Prescribing for out-patients by nursing staff in a dermatology department

Nurse prescribing for a small range of products has been introduced in primary care, but not in hospitals, in the U.K. We have evaluated the benefits, costs, practicality and patient satisfaction with the formal introduction of dermatology nurse prescribing in the out-patient treatment facility of a district general hospital dermatology department with a wide geographical catchment area. Over a 6-month period, 91 items were prescribed to 47 patients on 72 occasions (items/patient: range 1-8, mean 2, median 1). The cost to the department was 249.04 Pounds (cost per patient: range 0.39 Pound-24.61 Pounds, mean 5.30 Pounds). A small number of patients appeared to use nurse prescribing as a substitute for medical consultations. A total of 33 of 45 adult patients replied to a questionnaire. In 15 respondents, the prescription was necessitated by a change in the skin condition and in 10 by the exhaustion of supplies of the current medication, and both of these factors applied in six patients. All had understood the instructions for the use of the treatment prescribed, and only three felt that it had failed to work as anticipated. Only one patient had (unspecified) side-effects, caused by a prescription for a topical antipruritic. Eight patients were able to defer appointments with their general practitioner as a result of the nurse-prescribed item being supplied. Prescribing by appropriately trained nurses therefore appears to be a safe and effective development in dermatology.