Background Therapeutic interventions, including prescribing medication, was a nationally agreed element of the advanced role (Department of Health, 2010), a view supported by Help the Hospices (2013). Palliative care patients often present with multiple complex symptoms and the benefits of Nurse Independent Prescribers (NIP) include faster access to medicines and rapid symptom control (Quinn & Lawrie, 2010; Dawson, 2013). However, increasing demands on Community Palliative Care Teams providing timely access to medicines and embracing seven-day working, highlight a need to evaluate the role of the NIP within this service, to determine their benefits and enhance planning.
Aims This report’s objective was to examine the prescribing practice of a NIP within the Community Specialist Palliative Care Team, examining the scope, appropriateness of prescribing and reviewing benefits to patients and carers.
Methods Quantitative data was collected for one year from one NIP, collated according to the drug monographs in Palliative Care Formulary 6 (Twycross, Wilcock & Howard, 2017) and evaluated according to the range of drugs and frequency of prescribing.
Patient and carers’ experience of NIP was gathered qualitatively via semi-structured interviews and written feedback. Thematic analysis was undertaken on these accounts to identify findings.
Results Data analysis showed the range and frequency of prescribing were appropriate and within the NIP’s scope of practice. Over one third of prescriptions involved analgesics. Patient and carer responses were overwhelmingly positive and related to the nurse/patient relationship and expertise in prescribing for complex symptoms.
Conclusions The NIP demonstrated appropriate prescribing practice. Patients and carers reported receiving medications more promptly and having doses adjusted when Out of Hours services were reluctant to do so. This provides evidence of the value of NIP training within the team.
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