16. The impact of legistlation on the prescription of controlled drugs by nurses (109)

Karen Stenner, Research Fellow, School of Health and Social care, University of Reading, Reading, United Kingdom
Co authors: M Courtenay
k.l.stenner@reading.ac.uk

Abstract:

Background:

Although there is growing evidence that nurse prescribing may be beneficial, little is known about the impact of prescribing on specialist nursing roles such as prescribing for patients in pain. This is important given recent proposals to change legislation surrounding the prescription of controlled drugs (Home Office 2006).

Aim:

To explore the views of Nurse Independent Prescribers and Nurse Supplementary Prescribers on the adoption of the role of prescribing for patients in pain and how the legislation on prescribing controlled drugs has impacted on practice.

Method:

Semi-structured interviews were used to explore the views of a purposive sample of 26 specialist pain nurses (and qualified prescribers’), working in a variety of clinical settings and prescribing for acute and chronic pain. Data was collected between November 2006 and April 2007. A thematic analysis was conducted on the interview data.

Results:

The level of prescribing and the impact of legislation restricting controlled drug prescribing varied across each setting. These restrictions caused most concern for nurses working in the hospital setting where there was confusion over the pain types for which nurses could legally prescribe. Fewer problems were reported by nurses working in palliative pain in community settings. Nurses working in chronic pain within hospital outpatient clinics tended to make recommendations rather than prescribe. Supplementary prescribing was considered inappropriate and rarely used by participants.

Discussion:

Nurses do prescribe controlled drugs independently however, factors such as budgetary control and problems accessing patient records (as well as current legislation), limits the prescription of these medicines. Although nurses do prescribe in the hospital setting, difficulties experienced classifying pain types means that nurses are uncertain of the conditions for which they can legally prescribe.

Conclusions:

Benefits would arise from removing current restrictions surrounding controlled drug prescribing. However, any benefits would rely on appropriate clinical governance procedures.

Biography:

Karen Stenner is a Research Fellow at the School of Health and Social Care, University of Reading. As an experienced qualitative researcher, Karen has conducted numerous research projects in the area of health and social sciences. She is currently working with Professor Molly Courtenay on a number of projects investigating the impact of Nurse Independent and Nurse Supplementary Prescribing in the UK.