Use of Accelerated Laboratory Evaluation by Extended Nurse Prescribers: A tool to improve practice?

Abstract

Bacground – Because of the link between inappropriate antibiotic prescribing and antibiotic resistance, several strategies have been implemented to decrease inappropriate prescribing and improve prescribing practices. As 80% of antibiotic prescribing takes place in primary care, this area has often been the focus of these attempts. An example of such a strategy is the Accelerated Bacteriological Laboratory Evaluation (ABLE) service in Grampian, which provides an overnight microbiology results service. Aim - To describe the knowledge and use of the Accelerated Bacteriological Laboratory Evaluation (ABLE) service by Extended Nurse Prescribers in Grampian (UK). 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 nine percent (31) of respondents knew about the ABLE service, and 88% (30) had used it, with 73% (22) using it often. Over half of respondents (55%) stated that they had insufficient information to allow them to make best use of the service. The main barrier to ABLE use was difficulty accessing results (50%/6). The main motivator for ABLE use was the desire to prescribe the correct antibiotic (71%/17). Conclusions – Although the majority of respondents were aware of the ABLE service and have used it, more information at more regular intervals is needed to encourage maximal use. Respondents were more likely to use the service for some conditions than others. Inclusion of information about ABLE in the Extended Nurse Prescribing course followed by regular postal and/or electronic reminders/updates would be preferred. These changes and the expansion of accelerated laboratory evaluation nationwide may help to reduce and improve prescribing practices.