Hastanelerde Kalite Yönetimi Sisteminin Gelişmesinde Halkla İlişkiler Uygulayıcılarının Rolü Erciyes Üniversitesi Diş Hekimliği Fakültesi Örneği

Background: There is a drive to improve the quality of service provision for patients with diabetes and to enable better self-management of this condition. The adoption of prescribing by nurses is increasing worldwide and can potentially enhance service provision. Evidence suggests that patients prefer services where their lifestyle factors and opinions are considered by healthcare professionals within a partnership approach. Few studies have explored patients’ views about their consultations with a nurse prescriber. Objective: To explore the views patients with diabetes have about their consultations with nurse prescribers and any impact this may have on their medications management. Design: A qualitative study involving semi-structured interviews and thematic analysis. Setting: Six primary care sites in which nurses prescribed medications for patients with diabetes in England. Data was collected in 2009. Participants: Interviews took place with 41 patients with diabetes from the case loads of 7 nurse prescribers. Results: Findings are reported under three themes; the nurse consultation style, benefits of the nurse prescriber consultation and views on involvement and decision-making. Key aspects of the nurse consultation style were a non-hurried approach, care and rapport, approachability, continuity, and providing clear information based on specialist knowledge. Many benefits were described, including improved access to appropriate advice and medication, greater understanding and ability to self-manage, ability to address problems and improved confidence, trust and wellbeing. While patients were happy with the amount of information received and involvement they had decisions about their treatment, there was some controversy over the consistency of information provided on side-effects of treatment. Conclusions: The study provides new knowledge about what patients with diabetes value and benefit from in respect to care provided by nurse prescribers. Continuity of relationship, flexibility over consultation length, nurses’ interpersonal skills and specialist diabetes knowledge were identified as crucial to good quality care. Patients require that nurse prescribers are skilled in providing a person-centred approach and have access to specialist training. The level of information and involvement offered to patients should reflect patients’ requirements

Nurse prescribing for inpatient pain in the United Kingdom: A national questionnaire survey

Background: Nurses make a valuable contribution to pain services and have the potential to improve the safety and effectiveness of pain management. A recent addition to the role of the specialist pain nurse in the United Kingdom has been the introduction of prescribing rights, however there is a lack of literature about their role in prescribing pain medication. Objective: The aim of this study was to develop a profile of the experience, role and prescribing practice of these nurses. Design A descriptive questionnaire survey. Setting: 192 National Health Service public hospital inpatient pain services across the United Kingdom. Participants: 161 qualified nurse prescribers were invited to participate, representing 98% of known nurse prescribers contributing to inpatient pain services. The survey was completed in November 2009 by 137 nurses; a response rate of 85%. Results: Compared with nurse prescribers in the United Kingdom in general, participants were highly qualified and experienced pain specialists. Fifty-six percent had qualified as a prescriber in the past 3 years and 22% reported that plans were underway for more nurses to undertake a nurse prescribing qualification. Although all participants worked in inpatient pain services, 35% also covered chronic pain (outpatient) services and 90% treated more than one pain type. A range of pain medications were prescribed, averaging 19.5 items per week. The role contained a strong educational component and contributed to informing organisational policy on pain management. Prescribing was said to improve nurses’ ability to promote evidence-based practice but benefits were limited by legislation on prescribing controlled drugs. Conclusions: Findings demonstrate that pain nurses are increasingly adopting prescribing as part of their advanced nurse role. This has implications for the development needs of pain nurses in the United Kingdom and the future role development of nurses in other countries