Changing practice for neuraxial applications using NRFit™ small-bore connectors to improve patient safety.

Clinical staff always aim to offer the best care for their patients while striving to minimise the risk of errors. The worldwide adoption of the NRFit™ system for neuraxial and regional block procedures is a major step forward. This article discusses the history of neuraxial needles and the experience of a major teaching hospital in adopting non-luer equipment for neuraxial procedures. References are made to resources that are available for other hospitals in the process of implementing the change to the NRFit system, which should result in the reduction of harm to patients.

Nurse prescribing for inpatient pain in the United Kingdom: a national questionnaire survey.

BACKGROUND: Nurses make a valuable contribution to pain services and have the potential to improve the safety and effectiveness of pain management. A recent addition to the role of the specialist pain nurse in the United Kingdom has been the introduction of prescribing rights, however there is a lack of literature about their role in prescribing pain medication. OBJECTIVE: The aim of this study was to develop a profile of the experience, role and prescribing practice of these nurses. DESIGN: A descriptive questionnaire survey. SETTING: 192 National Health Service public hospital inpatient pain services across the United Kingdom. PARTICIPANTS: 161 qualified nurse prescribers were invited to participate, representing 98% of known nurse prescribers contributing to inpatient pain services. The survey was completed in November 2009 by 137 nurses; a response rate of 85%. RESULTS: Compared with nurse prescribers in the United Kingdom in general, participants were highly qualified and experienced pain specialists. Fifty-six percent had qualified as a prescriber in the past 3 years and 22% reported that plans were underway for more nurses to undertake a nurse prescribing qualification. Although all participants worked in inpatient pain services, 35% also covered chronic pain (outpatient) services and 90% treated more than one pain type. A range of pain medications were prescribed, averaging 19.5 items per week. The role contained a strong educational component and contributed to informing organisational policy on pain management. Prescribing was said to improve nurses' ability to promote evidence-based practice but benefits were limited by legislation on prescribing controlled drugs. CONCLUSIONS: Findings demonstrate that pain nurses are increasingly adopting prescribing as part of their advanced nurse role. This has implications for the development needs of pain nurses in the United Kingdom and the future role development of nurses in other countries.