An evaluation of a Diabetes Specialist Nurse prescriber on the system of delivering medicines to patients with diabetes

Abstract

Aim: To evaluate the impact of a Diabetes Specialist Nurse prescriber on insulin and oral hypoglycaemic agent medication errors and length of stay.

Background: The National Health Service has committed to a 40% reduction in the number of drug errors in the use of prescribed medicines. Drug errors in diabetes care are a common cause of significant morbidity and complications. Nurse prescribing creates an opportunity for nurses to improve care for these patients.

Design: A quasi-experiment using six wards in a single hospital trust.

Methods: Inpatient care of a convenience sample of patients with diabetes was evaluated before (n = 27) and after (n = 29) the intervention of a Diabetes Specialist Nurse prescriber. Prospective data were collected to measure insulin and oral hypoglycaemic medication errors and length of stay.

Results: There was a significant reduction in the total number of errors between the pre-intervention and intervention group (mean reduction 21 errors) (p = 0.016). The median length of stay was reduced by three days. The total number of errors and length of stay were affected by admission category (p = 0.0004).

Conclusions: A medicines management intervention, provided by a Diabetes Specialist Nurse prescriber, had a positive effect on the system of delivering medicines to patients with diabetes and significantly reduced the number of errors. This reduction had some effect on length of stay. The cost saving was sufficient to finance a Diabetes Specialist Nurse prescriber post.

Relevance to clinical practice: (i) Errors frequently occur in the prescription and administration of medicines to patients with diabetes. (ii) The education of healthcare professionals is a factor contributing to these errors. (iii) Nurse prescribing provides a new system by which to educate patients and staff about their medicines. (iv) A Diabetes Specialist Nurse prescriber can reduce insulin and OHA MEs. This reduction had some effect on LOS.