A prospective audit of a nurse independent prescribing within critical care

Carberry, Martin; Connelly, Sarah; Murphy, Jennifer

doi:10.1111/j.1478-5153.2012.00534.x

Cited by 22 publications

(18 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This may reflect the extent of the medication safety resources employed within critical care (e-prescribing, specialist critical care pharmacist 7 days/week, extensive critical care guidelines, education sessions, robust and responsive clinical incident reporting system)16 and use of advanced nurse practitioners 17…”

Section: Discussionmentioning

confidence: 99%

Pharmacist prescribing in critical care: an evaluation of the introduction of pharmacist prescribing in a single large UK teaching hospital

et al. 2017

View full text Add to dashboard Cite

ObjectivesTo evaluate the introduction of pharmacist independent prescribing activity across three general critical care units within a single large UK teaching hospital. To identify the prescribing demographics including total of all prescriptions, number prescribed by pharmacists, reason for pharmacist prescription, range of medications prescribed, pharmacist prescribing error rate and the extent of pharmacist second ‘clinical check’.MethodsRetrospective evaluation of e-prescribing across all general critical care units of a single large UK teaching hospital. All prescribing data were downloaded over a 1-month period (May to June 2016) with analysis of pharmacist prescribing activity including rate, indication, therapeutic class and error rate.ResultsIn total, 5374 medicines were prescribed in 193 patients during the evaluated period. Prescribing pharmacists were available on the units on 60.4% (58/96) of days, during their working hours and accounted for 576/5374 (10.7%) of medicines prescribed in 65.2% (126/193) of patients. The majority (342/576) of pharmacist prescriptions were for new medicines. Infections, central nervous system, and nutrition/blood were the top three British National Formulary (BNF) therapeutic categories, accounting for 63.4% (349/576) of all pharmacist prescriptions. The critical care pharmacist prescribing error rate was 0.18% (1/550).ConclusionsPharmacist independent prescribers demonstrated a high degree and wide-ranging scope of prescribing activity in general critical care patients. Pharmacists contributed a significant proportion of total prescribing, despite less than full service coverage. Prescribing activity was also safe with a very low error rate recorded.

show abstract

Section: Discussionmentioning

confidence: 99%

Pharmacist prescribing in critical care: an evaluation of the introduction of pharmacist prescribing in a single large UK teaching hospital

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Carberry et al . () conducted a short prospective audit in three ICUs of all prescriptions made by three groups, trainee medical staff, advanced nurse practitioners in critical care (ANPCC) and consultants, over 7 days. They examined error rates between the three groups.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Pirret also found that she prescribed a wider range of medications when authorized to prescribe, with significant increases in diuretics, antiarrhythmics, intravenous fluids and antibiotics. Carberry et al (2012) conducted a short prospective audit in three ICUs of all prescriptions made by three groups, trainee medical staff, advanced nurse practitioners in critical care (ANPCC) and consultants, over 7 days. They examined error rates between the three groups.…”

Section: Literature Reviewmentioning

confidence: 99%

A 5‐year retrospective audit of prescribing by a critical care outreach team

Wilson

2017

Nursing in Critical Care

View full text Add to dashboard Cite

UK prescribing legislation changes made in 2006 and 2012 enabled appropriately qualified nurses to prescribe any licensed medication, and all controlled drugs in schedule 2-5 of the Misuse of Drugs Regulations 2001, for any medical condition within their clinical competence. Critical Care Outreach nurses who are independent nurse prescribers are ideally placed to ensure that acutely ill patients receive treatment without delay. The perceived challenge was how Critical Care Outreach nurses would be able to safely prescribe for a diverse patient group. This study informs this developing area of nurse prescribing in critical care practice. The aims of the audit were to: identify which medications were prescribed; develop a critical care outreach formulary; identify the frequency, timing and number of prescribing decisions being made; identify if prescribing practice changed over the years and provide information for our continuing professional development. This article reports on data collected from a 5-year retrospective audit; of prescribing activity undertaken by nine independent nurse prescribers working in a 24/7 Critical Care Outreach team of a 600-bedded district general hospital in the UK. In total, 8216 medication items were prescribed, with an average of 2·6 prescribed per shift. The most commonly prescribed items were intravenous fluids and analgesia, which were mostly prescribed at night and weekends. The audit has shown that Critical Care Outreach nurse prescribing is feasible in a whole hospital patient population. The majority of prescribing occurred after 16:00 and at night. Further research would be beneficial, particularly looking at patient outcomes following reviews from prescribing critical care outreach nurses. The audit is one of the only long-term studies that describes prescribing practice in Critical Care Outreach teams in the UK.

show abstract

“…The consensus process also highlighted interventions that the pharmacists thought less important or less proven in terms of critical care medication safety. The removal of nurse and pharmacist (All) prescribers after Round 1 and pharmacist prescribers (Advanced) after Round 2 suggest that more research needs to be carried out to understand the effect of non‐medical prescribers on medication errors in critical care patients . For example, we have recently reported that clinical pharmacists demonstrated a high degree and wide‐ranging scope of prescribing activity in general critical care patients with a very low error rate .…”

Section: Discussionmentioning

confidence: 99%

Reducing medication errors in critical care patients: pharmacist key resources and relationship with medicines optimisation

Bourne

Shulman

Jennings

2018

International Journal of Pharmacy Practice

View full text Add to dashboard Cite

show abstract

A prospective audit of a nurse independent prescribing within critical care

Abstract: These findings could be used to inform research and role development within the critical care.

Cited by 22 publications

References 5 publications

Pharmacist prescribing in critical care: an evaluation of the introduction of pharmacist prescribing in a single large UK teaching hospital

Pharmacist prescribing in critical care: an evaluation of the introduction of pharmacist prescribing in a single large UK teaching hospital

A 5‐year retrospective audit of prescribing by a critical care outreach team

Reducing medication errors in critical care patients: pharmacist key resources and relationship with medicines optimisation

Contact Info

Product

Resources

About