What workforce preparation is required for successful implementation of nurse prescribing under supervision?

Background: Nurse prescribing is proposed globally in a variety of models in an attempt to meet health needs of the growing population. Providing appropriate preparation, knowledge, and supported skill development commensurate with this expanded scope has been identified as a key component to the successful adoption of this practice change. Aim: To explore nurses’ preferences for the educational preparation and support required to maximise uptake of expanding nursing practice to include prescribing according to a supervised model. Methods: A cross-sectional online survey, tested for face and content validity, was distributed to registered general nurses across Australia excluding nurse practitioners, enrolled nurses, and student nurses between March and July 2021. Quantitative data relating to demographics, nursing experience, and educational requirements to become a prescriber were analysed descriptively. Pearson χ2 tests were used to examine associations between participant demographics and preferences for education. Binary logistic regression was used to further examine whether demographic factors were significant predictors of educational preferences. Open-ended responses were analysed using content analysis techniques. Findings: There were 4,424 surveys completed by nurses from all jurisdictions. More than half of (n=2,907,65.7%) respondents considered that education should be delivered by health services in conjunction with universities using a blended approach with workplace integrated practice. Respondent's desire authorised prescriber support and a multidisciplinary approach for successful adoption. The most frequently reported (n=3,523, 79.6%) factor influencing the desire to undertake a specific program was course accreditation at a national level and contribution to a formal qualification. χ2 tests showed significant associations between participants characteristics and educational preparation factors; however, logistic regression showed a similar trend for all educational preparation items with no significant effect of age group, qualification, years of experience or state groups. Discussion: Implementation of an expanded scope of practice to include prescribing under the supervision of an authorised prescriber requires a nursing workforce prepared to undertake further education and authorised prescriber's support. Nurses seek a rigorous national educational program delivered in collaboration with colleagues. Conclusion: Health services planning to expand nursing practice to include prescribing should consider issues raised in this study. The findings highlight areas for future research and actions to optimise uptake of this new nursing role

What workforce preparation is required for successful implementation of nurse prescribing under supervision?

Background: Nurse prescribing is proposed globally in a variety of models in an attempt to meet health needs of the growing population. Providing appropriate preparation, knowledge, and supported skill development commensurate with this expanded scope has been identified as a key component to the successful adoption of this practice change. Aim: To explore nurses’ preferences for the educational preparation and support required to maximise uptake of expanding nursing practice to include prescribing according to a supervised model. Methods: A cross-sectional online survey, tested for face and content validity, was distributed to registered general nurses across Australia excluding nurse practitioners, enrolled nurses, and student nurses between March and July 2021. Quantitative data relating to demographics, nursing experience, and educational requirements to become a prescriber were analysed descriptively. Pearson χ2 tests were used to examine associations between participant demographics and preferences for education. Binary logistic regression was used to further examine whether demographic factors were significant predictors of educational preferences. Open-ended responses were analysed using content analysis techniques. Findings: There were 4,424 surveys completed by nurses from all jurisdictions. More than half of (n = 2,907,65.7%) respondents considered that education should be delivered by health services in con- junction with universities using a blended approach with workplace integrated practice. Respondent’s desire authorised prescriber support and a multidisciplinary approach for successful adoption. The most frequently reported (n = 3,523, 79.6%) factor influencing the desire to undertake a specific program was course accreditation at a national level and contribution to a formal qualification. χ2 tests showed significant associations between participants characteristics and educational preparation factors; however, logistic regression showed a similar trend for all educational preparation items with no significant effect of age group, qualification, years of experience or state groups. Discussion: Implementation of an expanded scope of practice to include prescribing under the supervision of an authorised prescriber requires a nursing workforce prepared to undertake further education and authorised prescriber’s support. Nurses seek a rigorous national educational program delivered in collaboration with colleagues. Conclusion: Health services planning to expand nursing practice to include prescribing should consider issues raised in this study. The findings highlight areas for future research and actions to optimise uptake of this new nursing role

Baseline Assessment of 25-Hydroxyvitamin D Assay Performance: A Vitamin D Standardization Program (VDSP) Interlaboratory Comparison Study.

The Vitamin D Standardization Program (VDSP) coordinated an interlaboratory study to assess the comparability of measurements of total 25-hydroxyvitamin D [25(OH)D] in human serum, which is the primary marker of vitamin D status. A set of 50 individual donor samples were analyzed by 15 different laboratories representing national nutrition surveys, assay manufacturers, and clinical and/or research laboratories to provide results for total 25(OH)D using both immunoassays (IAs) and LC tandem MS (MS/MS). The results were evaluated relative to bias compared with the target values assigned based on a combination of measurements at Ghent University (Belgium) and the U.S. National Institute of Standards and Technology using reference measurement procedures for the determination of 25(OH)D2 and 25(OH)D3. CV and mean bias for each laboratory and assay platform were assessed and compared with previously established VDSP performance criteria, namely CV </= 10% and mean bias </= 5%. Nearly all LC-MS/MS results achieved VDSP criteria, whereas only 50% of IAs met the criterion for a </=10% CV and only three of eight IAs achieved the </=5% bias. These results establish a benchmark for the evaluation of 25(OH)D assay performance and standardization activities in the future

Baseline Assessment of 25-Hydroxyvitamin D Reference Material and Proficiency Testing/External Quality Assurance Material Commutability: A Vitamin D Standardization Program Study.

The Vitamin D Standardization Program (VDSP) coordinated a study in 2012 to assess the commutability of reference materials and proficiency testing/external quality assurance materials for total 25-hydroxyvitamin D [25(OH)D] in human serum, the primary indicator of vitamin D status. A set of 50 single-donor serum samples as well as 17 reference and proficiency testing/external quality assessment materials were analyzed by participating laboratories that used either immunoassay or LC-MS methods for total 25(OH)D. The commutability test materials included National Institute of Standards and Technology Standard Reference Material 972a Vitamin D Metabolites in Human Serum as well as materials from the College of American Pathologists and the Vitamin D External Quality Assessment Scheme. Study protocols and data analysis procedures were in accordance with Clinical and Laboratory Standards Institute guidelines. The majority of the test materials were found to be commutable with the methods used in this commutability study. These results provide guidance for laboratories needing to choose appropriate reference materials and select proficiency or external quality assessment programs and will serve as a foundation for additional VDSP studies