Nurses: The agenda for change

Abstract

This paper highlights the level of expertise and ability of nurses to change the clinical approach of a multi-disciplinary team in service provision. This is in relation to improving a drug clinic’s outlook and care programme approach for alcohol. The senior nurses saw a gap in service provision for alcohol and, through conducting an audit and further qualitative research, they were able to identify which clinical approaches needed updating and ‘finetuning’ in the London borough of Islington, producing updated guidelines for the clinic. The results showed that there was a cohort of clients attending for treatment who had a dual problem with alcohol and drugs. This was often missed on the initial assessment form. From the audit and further local research, the assessment was changed, which improved the identification of an alcohol dependency so that an appropriate care plan could be draw up. From the qualitative study there was also a perceived resistance from the client group to address their alcohol dependency, and on being breathalysed when receiving a script for methadone. It was felt that the reasoning for this could be the clinical procedure was not being explained. However, what was identified from the clinical research was that this reasoning from the client group was unjustified with clear clinical reasons for this procedure being given to the client from the nursing staff. Importantly, this paper aims to illustrate the clinical development role nurses can play in improving care for services through evidence-based practice and development of updated guidelines. The guidelines produced from this work have, in turn, ensured better care for clients of the service.