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Advancing Practice Through Prescribing
Is there a better way?
Stephan Harding
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, City East Campus, Adelaide SA
Andrew Gardner
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, City East Campus, Adelaide SA
Abstract
The literature demonstrates a clear relationship between the rate of adverse effects and the number of prescribers that a service consumer may consult. This brings into question the benefits, for the service consumer, of nurses prescribing. Given the complexities of care for certain population groups, for example older people, it is suggested that there is greater benefit in professionals working collaboratively toward the best outcome for the person in care, with nurses offering more informed advice to their partners in service delivery.
Nurses who advance their practice through the development of an expert knowledge base relevant to their area of expertise can contribute to the diagnosis and management of particular client groups by providing specialist advice to primary and direct care professionals. It is proposed that this could be achieved using an 'academic detailing' approach rather than becoming another prescriber of pharmacotherapy.
Keywords
nursing, expert knowledge, advanced practice, knowledge worker, extended practice, nurse prescribing, collaborative practice, academic detailing
References
Australian Bureau of Statistics (ABS) (1996) Projections of population of Australia, States and Territories 1995-2051, cat. 3222.0. Australian Government Printing Service, Canberra.
Allard J, Hebert R, Rioux M, Asselin J and Voyer L (2001) Efficacy of a clinical medication review on the number of potentially inappropriate prescriptions prescribed for community dwelling elderly people. Canadian Medical Association Journal 164(9): 1291-6.
Ames D and Chiu E (1994) Depression and the elderly. Mental Health in Australia 6(1): 12-17.
Armstrong S, Cozza K and Watanabe K (1997) The Misdiagnosis of Delirium Psychosomatics 38(5): 433-9.
American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders 4th edn. American Psychiatric Association. Washington DC.
Australian Council For Safety And Quality In Health Care (2002) Second National Report on Patient Safety Improving Medication Safety. Commonwealth of Australia. Canberra.
Avorn J and Soumerai S (1983) Improving drug-therapy decisions through educational outreach. A randomised controlled trial of academically based detailing. The New England Journal of Medicine 308: 1457-63.
Australian Medications Handbook (2003) Australian Medications Handbook Pty Ltd. Adelaide.
Beresin E (1988) Delirium in the Elderly. Journal of Geriatric Psychiatry and Neurology 1: 127-43.
Blazer D (1997) Depression in the elderly: myths and misconceptions. The Psychiatric Clinics of North America 20(1): 111-119.
Callaghan J and Story I (1994) The impact of an ACAT clinical/consultant pharmacist on medication use by older people. Lincoln Papers in Gerontology 26:1-40.
Commonwealth Department of Health and Ageing (2000) The use of hospitals by older people: a casemix analysis. Occasional papers: New series No 11. Commonwealth of Australia. Canberra.
Commonwealth Department of Health and Ageing (2002) The National Strategy for Quality Use of Medicines. Commonwealth of Australia. Canberra.
Commonwealth Department of Health and Ageing (2003) Quality Use of Medicines. http://www.health.gov.au/haf/nmp/quality.htm [accessed May 2003] Commonwealth of Australia. Canberra.
Ghandi T, Weingart S, Borus J, Seger A, Peterson J, Burdick E, Seger D, Shu K, Federico F, Leape L and Bates D (2003) Adverse drug events in ambulatory care. New England Journal of Medicine 348(16): 1556-64.
Gray S, Lai K and Larson E (1999) Drug induced cognitive disorders in the elderly: incidence, prevention and management. Drug Safety 21(2): 101-22.
Gurwitz J, Field T, Harrold L, Rothschild J, Debellis K, Seger A, Cadoret C, Fish L, Garber L, Kelleher M and Bates D (2000) Incidence and preventability of adverse drug events among older persons in the ambulatory setting. Journal of the American Medical Association 289(9): 1107-16.
Hollister L (1986) Drug-induced psychiatric disorders and their management. Medical Toxicology 1: 428-48.
Inouye S and Charpentier P (1996) Precipitating factors for delirium in hospitalized elderly persons: predictive model and interrelationship with baseline vulnerability. Journal of the American Medical Association 275(11): 852-7.
Jacobson S (1997) Delirium in the Elderly, Psychiatric Clinics of North America 20(1): 91-110.
Jarrett P, Rockwood K, Carver D, Stolee P and Cosway S (1995) Illness presentation in elderly patients. Archives of Internal Medicine 155(10): 1060-4.
Lipowski Z (1983) Transient cognitive disorders (delirium, acute confusional states) in the elderly. American Journal of Psychiatry 140: 1423-36.
Lyness, J (1990) Delirium: Masquerades and Misdiagnosis in Elderly Inpatients, Journal of the American Geriatric Society 38: 1235-8.
May F, Rowett D, Gilbert A, McNeece, J and Hurley E (1999) Outcomes of an educational outreach service for community medical practitioners: non-steroidal anti-inflammatory drugs. Medical Journal of Australia 170: 471-4.
McClure F, Gladsjo J and Jeste D (1999) Late-onset psychosis: clinical, research and ethical considerations. The American Journal of Psychiatry 156(6): 935-40.
Mundinger M, Kane R, Lenz E, Totten A and Tsai W (2000) Primary care outcomes in patients treated by nurse practitioners or physicians: a randomised controlled trial. Journal of American Medical Association 283: 59-68.
O'Conner M (1987) Depression in the elderly. Current Therapeutics January: 47-56.
Patten S and Hope E (1994) Neuropsychiatric adverse drug reactions: passive reports to Health and Welfare Canada's adverse drug reaction database (1965-present) International Journal of Psychiatry in Medicine 24(1): 45-62.
Roberts P and Priest H (1997) Achieving interprofessional working in mental health. Nursing Standard 12(2): 39-41.
Sorensen L, Stokes J, Woodward M and Roberts M (2000) Medication misadventure risks - findings at home visits, (Abstract in Australian Council For Safety And Quality In Health Care 2002 Second National Report on Patient Safety: Improving Medication Safety) Commonwealth of Australia. Canberra.
Trindale E, Menon D, Topfer L and Coloma C (1998) Adverse effects associated with selective serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. Canadian Medical Association Journal 159(10): 1245-52.
Way D, Jones L, Baskerville B and Busing N (2001) Primary health care services provided by nurse practitioners and family physicians in shared practice. Journal of the Canadian Medical Association 165(9): 1210-14.
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