| Journals Watch
2001 This section features a constantly updated list of recently published articles relevant to nurse prescribing. Abstracts of the papers are included and incorporate an expert's opinion about the article. Users are encouraged to submit their views about published papers through the feedback section. Please note: In this section of the website we aim to cover articles on areas where nurses do prescribe. However, not all the treatments or appliances mentioned are prescribable by nurses. For that reason, nurses should check the up-to-date versions of the Nurse Prescribing Formulary and Drug tariff if they are in any doubt. Patient
Group Directions (PGDs) Miles K et al. Patient group directions in nurse-led sexual health clinics. Nursing Standard 2001; 16(7): 33-34 Summary: Fewer prescriptions were needed from doctors following the introduction of patient group directions (PGDs) at a nurse-led sexual health clinic in London, saving time for nurses, doctors and patients, according to the audit described in this article. Three PGDs were approved, for the supply of clotrimazole cream and pessaries for vulvovaginal candidiasis and for metronidazole for bacterial vaginosis. In 11 weeks, data were collected for 408 patients and reviewed. The number of prescriptions required from a doctor dropped from 35.4% to 16.9% of the nurses' caseload following the introduction of the PGDs. Although documentation was found to be appropriate, the results suggested that the PGDs for clotrimazole cream and pessaries may have been used inappropriately. Nurses were supplying treatment in the absence of positive microscopy diagnosis. It is accepted practice at the clinic to treat women presenting with symptoms and signs of candidiasis with negative microscopy results once other causes are ruled out. The PGD did not therefore reflect locally accepted practice and its eligibility criteria have now been redefined. This highlights the need for early review of new PGDs to ensure safe and accountable practice. back Website: www.nursing-standard.co.uk
Parker S. Interpreting patient group directions. Practice Nursing 2001; 12: 11-13 Summary: The use of patient group directions (PGDs; or protocols as they used to be called) became a legal requirement in August last year. They apply only to the supply or administration of medicines to patients who have not been seen individually by a doctor. They should not be confused with the issue of nurse prescribing and, in general practice, apply particularly to the administration of vaccines. The author, who is head of the nursing division at the Medical Defence Union (MDU), says that the MDU has received a number of calls about PGDs and that most primary care groups or trusts have taken the need to draft PGDs on board. She describes the circumstances in which PGDs should be used, what information they should contain for general practice, and which medicines can be included in them. back Website: www.practicenursing.com Waters A. Patient group directions: a safer practice for nurses. Nurse Prescriber/Community Nurse 2001; 7(2): 31-32. Summary: Patient group directions (PGDs) may offer nurses real advantages in terms of safe and extended practice, according to this article. Their advent means that there is no reason why practice nurses should continue to supply or administer medicines illegally but there are still nurses and GPs who don’t know what they are, according to the chair of the RCN’s Practice Nurse Association quoted here. Some GPs remain concerned about their liability although they are happy for nurses in walk-in centres to use PGDs, as health authorities take the responsibility. If GPs will not sanction the development and use of PGDs, the author suggests some actions nurses can take: educate GPs (unless they are writing prescriptions for each treatment supplied/administered by the nurse, the nurse is breaking the law); contact health authority or board/trust; download a model PGD (see our links section) and get a doctor and pharmacist to help write one; and contact relevant drug manufacturers. back
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