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.

Minor Ailments
Click on the article title below to read the summaries. 

• National constipation audit shows room for improvement
• Thrush – oral and vaginal 
• Treating UTIs in adults in general practice

return to index 

• Treating UTIs in adults in general practice

Hummers-Pradier E and Kochen MM. Urinary tract infections in adult general practice patients. British Journal of General Practice 2002; 52: 752-761

This literature review concludes that although there is good documentation for diagnosis and treatment of uncomplicated urinary tract infections (UTIs) in women, recommendations are not always followed in daily general practice.

The authors stress that: dipsticks can be used to examine urine (if both nitrites and leukocytes are negative, the probability of a UTI is low and antibiotics should not be given; if nitrites are positive, antibiotics are justified; a positive results for leukocytes on their own means that a culture should be taken and treatment delayed); that the first-choice drugs are trimethoprim and nitrofurantoin and in most cases three-day courses are effective; and that additional diagnostic procedures are not indicated in most cases.

Recurrent UTIs can be treated in the same way as initial ones but frequently recurring ones can be treated successfully with long-term low-dose treatment with first-choice drugs. Second-choice drugs should be avoided.

Further research is required on some aspects of UTIs including their treatment in elderly women and in men, as well as the non-pharmacological treatments that a lot of women turn to. Research is also required on the sort of complicating factors such as diabetes that are not rare in general practice so that patients who will benefit from further diagnostic procedures can be identified and treatment regimens tailored for complicated cases.
 

• Thrush – oral and vaginal

Blenkinsopp A. et al. Fungal infections II – Vaginal and oral thrush. Primary Healthcare 2003; 13(2): 33-34

This article provides prescribing and other advice for nurses managing patients with vaginal or oral thrush. The different treatment options, are discussed, together with prevention and the particular considerations applying to special patient groups.

Website: Primary Healthcare
 

• National constipation audit shows room for improvement

1. Addison R. et al. A national audit of chronic constipation in the community. Nursing Times 2003; 99(11): 34-35

2. Crouch D. Easing the pain of constipation. Nursing Times 2003; 99(11): 23-25

A nurse-led national audit of chronic constipation involving 923 patients at home or in residential/nursing homes has shown that many patients still have poorly controlled constipation despite receiving laxatives regularly [1].

Combination laxative therapy was used in 42% of patients, with 133 different combinations. This indicates lack of a treatment plan and failure to follow treatment guidelines. Just under half the patients were still chronically constipated at the first assessment but this had decreased to just under a third by the end of the four-week audit period and the mean bowel frequency had also increased. Most patients were dissatisfied with their bowel care. The article then discusses the demands constipation makes on NHS resources, and nurses’ time in particular, and how care can be improved in future.

Current developments in constipation management and understanding of its causes are discussed by David Crouch [2]. Practitioners stress the importance of understanding that constipation can have lifestyle or psychological causes as well as dietary ones. Ray Addison, a nurse consultant for bladder and bowel dysfunction, and lead author of the national audit, is quoted as saying that this is a good time to stimulate professional interest because nurses can now prescribe laxatives.

Website: Nursing Times