Diabetes Nurse Specialist Prescribing
In 2011, Health Workforce New Zealand (HWNZ), in collaboration with the Ministry of Health’s Nursing Team, and the New Zealand Society for the Study of Diabetes (NZSSD) established the diabetes nurse specialist prescribing project to demonstrate the effectiveness and safety of diabetes nurse prescribing.
Diabetes nurse specialists (DNS) operate with a high degree of autonomy with significant responsibility for the delivery of diabetes services, and having responsibility for prescribing common medicines for people with diabetes (under supervision and in partnership with medical practitioners) is a natural extension of their current role.
Prescribing by diabetes nurse specialists will result in improved continuity of care for patients, reduce the need for separate appointments for routine prescriptions and reduce pressure on medical staff.
The demonstration took place over a six month period between April and September 2011 with twelve DNSs at demonstration sites in Auckland, Hawkes Bay, Palmerston North and Hutt Valley becoming designated prescribers.
A comprehensive external evaluation was conducted to evaluate the effectiveness and safety of diabetes nurse prescribing during the demonstration project. The evaluation report found that:
- DNS prescribing is safe, of good quality, and clinically appropriate
- DNS prescribing contributes to an effective diabetes specialist service (however productivity gains were unable to be measured due to short timeframes)
- DNS prescribing is acceptable to patients who indicate they are highly satisfied with the change.
Positive results from the demonstration include:
- patient outcomes remained stable throughout the demonstration and showed an overall improvement in HbA1c
- patients found DNSs extremely knowledgeable, had high levels of confidence in prescribing decisions and would return to a DNS for a prescription in the future
- the wider diabetes team members are supportive of DNS prescribing and team relationships in the diabetes centres have grown in collegiality
- DNSs are very satisfied with their extended role and responsibility and a positive impact on workload is anticipated because the prescription is clearly more efficient.
Read the full evaluation report ‘Evaluation of the Diabetes Nurse Specialist Prescribing Project’ (PDF, 1.8MB).
Update
HWNZ is continuing to support The New Zealand Society for the Study of Diabetes (NZSSD) in the recruitment of the second cohort of diabetes nurses who can prescribe in diabetes care in a variety of practice settings.
NZSSD has now completed the Registrations of Interest (ROI) process. Six proposals have been selected with a total of 16 nurses forming the second cohort and the first South Island site chosen.
The initiative demonstrates stronger integration between primary and secondary care, with primary care nurses working closely with their colleagues in hospitals.
The sites are:
- Northland DHB with Manaia PHO
- Counties Manukau DHB with Diabetes Projects Trust & East Tamaki PHO
- Whanganui DHB with MidCentral Health
- Auckland Diabetes Centre
- Central Otago Health Services
- Hutt Valley DHB.
Nurses are now working with their supervisors to complete the required practicum before they can apply to the Nursing Council to become authorised to prescribe.
For more information on the diabetes nurse prescribing demonstration see our:
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