Nicola Carey

University of the Highlands and Islands | UHI · Centre of Rural Health Science

Aim To obtain consensus on barriers and facilitators to nurse prescribing following its recent introduction in Spain. Design A three round online Delphi survey and focus group. Methods An exploratory method was used with three consecutive rounds of questionnaires based on anonymity and feedback, and a focus group. The study was carried out with p...

Objectives Non-medical prescribing (NMP) is a key feature of the UK healthcare system that refers to the legal prescribing rights granted to nurses, pharmacists and other non-medical healthcare professionals who have completed an approved training programme. NMP is deemed to facilitate better patient care and timely access to medicine. The aim of t...

Background: Palliative care, a recognised component of care by the World Health Organization is poorly developed in low- and middle-income countries. Mobile phone technology, an effective way to increase access and sustainability of healthcare systems globally, has demonstrated benefits within palliative care service delivery, but is yet to be uti...

Background: Pain is one of the commonest symptoms in patients of all ages presenting to ambulance services. Children in pain make up a relatively small proportion of the number of those attended by prehospital care and pain management is needed in only 40% of cases. This might go some way to explain why the management of paediatric pain is perceive...

Background Pain is one of the commonest symptoms in patients of all ages presenting to ambulance services. Children in pain make up a relatively small proportion of the number of those attended by prehospital care and pain management is needed in only 40% of cases. This might go some way to explain why the management of paediatric pain is perceived...

Clinical relevance: Eyecare professionals assess older adults against the vision requirements for driving and discuss this with them on a regular basis. Improved access to resources/training would be beneficial and help eyecare professionals navigate more difficult conversations about driving, e.g., following acute vision changes. Background: Th...

Background Infection is more frequent, and serious in people aged > 65 as they experience non-specific signs and symptoms delaying diagnosis and prompt treatment. Monitoring signs and symptoms using decision support tools (DST) is one approach that could help improve early detection ensuring timely treatment and effective care. Objective To identi...

Objectives To support workforce deficits and rising demand for medicines, independent prescribing (IP) by nurses, pharmacists and allied health professionals is a key component of workforce transformation in UK healthcare. This systematic review of qualitative research studies used a thematic synthesis approach to explore stakeholders’ views on IP...

Non-medical prescribing (NMP) is deemed to facilitate better patient care and timely access to medicine. This scoping review protocol is designed to explore and synthesise the evidence on costs and consequences of NMP services provided by non-medical healthcare professionals. This protocol is prepared based on the framework recommended by Arksey an...

Pain is one of the most common symptoms presented by patients of all ages to ambulance services. While children in pain make up a relatively small proportion of the patients attended by prehospital care services, medical intervention is needed in only 40% of cases. This might go some way to explaining why management of paediatric pain is perceived...

We present findings from a longitudinal ethnographic study of infertile couples seeking treatment following initial GP referral to specialist fertility services. Repeated observations and interviews were undertaken with the same 14 heterosexual participants over an 18-month period. Heterosexual, non-donor couples comprise the majority of fertility...

Diabetes mellitus increases the risk of adverse maternal and fetal outcomes. Preconception care is vital to minimise complications; however, preconception care service provision is hindered by inadequate knowledge, resources and care fragmentation. Mobile health technology, particularly smartphone apps, could improve preconception care and pregnanc...

Paramedic independent prescribing in primary care in England – self-report audit of prescribing and medicines management activities. Judith Edwards1, Andy Collen2 , Dr Melaine Coward1, Dr Nicola Carey1 1School of Health Sciences, University of Surrey, 2South East Coast Ambulance Service Background and Aims: In 2018 the United Kingdom (UK) becam...

This rapid review was commissioned by the GOC with the aim to identify known barriers and facilitators to implementing non-medical prescribing that impact on Optometrist therapeutic prescribing, related to additional supply, independent and supplementary prescribing. An additional aim was to identify literature on the scope of Optometrist therapeut...

This paper sets out key challenges related to detection and management of infection in nursing home residents, and then explores the situation in South Africa, and use of decision support tools as a mechanism to improve this area of practice. In line with global trends, concerns have been raised about the rapidly increasing aging population in Sout...

Women with diabetes are at increased risk of adverse maternal and foetal outcomes. Preconception care can minimise risk of complications and improve outcomes, but current provision is inadequate. Electronic health technology, particularly apps, could improve preconception care provision but research is lacking in this area. The aim of this article...

Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by all...

With the demand for medication continually growing, Nicola Carey and Karen Stenner discusses how non-medical prescribing can ease the burden; showcasing a new online toolkit ‘Preparing to Prescribe’, that will aid the future training of prescribers

The aim of this study was to explore the role and responsibilities of non-medical prescriber leads in the southwest of England. A questionnaire was completed by 22 leads in this region in 2019. A total of 2388 healthcare professionals were reported to have the prescribing qualification amongst the 22 participating organisations. Just under half (44...

Introduction In order to avoid unnecessary hospital admission and associated complications there is an urgent need to improve the early detection of infection in nursing home residents. Monitoring signs and symptoms with checklists or aids called decision support tools may help nursing home staff to detect infection in residents, particularly durin...

Paramedic practice is evolving and the number of advanced paramedics in primary care roles in the UK has risen dramatically. Recent legislation granting paramedics independent prescribing rights means UK paramedics are the first worldwide to receive this extension in scope of practice – a significant milestone for the paramedic profession. Paramedi...

Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health pro...

Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by all...

Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by all...

Background: Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by al...

Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health pro...

Background Worldwide paramedics are integrating into services outside ambulance settings [1-3]. Legislation in the United Kingdom in 2018 granted the paramedic profession independent prescribing rights [4]. The first paramedic prescribing training programmes became available in September 2018 in England. Requisite for training is working at advance...

Background: With life expectancy continuing to rise in the United Kingdom there is an increasing public health focus on the maintenance of physical independence among all older adults. Identifying interventions that improve physical outcomes in pre-frail and frail older adults is imperative. Methods: A systematic review of the literature 2000 to...

This chapter considers ageing and diversity in relation to people who are growing older with pre-existing physical disabilities and/or physical or mental health related long-term conditions (LTCs).1 Considerable attention has been given to older people with age-acquired health problems and/or disabilities (who ‘age into disability’, Molton and York...

Objective: Making best use of existing skills to increase service capacity is a global challenge. The aim was to systematically review physiotherapy and podiatrist prescribing and medicines management activity, including evidence of impact on patient care, levels of knowledge and attitudes towards extended medicines role. Methods: A search of MEDLI...

Aim: Patient redirection can help reduce service demand by providing information about more appropriate services. There is, however, no evidence about the effect of nurse-led patient redirection in urgent care centre settings. The aim of this project was to develop and evaluate a nurse-led patient 'self-care and redirection first' intervention in...

Background Self-management interventions have become increasingly popular in the management of long-term health conditions; however, little is known about their impact on psychological well-being in people with Multiple Sclerosis (MS). Purpose To examine the effectiveness of self-management interventions on improving depression, anxiety and health...

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Background: Women with diabetes are at increased risk of adverse maternal and fetal outcomes. Preconception care can improve pregnancy outcomes and is paramount to minimise complications, but, current provision is sub-optimal. Mobile technology, particularly smartphones and apps have the potential to improve preconception care provision but resear...

Aim: To develop and evaluate an educational intervention for formal care workers on pressure ulceration in the community. Background: Pressure ulcers are a major burden to health care, and with an aging population likely to increase. Formal care workers are ideally placed to identify high risk but lack standardised educational provision. Design...

Background: Worldwide, 199.5 million women have diabetes mellitus (DM). Preconception care (PCC) education starting from adolescence has been recommended as an effective strategy for safeguarding maternal and child health. However, traditional preconception care advice provided by health care professionals (HCPs) within clinic settings is hindered...

Table of content P3 Medial longitudinal arch development of school children Jasper W.K. Tong, Veni P. Kong P4 Is measuring the subtalar joint reliable? Lily Sze, Susie Gale, John Veto, Carla McArdle P5 Comparison of turning gait biomechanics between able-bodied and unilateral transtibial amputee participants Thanaporn Tunprasert, Victoria Bradley,...

AimThe aim of this study were to compare nurse prescribers and non-prescribers managing people with diabetes in general practice regarding: (a) patient characteristics; (b) activities and processes of care; (c) patient outcomes (self-management, clinical indicators, satisfaction) and (d) resource implications and costs.Background Over 28,000 nurses...

There is a need to reduce symptoms, exacerbations and improve quality of life for patients with respiratory diseases. Across the world, increasing numbers of nurses are adopting the prescribing role and can potentially enhance service provision. Evidence suggests improved quality of care and efficiencies occur when nurses adopt the prescribing role...

Aims and objectives: To provide information on the profile and practice of nurses in the UK who prescribe medication for pain. Background: Pain is widely under-reported and under-treated and can have negative consequences for health and psychosocial well-being. Indications are that nurses can improve treatment and access to pain medications when...

Background: Over 50,000 non-medical healthcare professionals across the United Kingdom now have prescribing capabilities. However, there is no evidence available with regards to the extent to which non-medical prescribing (NMP) has been implemented within organisations across a strategic health authority (SHA). The aim of the study was to provide...

General Information. The questionnaire is aimed at non medical prescribers (NMPs). It should take you about 15 minutes to complete. Most questions require you to tick the box(s) that apply. If you make a mistake just tick the box you do require and it will change automatically. You can also scroll backward through the pages if you want to change a...

This article examines the literature on non-medical prescribing to establish its impact on UK healthcare. It discusses how better access to medication through non-medical prescribing can improve patient safety and patient-centred care, and how nurse prescribing can help ensure quality of care in the NHS during the current financial crisis.

In the United Kingdom, non-medical prescribing (NMP) has been identified as one way to improve healthcare quality and efficiency. Healthcare organisations are charged with overseeing the clinical governance of NMP and guidance recommends the identification of a lead director to be responsible for its implementation. While over twelve million items...

Background: There is a drive to improve the quality of service provision for patients with diabetes and to enable better self-management of this condition. The adoption of prescribing by nurses is increasing worldwide and can potentially enhance service provision. Evidence suggests that patients prefer services where their lifestyle factors and op...

Skin disease can have a huge impact on quality of life for patients and their families. Nurses have an important role in the delivery of specialist dermatology services, and prescribing enhances the care they provide. The views of dermatology patients about nurse prescribing are unknown. To explore the views of dermatology patients about nurse pres...

To explore the views of patients with diabetes about nurse prescribing and the perceived advantages and disadvantages. Patients were recruited from the case-loads of seven nurse prescribers in six National Health Service sites in England. Sites reflected the key settings in which nurses typically prescribe for patients with diabetes within primary...

This paper is a report of a study exploring the views of nurses and team members on the implementation of nurse prescribing in diabetes services. Nurse prescribing is adopted as a means of improving service efficiency, particularly where demand outstretches resources. Although factors that support nurse prescribing have been identified, it is not k...

carey n, stenner k & courtenay m (2010) Journal of Nursing and Healthcare of Chronic Illness2, 13–21 How nurse prescribing is being used in diabetes services: views of nurses and team members Aim. To explore the views of nurses, doctors, non-nurse prescribers and administrative staff on how nurse prescribing is being used in diabetes services. Back...

Because role change can be disruptive, the introduction of nurse prescribing could potentially lead to confusion and conflict over role boundaries and definitions. This article considers how adopting prescribing has influenced the role of nurse prescribers who treat and manage patients with diabetes. Interviews with 10 nurse prescribers, nine docto...

Nurse Independent and Nurse Supplementary Prescribing has extended the role that nurses in the UK have in the management of care for patients with diabetes. Concerns surround nurses' pharmacological knowledge and provision of continuing professional development to meet the needs of nurse prescribers. To examine the continuing professional developme...

Aim. To explore the practices of nurse prescribers who care for people with diabetes. Background. The use of medicines is an important component of the care of patients with diabetes. However, education and support is equally important to the successful management of this group. These are areas of care in which nurses have traditionally been involv...

Background Recent United Kingdom government policy emphasises that prescribing by nurses can improve access to medicines. However, the views of nurses prescribing for children have not been explored. Aim To explore the views of children’s nurses working in a specialist hospital on the adoption of the prescribing role in their practice. Method A lon...

Recent United Kingdom government policy emphasises that prescribing by nurses can improve access to medicines. However, the views of nurses prescribing for children have not been explored. To explore the views of children's nurses working in a specialist hospital on the adoption of the prescribing role in their practice. A longitudinal, qualitative...

This study aimed to explore the prescriptions issued to patients with diabetes by nurse independent and nurse supplementary prescribers working in general practice. A total of 19 prescriptions were collected and assessed from four case-study sites based in general practice between October 2007 and September 2008. Prescriptions were collected from p...

To explore stakeholder views on the impact of nurse prescribing on dermatology services. Nurse led care enhances the services that dermatology patients receive. Research indicates that care delivered by nurse prescribers can improve efficiency and access to medicines. There is no evidence exploring the impact of nurse prescribing on the configurati...

This article aims to explore the views of doctors and nurses, who care for people with diabetes, about the prescribing programme. Interviews with 10 nurse prescribers, nine doctors and three non-nurse prescribers were conducted in nine case study sites across England between October 2007 and September 2008. Prescribing was seen as a natural extensi...

To explore the views of doctors and clinical leads (CLs), who care for children and young people, on nurse prescribing in one specialist children's hospital. Nearly 14,000 nurses in the UK have virtually the same prescribing rights as doctors. Benefits of nurses adopting this role have been reported, but doctors do have some concerns. Increasing nu...

This paper is a report of a study exploring the content and processes in consultations between nurse prescribers and patients with dermatological conditions. Communication skills, consultation time, information and follow-up are central to the treatment and management of patients with dermatological conditions. The contribution nurses make to the c...

This study aimed to explore the views of health care professionals on the implementation of nurse prescribing in a specialist children’s hospital. An intrinsic case study approach was taken using thematic analysis on semistructured interview data collected during 2006 and 2007. Participants were seven children’s nurses who were qualified nurse pres...

This paper is a report of a study conducted to explore doctor and non-prescribing nurse views about nurse prescribing in the light of their experience in dermatology. The cooperation of healthcare professionals and peers is of key importance in enabling and supporting nurse prescribing. Lack of understanding of and opposition to nurse prescribing a...

To examine the prescribing practices of nurse supplementary prescribing in diabetes. 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...

To identify, summarise and critically appraise the current evidence regarding the impact and effectiveness of nurse-led care in acute and chronic pain. A diverse range of models of care exist within the services available for the management of acute and chronic pain. Primary studies have been conducted evaluating these models, but, review and synth...

The findings reported in this paper explore the prescriptions issued to dermatology patients by nurse prescribers. Thirty five prescriptions on which 79 items were prescribed were collected from 10 nurse prescribers and independently assessed. Each nurse formed the focus of a case study, which represented a setting within England in which nurses pr...

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

The aim of this study was to examine the prescribing practices of nurse independent prescribers caring for patients with diabetes. Medication management is an area of care in which nurses, caring for patients with diabetes, are involved. Prescribing should optimise the role of these nurses. Although nurses in the United Kingdom have virtually the s...

This paper is a report of a study to examine Nurse Independent/Nurse Supplementary Prescribing for people with diabetes and the extent to which these nurses feel prepared for this role. An area of care in which nurses, caring for people with diabetes, are involved is the management of medications. There is little or no evidence examining the prescr...

This paper is a report of a survey to provide an overview of nurse independent prescribing and nurse supplementary prescribing across the United Kingdom. Evidence examining the frequency of prescribing by nurses is conflicting, and it is evident that several factors hamper prescribing practice. As of May 2006, legislative changes gave appropriately...

To identify systematically, summarize and critically appraise the current evidence regarding the activity and effects of nurse-led care in diabetes. A diverse range of nurse-led models of care exist in diabetes. Primary studies have been conducted evaluating these models, but review and synthesis of the findings from these studies has not been unde...

The overall aim of the research was to provide a national evaluation of Nurse Independent and Nurse Supplementary Prescribing in diabetes in the UK. A key component was to examine service provision by nurse prescribers for patients with diabetes.The NMC database was used to randomly select and distribute questionnaires to 1992 registered Nurse Inde...

No other country in the world has such extended prescribing rights for nurses as the United Kingdom. Concerns surround the move of nursing towards a medical model of care, and the level of medical practice support required by trainee prescribers. To provide an overview of the nurses adopting the role of independent extended supplementary prescriber...

Nurses are able to prescribe independently from a list of nearly 250 prescription only medicines for a range of over 100 medical conditions or, from the whole British National Formulary as a supplementary prescriber. There is some evidence available on the prescribing practices of district nurses and health visitors and early independent extended p...

To examine the prescribing practices of supplementary nurse prescribers (working in both primary and secondary care) who prescribe medicines for patients with skin conditions and the factors that facilitate or inhibit this mode of prescribing. Nurses work in a variety of roles, with varying levels of expertise, are involved in the treatment managem...

To examine the prescribing practices of independent extended nurse prescribers for patients with skin conditions. Nurse-led services are one means of improving healthcare provision for dermatology patients. The advent of nurse prescribing should optimize the role of the nurse in these situations. Medicines for skin conditions constitute a significa...

The aim of this study was to evaluate 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 whilst in hospital. The setting was six wards in a single United Kingdom district general hospital trust. The standar...

To identify systematically, summarize and critically appraise the current evidence regarding the impact and effectiveness of nurse-led care in dermatology. A diverse range of nurse-led models of care exist in dermatology. Primary studies have been conducted evaluating these models, but review and synthesis of the findings from these studies have no...

Background: From Spring 2006, independent extended nurse prescribers in the United Kingdom will be able to prescribe any licensed medicines except controlled drugs. Supplementary nurse prescribers are currently able to prescribe any medication. No other country in the world has such extended prescribing rights for nurses. Aspects of prescribing vi...

Nurses play lead roles in the delivery of care in dermatology. While a number of primary studies have been conducted evaluating nurse-led care in dermatology, review and synthesis of the findings from these studies has not been undertaken. To systematically identify, summarize and critically appraise the current evidence regarding the impact and ef...

Recommendations were first made in 1986 for nurses to take on the role of prescribing (Department of Health [DoH], 1986). Eight years later (although limited to district nurses and health visitors), nurses in eight demonstration sites throughout England began to independently prescribe (Morris, 1994). There are now approximately 29000 district nurs...

Approximately 10% of hospital inpatients suffer from diabetes. These patients are likely to be admitted to hospital twice as often and stay twice as long as people without diabetes (Currie et al, 1997), and this figure is expected to rise in the future. At present there is a lack of understanding about diabetes among hospital staff (Audit Commissio...