Healthcare Article Nurses Acute Role Assignment

Added on - 21 Apr 2020

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1Running head: HEALTHCARENursingName of student:Name of university:Author note:
2HEALTHCAREContextThe article by Jones et al., (2011) has selected a significant research topic of nurse prescribingroles in the acute role. The role of nurses in acute care settings has evolved through the years to meetthe increasing demand for health care services. According to Haririan (2016) prescribing by nurses isa key approach that aims to optimise the ability of nurses to bring improvement in the speed of accessto high quality care. Non medical prescribing has bene indicated to bring improvements in clinicaldecision making across teams. A number of countries have implemented this novice role includingSingapore where the practice is in the limelight. On an international basis, prescription rights forNurse Practitioners varied significantly from limited formulary to full prescriptive authority. In 2014,National Nursing Taskforce (MOH) in Singapore recommended for the hospitals to initiate aprescription framework for nurses to prescribe medicines on the basis of drug formulary (Ayre & Bee,2014). As suggested by Jones et al., (2011) not much information is available regarding theimplementation of this role into practice.At the time when the study by Jones et al., (2011) was conducted, there was a lack of suitablestudies that evaluated nurse prescription in acute care settings. The majority of the studies was onlyresponsible for reporting nurse prescriber’s view of the prescribing roles they had. In this regard, theperceptions of other stakeholders were not taken into consideration, which forms an integral elementfor understanding the suitability of this new emerging role. Further studies were needed that highlightthe views of healthcare peers across different settings in relation to nurse prescribing roles as well asthe dissimilarities in roles of nurse and medical prescribers.Key AimsThe main aim of the study conducted by Jones et al., (2011) was to carry out an assessment ofthe functioning of nurse prescribing in an acute care hospital setting in the city of England, UK. Thepurpose of this study was to bridge the gap in existing literature regarding the ways in which nurseprescribers can work and lead to better patient outcomes and satisfaction levels. The author succededin achieving their aims as the study was flourishing in addressing the research question.MethodsThe research was carried out following a mixed method single case study approach. The studywas conducted in the year 2005-2006. An acute care hospital in England was the setting for the studythat was located at a metropolitan borough of England that is densely populated and having itspopualtion from diverse ethnic backgrounds. The study had three clinical departments as units ofanalysis; namely the hypertension clinic, renal clinic and renal satellite unit. As the study methodpurposive sampling was done for recruiting the participants. A total number of 18 hospital staff were
3HEALTHCAREselected of which 3 were prescribers, seven were colleagues, and 8 were senior hospital staff. Inaddition, 2 nurses and 2 doctors took part in the study as non-participant observers. Semi-structuredinterviews was the tool for data collection with these participants. 52 patient-prescriber consultationswere done with 47 patients. 122 patients were considered for a questionnaire survey was done with.Qualitative data analysis was done with the help of data analysis framework porposed by Ritchie andSpencer. This was a deductive approach enabling an accurate sifting, charting and organisation of datadepending on themes and key issues. SPSS software was used for quantitative data analysis.Descriptive statistics helped in summarising numerical data (Jones et al., 2011).A mixed method was suitable for the study as it was aligned with the research aim. Since thestudy wanted to highlight the overall experience of practitioners and stakeholders in relation to nurseprescribing, a mixed method enabled qualitative as well as quantitative approach. Such a methodenures deeper, broader and more significant information. Rich datasets can be attained by this method(Nieswiadomy & Bailey, 2017). As opined by Parahoo (2014) mixed methods augment the credibilityand reliability of all studies with the help of the triangulation of the different evidences. A betterunderstanding of the study problems is achieved through this method. However, it is to be noted thatit was inappropriate to conduct the study in one single setting and with only three clinicaldepartments. Due to such an approach, it can be stated that the study results were not generalised asthe sample population was not a true representation of the general population. Purposive sampling hascertain disadvantages, including researcher bias (LoBiondo-Wood et al., 2014).FindingsThe staffs taking part in the study pointed out that the main aim of nurse prescribing wasdirected towards patient benefits and enhanced team working. Further, nurse prescribing holds thepotential for ensuring working advancements and legitimisation of practice. Staff satisfaction andincreased patient satisfaction could also be achieved through nurse prescribing, as reported by thestaff. The nurse practitioners reported that prescribing practice was a key approach for guiding betterteam work and patient care delivery. Nurses could also use their nursing skills in a better manner. Thecentral themes emerging from the data set were increased confidence to prescribe, improved patientcare, increased role fulfilment and successful implementation of nurse prescribing. The data did notpoint out any statistically significant differences between the manner in which doctors and nursesperformed the prescribing roles. Nevertheless, it is to be highlighted that a statistically significantdifference existed between the medication-related information satisfaction ratings of patientswitnessing a nurse prescriber, compared to those witnessing prescription by a doctor.The findings of the study were easy to follow the flow of information were aligned with theresearch questions. The findings were also believable to the extent that nurses have come a long wayin taking up different roles and additional responsibilities in acute care settings. Agreeing to the
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