursing 2004; 18(3): 4–6.

Professional Nurse 2004; 19(11): 35–37.

Cornforth P. Listen Up: We need more consistency in nurse prescribing. Nursing Times 2004; 100(44): 17.