Margaret Edwards

Nurse prescribing roles in acute care: an evaluative case study

AIM This paper is a report of an evaluation of the implementation of nurse prescribing in an acute care hospital in England. BACKGROUND At the time of the study, evaluation of nurse prescribing had taken place in community settings, but little was known about its impact and effectiveness in acute care. Although nurse prescribing has permitted doctor-nurse substitution in acute episodic care, some doctors have expressed concerns about patient safety in relation to nurse prescribing. METHODS A mixed methods single-case study was conducted in 2005-06, using purposive sampling. Semi-structured interviews were carried out with 18 hospital staff, non-participant observation of two nurses and two doctors undertaking 52 patient-prescriber consultations with 47 patients, and a questionnaire survey with 122 patients (response rate 61%: n=74). RESULTS Nurse prescribing was found to benefit patients through service delivery improvement and using staff skills differently. Nurse prescribers and their colleagues were positive about role and service changes and their impact on patient care. No differences were found between the ways in which nurses and doctors performed prescribing roles, but there was a statistically significant difference between the medication-related information satisfaction ratings of patients who had seen a nurse prescriber, compared to those seen by a doctor. CONCLUSION Nurses and doctors were found to provide equivalent care. Shared vision, local champions, action learning and peer support were the enabling factors that helped to embed the new prescribing roles within the study site.

Nitrosative stress induced cytotoxicity in Giardia intestinalis

Aims: To investigate the antigiardial properties of the nitrosating agents: sodium nitrite, sodium nitroprusside and Roussins black salt.

Hospital and home rehabilitation did not differ for functional competence in activities of daily living.

In patients discharged from hospital and referred for rehabilitation, how does home rehabilitation compare with hospital rehabilitation? ### Design: randomised controlled trial. ACTRN 12605000638639. ### Allocation: concealed. ### Blinding: blinded (occupational therapist, {data collectors, outcome assessors, and data analysts}*). ### Follow-up period: 6 months. ### Setting: patients’ homes or day hospitals in Adelaide, Australia. ### Patients: 229 patients (mean age 72 y, 52% women) who were medically stable, ready to be discharged from hospital, and required ⩾12 rehabilitation sessions. Patients were excluded if they lived outside of the health region or were judged by the referring physician to be unsuitable for rehabilitation. ### Intervention: rehabilitation in a day hospital (n = 113) or at home (n = 116). Hospital rehabilitation consisted of 3-hour high-intensity individual or group sessions, 3–5 times/week for 4–6 …