Infection Control Nurse: a national survey

AIM: To study presence and activity of Infection Control Nurses (ICN) in Italian National Health System (NHS) hospitals. BACKGROUND: Infection Control Nurses play an essential and evidence-based role for optimal infrastructure and essential activities of infection control and epidemiology programmes in hospitals. METHODS: A survey of all Italian NHS hospitals (N = 529). Hospital health directors were asked to complete a questionnaire with a specific section on ICN presence, activities and roles played. Response rate was 87.5% (463 of 529). RESULTS: More than 50% of hospitals (250 of 463) have an ICN: 25% (116 of 463) have at least one part-time employed ICN and 23.3% (108 of 250) have at least one ICN employed full-time. Infection Control Nurses are more common in hospitals with >250 beds (P < 0.01). Infection Control Nurses working in hospitals with >250 beds are highly active in surveillance activities, personnel education and management of study groups (P < 0.01). CONCLUSIONS: In Italian NHS hospitals ICNs have yet to become pillar figures in hospital infection control.     

Nurse prescribing: a case for clinical supervision

This article will discuss the implications of nurse prescribing in mainstream primary health care and its impact on the fields of mental health and learning disabilities. Complexities and issues which require serious consideration by those nurses wishing to pursue such a specialist and extended role will be discussed in relation to these practice areas. Titchen's (1998) critical companionship model will be illustrated as an example of one framework for clinical supervision. This is to allow the processes, competencies and contextual issues to be explored by both novice and expert prescribers. The article concludes that for safe, effective and competency-based practice, clinical supervision also assists in mediating the professional and political aspirations in support of supplementary nurse prescribing.     

Nurse supplementary prescribing for patients with diabetes: a national questionnaire survey

Aims and objectives. To examine the prescribing practices of nurse supplementary prescribing in diabetes. Background. Nurses in several roles are involved in the management of medicines for patients with diabetes. Nurse prescribing should help optimise these roles. Nurses in the UK have virtually the same independent prescribing rights as doctors. There is little or no evidence on the extent to which nurse supplementary prescribing is used, or the impact and activity of nurse supplementary prescribing for patients with diabetes. Design. Survey. Method. A random sample of 214 nurse supplementary prescribers self‐completed a written questionnaire. Results. The majority of nurses held an academic qualification at degree level or higher, had a wealth of clinical experience, worked full‐time, were based in primary care and worked in general practice. The majority of nurses prescribed between one and five items a week. Oral anti‐diabetic drugs, hypertension and lipid‐regulating drugs and insulins were the products most often prescribed. Over 85% had undertaken specialist training in diabetes prior to undertaking the prescribing programme. Conclusion. Supplementary prescribing provides a practical and useful framework within which to prescribe medicines for patients with diabetes and its associated complications. Specialist diabetes training is a necessary prerequisite for nurses prescribing in this area. It is evident that there is still a place for supplementary prescribing. Implications for clinical practice. ? Recent legislative changes mean that nurses can now independently prescribe practically any drug. ? Nurses in general practice appear to prescribe most frequently as a nurse supplementary prescriber for patients with diabetes. ? Nurse supplementary prescribers are likely to use this mode of prescribing to deliver medicines to patients with diabetes. ? Over two‐thirds prescribe for common but serious complications of diabetes, e.g. hypertension, hyperlipidaemia and cardiovascular disease     

Nurse practitioner services: content and relative work value

The resource-based relative value scale is used to quantify work for reimbursement of services in the Medicare Fee Schedule. This pilot study explored use of the resource-based relative value scale for services provided by nurse practitioners. Estimation of relative work values for office visits by nurse practitioners was consistent with the Medicare Fee Schedule. Content analysis revealed that nurse practitioners provide additional services including comprehensive patient evaluation and education and attendance to social factors. Future research is needed to examine systems that identify and reimburse nurse practitioners for their services.     

Nurse practitioners in major accident and emergency departments: a national survey.

Use of nurse practitioners in major accident and emergency (A&E) departments is rapidly increasing: currently they are used in 30% of such departments and this is expected to rise to 63% by the end of 1995. Most are trained by a formal programme in the employing hospital but 12% claim to have no formal training. The nurse practitioner could prescribe a limited range of drugs in 82% of major departments with 'official' nurse practitioners, but radiograph requesting was permitted in only 57% of such departments: of those not able to request radiographs, 95% blamed radiographers for preventing this.     

Viridans streptococcal bacteraemia: a clinical survey

The occurrence of viridans streptococcal bacteraemia (VSB) ina London postgraduate teaching hospital was analysed retrospectively.Over a 30-month period, 39 patients with VSB were identified,and the clinical significance of VSB was assessed for each,based upon clinical and laboratory information. Endocarditisaccounted for only 13% of the total patients with apparent VSB.A greater proportion of patients with VSB originated from thehaematology unit (21%) and in particular, the bonemarrow transplantationunit (15%). VSB also occurred in patients with solid epithelialmalignancies and in children aged <12 months. Mortality associatedwith VSB was 7%. Viridans streptococci are emerging as importantpathogens in previously unrecognized clinical settings, particularlyhospitalized, immunocompromised patients.