Context: Evidence in NATH Evaluation Work
All the evaluation work at NATH relies on an evidence base. In health and social care, that’s the essential foundation for safe, effective practice. At the moment, NATH is supporting the wider system in establishing the commissioning needs and evidence for supporting nurses prescribing within social care settings. With an ongoing national evaluation taking place alongside this work, being clear about both evidence and boundaries is vital. The Knowledge Library, and in particular Open Athens, gives us access to good evidence in the primary care settings, where access to physical libraries is scarce.
Background: Non-Medical Prescribing in Social Care
None medical prescribing has evolved significantly in the past two decades, but is still scarce in social care settings. Health professionals that work within those settings are often closer to patients’ day to day realities than traditional prescribers, and see them in their own homes, giving them a clear, practical insight into the impact of both conditions and drug side effects. In theory, this should reduce costly and potentially harmful drug prescribing errors and over-prescription. But what does the evidence say?
Role of Open Athens in Accessing Evidence
On the open internet, many papers are only available in abstract or summary forms. Open Athens gives you full text of more papers, and longer summaries of some that remain paywalled. This allows us to look for baselines.
For example, some professionals worry that non-medical prescribers in social care may make too many errors. But Avery et all (2012) found that in General Practice, prescribing errors affected one in every eight patients; if we can establish that errors in social care settings are lower than that, we can establish it is at least as safe, if not safer, than traditional routes. The same paper had detail in the full text that good communications and continuity of care, more likely with familiar professionals in a home-like setting, reduce errors. This can give us hope that non-medical prescribing may even have patient benefits in some cases, especially where nurses and other health professionals are well placed to notice subtle changes, understand the patients’ normal behaviour and routines and know other members of staff well.
Reflection: Value of Full Text Evidence
Access to full text articles is, of course, slower than merely asking for an AI summary or glancing at an abstract, but the level of detail in a full text paper is far more useful for the rigorous testing of ideas we need to make changes in health and care.
How to access Knowledge and Library Services
NHS Knowledge and Library Services gives you access to the most up to date and trusted evidence and information in healthcare today. It enables high quality decision making, professional development, research and innovation to achieve health improvement. To take full advantage of all the tools and resources, you first need to create an OpenAthens account.
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