title: Non-medical prescribing by nurse practitioners in accident & emergency and sexual health: a comparative study.
abstract: OBJECTIVE
  This article is a report of a study to explore the application and safety of non-medical prescribing in an accident and emergency and sexual health department. Background.  Since 1 May 2006 non-medical prescribers in the UK have had prescribing powers comparable with doctors. Evidence suggests that nurses give safe, competent, autonomous care packages in their scope of practice but despite the perceived benefits there is limited evidence detailing how it is specifically applied in practice.
  
  
  METHODS
  Cross-sectional comparative design.
  
  
  METHODS
  The study explored non-medical prescribing in accident and emergency and sexual health retrospectively reviewing 764 nurse prescribers' case notes. For intra-department comparison 490 case notes from those who could not prescribe were included. Patient attendances from 1 July 2009-30 June 2010 were randomly sampled. Prescribing frequency, range of medications and diagnoses, independent episode completion, and prescribing safety was recorded.
  
  
  RESULTS
  Over 53·5% (n = 409) of prescribers' patients required medication, with 99·8% (n = 568) being clinically appropriate. Analgesia was most commonly prescribed in accident and emergency (31%, n = 85) and antibiotics in sexual health (55%, n = 162). Intra-department comparison of independent episode completion had statistically significant results using the chi-square test in sexual health, but not in accident and emergency. The use of patient group directions in accident and emergency explains this difference. Safe prescribing practice was evident in 99·4% of cases, with a lack of documentation (n = 2) and a contraindicated prescription (n = 1) identified.
  
  
  CONCLUSIONS
  Nurses having access to medication facilitate safe, appropriate, and independent prescribing practice. Further research is advised in this area.
authors.affiliation: HIV/Sexual Health, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK. adam.black@imperial.nhs.uk
authors.forename: Adam
authors.initials: A
authors.lastname: Black
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000451:nursing* / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008131:London; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D024802:Nurse's Role; D057184:Practice Patterns, Nurses' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000458:organization & administration*; D017009:Professional Autonomy; D060728:Reproductive Health; D012189:Retrospective Studies; D055815:Young Adult