Abstract:
Background – Since 2001 a group of specially trained UK nurses have been allowed to prescribe a limited selection of oral and topical antibiotics for selected conditions. Theoretically at least, this means that nurses within Grampian may be contributing to the problems of over-prescribing and inappropriate prescribing of these drugs. This, in turn, may impact on the development of antibiotic resistance. Aim - To describe antibiotic prescribing practices of primary care Extended Nurse Prescribers in Grampian. Methodology - Quantitative - Anonymous, self-completed, postal questionnaire of all regional Extended Nurse Prescribers, informed by a preliminary content-setting focus group. Analysis – Descriptive statistics (thematic analysis of focus group). Key Findings – Response rate was 74% (35/47) and 57% (20) of respondents were practice nurses. Eighty eight percent (28) of respondents were active prescribers, and urinary tract infections (UTIs) were the condition for which antibiotics was most often prescribed, with the majority (65%/20) of prescribing for UTIs done on the basis of symptoms alone. Almost 60% of respondents did not feel their ENP course had prepared them for antibiotic prescribing, and 67% (10) of those who answered would like to see more specific information about prescribing for common conditions added to the course. Thirty percent (10) of respondents did not think that resistance was a problem in their work area, but 97% (34) thought that decreasing inappropriate antibiotic prescribing would lead to a decrease in antibiotic resistance. Conclusions – There is considerable disparity in antibiotic prescribing practices, with current guidelines being adhered to in some cases (bacterial vaginosis) but not always in others (otitis externa). There are also deficits in the ENPs’ knowledge of factors around antibiotic resistance. These findings, together with the ENPs’ feelings of being unprepared by their ENP course, suggest that changes to the ENP course at RGU are required to improve prescribing practices.