Background Non-medical prescribing legislation in the UK provides suitably qualified nurses with prescribing powers comparable with doctors. This facilitates autonomous practice and allows independent completion of care episodes. There is however limited evidence regarding the application and safety of nurse prescribing.
Aim Investigate the application of non-medical prescribing in sexual health.
Methods A cross-sectional study explored non-medical prescribing in a London based GUM department between 1 January 2010 and 30 June 2010. A retrospective review of randomly selected clinical notes was performed. This included 382 nurse prescriber led and 255 non-prescriber led GUM consultations. Prescribing frequency; range of medications and diagnoses; independent episode completion and prescribing safety were investigated.
Results Medication was dispensed in 52.9% (n=337) of consultations in the 637 combined episodes. A total of 427 diagnoses were identified that required 34 different medicinal products and 452 treatments to be dispensed in total by nurse practitioners. The management of sexual contacts accounted for 22.1% (n=60) of treatments. A statistical difference in independent practice existed between practitioners (χ2 test p<0.001), with prescribers 15.52 times (CI 9.41 to 25.59) more likely to independently complete episodes of care. Safe appropriate prescribing was identified in 99.1% (n=210) of cases. On two occasions a lack of documentation of concurrent medication or allergies made it difficult to assess safety. There were no serious errors in prescribing practice found.
Conclusions In our GUM clinic widespread use of prescribing skills was demonstrated. Nurses with prescribing skills were able to work more independently. Non-medical prescribing has been applied safely in accordance with clear treatment guidelines.
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