Purpose
Project aimThe aim of this project was to provide a managed roll out of diabetes nurse specialist prescribing through dedicated project management and facilitation based on what was learnt from the demonstration project. It was designed to enable nurses in other services across different practice settings and geographical regions to take up the role of prescriber under the supervision of an authorised prescriber in a controlled and supported manner.
Project objectives
The objectives were:
- To establish between four and six sites across New Zealand where there are diabetes nurse specialists (DNS) willing to take up the role with an authorised prescriber to supervise them. It was anticipated that up to 20 nurses would be involved
- To monitor the progress of the DNSs and their prescribing practice
- To monitor clinical parameters of their patients to ensure ongoing safety and appropriateness of DNS prescribing
- To develop key communication messages and recommendations for the further implementation of DNS prescribing.
Key Results
Project OutcomesQuality improvement, safety and clinical improvement indicators formed the basis of monitoring and outcome measurement. Critical success factors, enablers and barriers to embedding the DNS prescribing role into practice as business as usual were to be identified. Recommendations about any changes required to enable the model to be implemented and extended were also to be made.
Main results
A registration of Interest (ROI) process was utilised to select six sites with 15 DNSs to participate in the managed roll out. Of the 15 DNSs, three directly practised in primary health care and had strong collaborative relationships with their colleagues in specialist services. The remaining DNSs were based within specialist multidisciplinary teams with most providing outreach/satellite services in the primary health care setting. Clinical champions for the project were identified within each site, usually the Director of Nursing and a prescribing supervisor.