This handbook provides information for nurse prescribers in a highly condensed format, following the style of previous Oxford Handbooks. The Introduction, What is a nurse prescriber?, is followed by main sections headed: Principles, Practice, Accountability and Responsibilities, bringing together elements of healthcare policy, nursing practice and prescribing practice with some anatomy, physiology and principles of pharmacology. Almost half of the book (175 of 406 pages) is devoted to ‘Medical conditions’, which reads as if it is based on education provided to equip District Nurses and Health Visitors to prescribe from the first Nurse Prescribers' Formulary. Much of the remaining text draws heavily on the British National Formulary, various Department of Health publications and Nursing & Midwifery Council documents. Indeed, the greatest strength of the handbook lies in its provision of references to such material and to authoritative texts and sources of evidence that inform prescribing practice.
This strength is offset, however, by a number of weaknesses that compromise the value of the work as a whole. For example, under pharmacodynamics (pp 40–41), partial agonists are included as antagonists, definitions of antagonists are imprecise and coverage of enzymes as targets for drug action is scant. In the pharmacokinetics section (pp 49–50), volume of distribution is explained poorly as being calculated from the drug concentration in the blood. Only on the following page, following a section on prescribing for the extremes of life, is there a clear and accurate equation for the calculation of volume of distribution. Such weaknesses in basic science cause concern, because the handbook appears to be designed as an aide memoir for novice nurse prescribers whose pharmacological knowledge may not be strong. The bullet-pointed lists are not sufficiently informative or explanatory to serve as primary material for prescribing courses.
The coverage of policy and practice is generally much more secure than the pharmacology, but there is a significant error relating to computer-generated prescriptions in the statement that the patient's ‘second’ name (instead of surname) should be printed (p. 88). Under professional accountability (p. 108), the statement that the ‘prescriber must:’ is followed by the NMC principles for the administration of medicines, giving rise to a series of incongruous stipulations such as checking the expiry date on the label. The importance of concordance is given due attention (p. 72), but is also misused where adherence is meant, as in the statement that therapeutic drug monitoring can be used to check patient concordance with a regime (p. 49). Extensive cross referencing between sections would be more helpful if page numbers were given, and if repetition of material in different sections had been minimized.
Overall, the considerable potential of this handbook could have been realized more fully if its content had been aligned more carefully with the needs of its target readership, especially by strengthening the pharmacology and clinical pharmacology sections. In any new edition the ‘Medical conditions’ will need updating to reflect the full scope of nurse prescribing, the rapid expansion of which has clearly outpaced the production of this publication.