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Diabetes Nurse Specialists to become designated prescribers

Diabetes Nurse Specialists to become designated prescribers

With more than 9000 Northlanders known to have Diabetes and a projected increase of 72% by 2026 (14,500) it is welcome news that four Northland Diabetes Nurse Specialists (DNS) are undertaking relevant training, education and supervision to become designated prescribers.

The prescribing of medicines is regulated under the Medicines Act 1981 and its associated regulations, which provide for two classes of prescribers: authorised and designated prescribers.

Authorised prescribers are medical practitioners, dentists and registered midwives and have full prescribing rights and access to all medicines in the Medicines Regulations based on their scope of practice.

• In 2011 a new regulation was created within the existing Medicines Act 1981 designated prescriber category, to allow suitably qualified Registered Nurses to prescribe a limited range of diabetes related medicines and devices under the supervision of an authorised prescriber.

• Late in 2012 the Northland DHB successfully secured four positions in the national Diabetes Nurse Specialist (Registered Nurse) Prescribing 2012 Managed National Roll Out Project.

In November 2012 three DNS from Northland DHB Diabetes Service and one from Manaia PHO commenced the journey of becoming a designated prescriber.

“Prescribing by diabetes nurse specialists will result in improved continuity of care for patients, reduce the need for separate appointments for routine prescriptions and reduce pressure on medical staff”, said Northland DHB Margareth Broodkoorn Director of Nursing & Midwifery.

“It is a natural extension of their role. Diabetes nurse specialists operate with a high degree of autonomy with significant responsibility for the delivery of diabetes services, and will have responsibility for prescribing common medicines for people with diabetes (under supervision and in partnership with medical practitioners)”.

Diabetes patients are excited about the prospect of being able to work more closely with the nurse specialists.

“Alongside CarePlus and diabetes support services I can see huge benefits for people who need to have their diabetes management assessed”, Julie Vezey offered. “Patients perceive nurses to be more accessible and convenient when wanting help with their diabetes management and it will be much easier and affordable for diabetics who need prescriptions for their routine medicines”.

"I have always had a great relationship with the diabetes nurses at the centre. If I get into trouble I know I can ring her and she gives me advice”, said Geoff Sadler. “The registered nurse prescribing is a very positive thing alongside Care Plus and the care from my practice team. I’m on a lot of medication and if people can get help other than from their GP, that will be great."

Care Plus provides additional funding for primary health organisations (PHOs) to give better care to people who use high levels of care or have high needs because of chronic conditions or terminal illness. With Care Plus, patients receive expanded, better-coordinated, lower-cost services from a range of health professionals.

“The Northland Health Services Plan mandates that we work with our population health needs more effectively ‘upstream’, in the primary and community setting. Designated prescribers will in part help achieve this by providing more convenient, assessable health care service”, Margareth Broodkoorn said. “DNS prescribing is safe, of good quality, and clinically appropriate”.

All of our Northland Hospitals have a full time operational renal unit. Driven by obesity, an ageing population and a high number of people with a family history of Diabetes in aggregate, 9.4% of Northland’s adult population has either CVD or diabetes or both. Around 42% of the health service costs (inpatients, outpatients, Emergency Department, pharmaceuticals and laboratory tests) are consumed by this 9.4% of the population.

Add onto that the cost of seeing a doctor, limited appointment availability and the cost of transport to access secondary care services Diabetes Nurse Specialist prescribers will make a significant positive impact on the wellbeing of Northlanders.


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