Subject: RE: Requesting by nurses
One significant issue is that of getting proper consent to both the
collection of the sample and the testing itself.
Another is, of course, that of what you do with abnormal results. I
currently have a manslaughter case sub judice, which I cannot talk about in
detail, where one of the issues is or may be the lack of appreciation of the
significance by a nurse of abnormal results in a set of clinical chemistry
investigations she initiated.
Perhaps not only should consent for testing only be obtained by someone who
understands the nature and significance of the tests they are asking the
patient to undergo, but the test should only be initiated by someone who
understands the significance of the results both "normal" and abnormal....
A paper in the Jan 9th NEJM is worth a look at. it deals with the whole
issue of non medics providing medical care.
http://content.nejm.org/cgi/content/abstract/348/2/130 The conclusion is
"The results of this study suggest that in order to ensure that patients
receive the best possible care, it is essential to measure, understand, and
ultimately optimise the degree of integration among the services they
receive from different providers. This undertaking will require an effort
that is itself collaborative, engaging health care purchasers and patients,
health care administrators and researchers, and physicians and nonphysician
clinicians". IE don't develop it on an ad hoc basis without thought and
planning.
Robert Forrest
> -----Original Message-----
> From: clinical biochemistry discussion list
> [mailto:[log in to unmask]]On Behalf Of Eric Hindle
> Sent: 16 January 2003 12:23
> To: [log in to unmask]
> Subject: Requesting by nurses
>
>
> I appear to be getting quite a few enquiries to ask if nurses are
> premitted
> to make requests for pathology investigations. This seems to be due to the
> increasing numbers of nurse practitioners and nurse consultants. In the
> past I have agreed for some named practice nurses running CHD
> prevention, 'statin recall', 'thyroid recall' clinics etc and within the
> hospital the surgical pre-assessment clinics to make requests, on the
> understanding that they are working to protocol. Now the A/E staff have
> approached me.
>
> I would be interested to know how others are dealing with what I would
> imagine is not an uncommon scenario and are there any medico-legal issues?
> There may be fears that work load could go up, but maybe it would come
> down!
>
> Any views?
>
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