Nurse prescribing, although primarily carried out in the community setting, is growing in secondary and specialist care— for example, in in-patient services. The advent of the Nurse Prescribing Course has provided an opportunity for nurses working within the specialty of diabetes not only to prescribe medicines such as insulin and oral hypoglycaemic agents, but also to adjust therapy legally. Recent research has shown benefits of nurse prescribing for both patients and doctors.1 However, little or no research has actually examined nurse prescribing in diabetes, especially in the hospital setting.
The study by Courtenay et al. in this issue of Practical Diabetes International describes an evaluation of the impact of a diabetes specialist nurse (DSN) prescriber on insulin and oral hypoglycaemic agent medication errors, length of hospital stay and patients' ability to self-manage their diabetes as in-patients. The main findings of this study are interesting but not totally surprising: a number of the medication errors highlighted are not new and some have existed for many years. The authors comment on the fact that previous research has reported similar errors and also a reduction in length of stay when care is provided by a DSN.2
The main findings of this study suggest that a DSN prescriber can reduce prescribing errors, which in turn reduces length of stay, resulting in a cost saving— large enough to fund a DSN prescriber post. However, in view of the fact that actual nurse prescribing was initiated in such a small number of cases, was the real impact in this study that a DSN was available to give advice and education to other professionals involved in the care?
Overall, although the numbers were small, this study has highlighted important aspects of care for people with diabetes admitted to hospital. The authors have also emphasised the problem of medication errors, especially in insulin therapy, which continue to occur for a significant number of in-patients.