The prescribing practices of nurses who care for patients with skin conditions: a questionnaire survey.

Aims and objectives
To explore the practice of nurses who prescribe medication for patients with skin conditions.

Background
Nurses have lead roles in dermatology services. In the United Kingdom, nurses in primary care frequently prescribe medicines for skin conditions, but there are concerns about role preparation and access to continuing professional development. The prescribing practices of nurse independent supplementary prescribers who care for patients with skin conditions are under-researched.

Design
Cross-sectional survey.

Methods
An online questionnaire was used to survey 186 nurses who prescribed for skin conditions from May–July 2010. Data were analysed using descriptive statistics and nonparametric tests.

Results
The majority worked in primary care (78%) and general practice (111, 59·7%). Twenty (10·8%) had specialist modules (at diploma, degree or master's level), 104 (55·9%) had dermatology training (e.g. study days), 44 (23·7%) had no training, and a further 18 (9·6%) did not respond. Oral antibiotics, topical antifungal and antibacterial drugs were frequently prescribed. Nurses with specialist dermatology training used their qualification in a greater number of ways, prescribed the broadest range of products and prescribed more items per week. Over 70% reporting on continuing professional development had been able to access it.

Conclusions
A large number of nurses in primary care prescribe medicines for skin conditions and are involved in medicines management activities. Lack of specialist dermatology training is a concern and associated with lower prescribing–related activities. Access to dermatology training and continuing professional development are required to support nurse development in this area of practice and maximise benefits.

Relevance to clinical practice
Nurse prescribers' involvement in medicines management activities has important implications in terms of improving access to services, efficiency and cost savings. To maximise their contribution, improved provision of specialist dermatology training is required. This will be of interest to education providers and service planners in the UK and countries around the world.