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Training access holds back nurse prescribers, warn researchers

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Access to specialist training is holding back nurses involved in prescribing pain medications, potentially at the expense of patient care, UK researchers have warned.

Researchers from the University of Surrey have carried out the first investigation into the profile of UK nurses who prescribe drugs for pain.

They surveyed 214 nurses, finding that half worked in primary care, 32% in secondary care and 14% in other settings.  The majority, 86%, independently prescribed one to 20 items per week. Non-opioid and weak opioids analgesics were prescribed by 95% of nurses, while 35% prescribed strong opioids.

However, while the majority had undergone training in prescribing for pain, nearly a third said they had experienced problems accessing the training. Those with the most specialist training prescribed a wider range of pain medications.

The authors said: “Improving access to ongoing training is essential in order to support development in this area of practice and to maximise benefits to patient care.”

The study is one of three papers on nurse prescribing presented this week at the Royal College of Nursing international research conference in London.

A second paper by Kingston University looked at what nurses were prescribing by assessing prescription data in England between 2005 and 2010.

The researchers found independent nurse prescribers prescribed 9.1% of all emergency contraception in primary care. However, the majority of prescriptions by nurses were for dressings and wound, continence and stoma care products.

A third study assessed whether community matrons were as safe and effective at prescribing as GPs. Researchers assessed 75 prescriptions made by 13 matrons at Birmingham Community Healthcare Trust. Only 3.73% of scripts were deemed inappropriate, which the researchers said “compared favourably” with data on medical prescribers.

Legislation came into effect on Monday giving independent prescribers the power to prescribe controlled drugs in schedules two to five, which includes morphine, diamorphine and prescription-strength co-codamol.

The change, which came into force on 23 April, means nurses and pharmacists now have the same prescribing rights as doctors.

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