Incorporating solitary supplementary prescribing practice into an Advanced Practitioner role: The experience of a...

A new role within an intestinal failure unit was devised, which involved training a dietitian to undertake the role of an Advanced Practitioner working within the medical team. In the United Kingdom, dietitians can only undertake supplementary prescribing qualifications, and this study evaluates the safety and effectiveness of this type of prescribing practice in an intestinal failure Advanced Practitioner role.

All adult inpatients with types 2 and 3 intestinal failure were included. An appropriate clinical management plan was agreed by the multidisciplinary team and a medical and surgical consultant reviewed the prescriptions made, including the clinical indication and rationale. Descriptive statistical analysis was used and data presented as means (+/- standard deviation) for continuous variables and percentages for categorical variables.

A total of 1030 prescription episodes were made by the supplementary prescriber in the 6-month study period. Of these episodes, 96.2 % (n = 991) related to parenteral or intravenous fluid prescriptions; 13.6 % (n = 135) of which related to a combination of parenteral support and intravenous fluid prescriptions and 0.2 % (n = 2) of these episodes were for resuscitation purposes. No prescription amendments were required following a weekly review by the medical or surgical consultant.

This study demonstrates that a dietetic-based Advanced Practitioner in a busy intestinal failure unit effectively and safely incorporated supplementary prescribing into their role. Supplementary prescribing was used to initiate a range of prescriptions, as part of a clinical management plan, and all were deemed to be the optimal prescription choice for the indication identified.