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dc.contributor.authorLatter, S.*
dc.contributor.authorSmith, A.*
dc.contributor.authorBlenkinsopp, Alison*
dc.contributor.authorNicholls, P.*
dc.contributor.authorLittle, P.*
dc.contributor.authorChapman, S.R.*
dc.date.accessioned2014-04-28T10:52:20Z
dc.date.available2014-04-28T10:52:20Z
dc.date.issued2012
dc.identifier.citationLatter S, Smith A, Blenkinsopp A, Nicholls P, Little P and Chapman S (2012) Are nurse and pharmacist independent prescribers making clinically appropriate prescribing decisions? An analysis of consultations. Journal of Health Services Research and Policy. 17(3): 149-156.
dc.identifier.urihttp://hdl.handle.net/10454/6062
dc.description.abstractOBJECTIVES: Legislation and health policy enabling nurses and pharmacists to prescribe a comprehensive range of medicines has been in place in the UK since 2006. Our objective was to evaluate the clinical appropriateness of prescribing by these professionals. METHODS: A modified version of the Medication Appropriateness Index (MAI) was used by 10 medical, seven pharmacist and three nurse independent raters to evaluate a sample of 100 audio-recorded consultations in which a medicine was prescribed by a nurse or pharmacist. Raters were current prescribers with recognized experience in prescribing. Consultations were recorded in nine clinical practice settings in England. RESULTS: Raters' analysis indicated that, in the majority of instances, nurses and pharmacists were prescribing clinically appropriately on all of the ten MAI criteria (indication, effectiveness, dosage, directions, practicality, drug-drug interaction, drug-disease interaction, duplication, duration, cost). Highest mean 'inappropriate' ratings were given for correct directions (nurses 12%; pharmacists 11%) and the cost of the drug prescribed (nurses 16% pharmacists 22%). Analysis of raters' qualitative comments identified two main themes: positive views on the overall safety and effectiveness of prescribing episodes; and potential for improvement in nurses' and pharmacists' history-taking, assessment and diagnosis skills. CONCLUSIONS: Nurses and pharmacists are generally making clinically appropriate prescribing decisions. Decisions about the cost of drugs prescribed and assessment and diagnostic skills are areas for quality improvement.en
dc.relation.isreferencedbyhttp://dx.doi.org/10.1258/jhsrp.2012.011090
dc.subjectClinical competence
dc.subject; Drug costs
dc.subject; Drug prescriptions; Economics; Nursing; Standards
dc.subject; England
dc.subject; Health services research
dc.subject; Humans
dc.subject; Nurse's practice
dc.subject; Nursing assessment
dc.subject; Pharmacists
dc.subject; Physician's practice
dc.subject; Referral and consultation
dc.subject; State medicine
dc.subject; REF 2014
dc.titleAre nurse and pharmacist independent prescribers making clinically appropriate prescribing decisions? An analysis of consultations
dc.typeArticle


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