Journals Watch 2002

This section features a regularly updated list of recently published articles relevant to nurse prescribing.

Abstracts of the papers are included and 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 Prescribers’ Formulary for District Nurses and Health Visitors (NPF) and the Nurse Prescribers’ Extended Formulary (NPEF) and Drug tariff if they are in any doubt. Alternatively contact your Regional Nurse Prescribing Lead for clarification.

Diabetes
Click on the article title below to read the summaries. 

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  • What does nurse prescribing hold for diabetes specialist nurses?

Padmore E. Nurse prescribing: obituary or opportunity? Journal of Diabetes Nursing 2002; 5(6)

The current legal situation for diabetes specialist nurses (DSNs) is in many ways worse than it was four years ago, argues Eileen Padmore in this editorial. The clarification of the legal position on PGDs has made DSNs realize how their practice is, and continues to be, illegal. Insulin management cannot really be put under a PGD, one reason being that an individual patient assessment is necessary to identify a specific dosage. The recommendation that DSNs become supplementary prescribers raises the possibility of a legal foundation for DSN practice, but this could take two more years.

There are also concerns about the nature of supplementary prescribing. It looks like the success of this initiative will depend upon the nature of the relationships DSNs forge with medical colleagues. It is possible that supplementary prescribing could become the gateway to independent prescribing from a wider formulary, without inflexible links to conditions.

DSNs should not risk missing the opportunities offered by these changes. As soon as possible, they should begin training and practising as supplementary prescribers, and should be constructive and continue to prove their worth.

Website: Journal of Diabetes Nursing

 

Kenny C. Diabetes: therapeutic goals. Practice Nurse 2002; 24(7): 22-26.

This article examines the therapies available to people with type 2 diabetes. Only about 20% of these patients achieve good control with diet and lifestyle measures. The second part of the National Service Framework for diabetes, which covers implementation strategies, will be published soon and it is likely that targets will be set for primary care organizations.

The author first considers oral agents (sulphonylureas, biguanides, alpha glucosidase inhibitors, thiazolidinediones and meglitinides). Every year, at least 5-10% of patients on one or more oral agent will move on to insulin. The prevention of cardiovascular disease, smoking cessation, hypertension and dyslipidaemia management must all be considered.