Background Diabetic specialist nurses (DSNs) have an increasingly important role in the inpatient setting. They influence prescribing decisions about diabetes treatment and many are independent prescribers.
To audit inpatient prescribing practice by DSNs and to evaluate their influence on prescribing
To determine the extent to which prescribing of antidiabetic medication by independent DSN prescribers complies with national and local trust guidelines.
To assess the legibility and comprehensiveness of DSN advice in inpatient medical notes.
To evaluate the extent in which prescribing of inpatient antidiabetic medication complies with the recommendations made in the DSN review.
Material and methods The weekly inpatient referral list was used to identify inpatients for review. A data collection tool was formulated, piloted and subsequently used to record information. DSN reviews in the inpatient medical notes and drug charts were evaluated by a band 6 pharmacist with no specialist knowledge of diabetes.
Results Data from 30 inpatients were collected from 11 wards during a 4 week period. Five DSNs were assessed including two independent DSN prescribers.
24 antidiabetic medicines were prescribed by independent DSN prescribers. All (100%; n = 24) prescriptions stated the correct drug name, frequency, route, form and administration times. The few errors that occurred were related to omission of information, including allergy status (30%; n = 4) and insulin delivery device (6%; n = 1).
38 DSN reviews were included as part of the audit. The majority of entries made by DSNs were considered to be legible (76%; n = 29) and comprehensive (84%; n = 32). Recommendations about new medication or changes to existing medication occurred in (67%; n = 20) of entries. Most patients (93%; n = 28) were subsequently prescribed medication that complied with the recommendations made in a DSN review.
Conclusion Prescribing of antidiabetic medication by independent DSN prescribers was demonstrated to be highly compliant with safety guidelines. DSN reviews can be interpreted easily by a junior pharmacist, indicating that they should be understandable by a junior doctor with limited specialist knowledge. Recommendations about prescribing antidiabetic medication in DSN reviews appear to be followed in the majority of inpatients.
References and/or Acknowledgements V Ruszala. Senior Clinical Specialist Pharmacist. North Bristol NHS Trust
No conflict of interest.
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