Non-medical prescribers writing discharge prescriptions in advance: evaluating the impact upon length of stay, patient experience, junior doctor workload and prescribing errors (HS4)

Project Summary:

One of the principal challenges for NHS hospitals is to provide quick access to services for an increasing number of patients while continuing to improve quality and staying within the budget agreed with commissioners. Reducing 18-week waits and improving Emergency Department (ED) 4-hour waits are key national performance targets.

University Hospital Southampton (UHS) launched a ‘No delays’ initiative in August 2012 to minimise avoidable internal delays in patient pathways. A new operational standard was introduced, stipulating that electronic discharge summary documents, including prescriptions and dispensed medicines, will be completed by 5pm on the day prior to the predicted day of discharge for the majority of patients.

Non-medical prescribing has been identified by the Department of Health as one option in a Compendium of Solutions to Implementing the European Working Time Directive for doctors in training and non-medical prescribers represent an obvious solution to the challenge of drafting discharge prescriptions in advance of the predicted day of discharge. A recent UHS pilot project to evaluate a consultant-led service including a dedicated non-medical prescriber and nurse case manager demonstrated facilitation of the discharge process and reduced length of stay.

The UHS ‘No delays’ initiative will encourage deployment of non-medical prescribers to support medical teams with drafting discharge prescriptions. An opportunity therefore arises to study the impact of non-medical prescribers on a number of qualitative outcomes including: patient experience, ward nurse and allied health professional experience and junior doctor experience. Quantitative outcomes for evaluation include: prescribing errors, time-to-discharge from consultant decision, length of stay and 30-day readmission rates.

Project Details:

The Faculty of Health Sciences, University of Southampton working in partnership with University Hospital Southampton NHS Foundation Trust, is offering a Clinical Academic Doctoral Fellowship for a qualified nurse.

The successful candidate will spend two days per week as a Band 5 Registered Nurse in University Hospital Southampton NHS Foundation Trust and 3 days per week working on the PhD research study. You will join a thriving and expanding group of Clinical Academic Doctoral Fellows based at the Clinical Academic Facility, Southampton General Hospital for the academic component of the Fellowship.

The Fellowship is for 4 years will begin in September 2013. You will be supported by an annual £14,000 stipend and an additional sum of £800 to support additional training and development costs during the Fellowship.

This is an exciting opportunity and will enable aspiring individuals to combine clinical practice with a research role, working across the University and University Hospital Southampton NHS Foundation Trust. The successful candidate will work with their nominated clinical mentor and a Faculty of Health Sciences academic mentor in a tri-partite arrangement to develop their clinical academic role in both practice and University settings.

It is essential that you have successfully achieved a 2:1 or a Postgraduate Diploma distinction in nursing. It would be desirable if you have achieved a 1st class honours degree.

Further information can be found in our FAQ document by clicking "Apply Online" below.

Interviews will be held in Southampton on 21st June 2013.