1 March 2010

Standing orders consultation

Minor changes to prescribing under standing orders are being proposed in a small-scale review of medicines regulations. But no other nurse prescribing issues are specifically addressed in the consultation document from the Ministry of Health. Talk of major prescribing reforms for nurses and nurse practitioners were shelved in 2007 but lobbying has been building for reform to allow innovations like prescribing diabetes nurses specialists. The consultation document only addresses minor changes to two sets of regulations under the 1981 Medicines Act including the Medicines (Standing Order) Regulations 2002. The proposed amendment would allow the issuer of a standing order (i.e. a physician or prescribing nurse practitioner) to determine when countersigning of a prescription or treatment is or is not required. The amendment follows consultation in 2006 when there was strong support for introducing more flexibility over countersigning. The full document and other proposed amendments can be viewed on the Ministry of Health website and submissions close on March 26.

Coroners’ reports calls for more nurses

Calls to attract more nurses into aged care and particularly to improve dementia unit staffing were made by two coroners after investigating the deaths of two aged care residents. Hastings coroner Chris Devonport in January endorsed Wellington coroner Garry Evans’s December call after both expressed concern about staffing levels and the safety of residents in dementia units. The deaths of Florence Coombes in Wellington and Nola Revell in Gisborne followed falls not seen by staff and raised questions about the actions of other dementia unit residents present at the time. Evans also endorsed and sent to the Minister of Health the recommendations made by recently-retired dementia hospital manager and nurse Barbara Martin for the Ministry to attract more registered nurses into aged care and for providers to allow managers to build in extra roster hours for emergencies.