The University of Southampton
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HLTH6108 Independent and supplementary Prescribing: Prescribing in Practice

Module Overview

This module focuses on the professional aspects of prescribing practice. In conjunction with the module Pharmacology and Applied Clinical Science for Prescribing and Advanced Medicines Management it comprises the HEI level 7 Independent and Supplementary Prescribing Programme. To register as an Independent and/or Supplementary Prescriber students must therefore successfully complete both modules. Completion of both modules is normally required within one academic year. As stipulated by the Health Care Professions Council (HCPC), the Allied Health Professions Federation (AHPF) and the Nursing and Midwifery Council (NMC) (HCPC 2013, AHPF 2013, NMC 2006) 12 days (12 X 6.5 hours for nurses, 12 x 7.5 hours for AHPs) supervised support from a Designated Medical Practitioner (DMP) is required for students undertaking this module. Students are required to fulfil all current professional and Department of Health requirements for course entry. Students must be employed in a clinical role and provide evidence of competence in assessing the client group with which they work.

Aims and Objectives

Module Aims

To enable students to complete their preparation to become Independent and/or Supplementary Prescribers. The outcomes for this module incorporate a number of the learning outcomes for Independent and Supplementary Prescribing for Nurses and Allied Health Professionals (NMC 2006, HCPC 2013, AHPC 2013) (Appendix 2)

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • Demonstrate the ability, using a range of assessment and consultation skills, to undertake and use a detailed and thorough client history/interview (which includes past and current medication) to inform diagnosis and promote concordance and adherence.
  • Demonstrate an extensive knowledge of drug actions and the ability to critically apply this knowledge with initiative, and originality, to the development of individual clinical/ medicines management plans,
  • Discuss in depth the application of relevant legislation to the practice of prescribing and practice within a framework of professional accountability and responsibility; acting as a role model for others
  • Critically analyse the influences on prescribing practice including diverse and complex sources of information/advice and decision support.
  • Demonstrate the ability to manage the implications of ethical dilemmas, and work proactively with others involved in prescribing, supplying and administering medicines to formulate solutions while prescribing safely, appropriately and cost effectively.

Syllabus

Summary of Indicative Syllabus/Module Content The indicative content is guided by the required content for Nurse and AHP Independent/Supplementary Prescribing (NMC 2006, HCPC 2013, AHPC 2012) Influences on, and psychology of, prescribing • How to build and maintain an effective relationship with patients and carers taking into account their values and beliefs. • Patient/client demand, and preference versus patient/client need – knowing when to say ‘no’ • Personal attitudes and their influences on prescribing practice. • External influences, at individual, local and national levels e.g. companies or colleagues • Patient/client partnership in medicine-taking, the patient choice agenda, including awareness of cultural and ethnic needs • concordance as opposed to compliance • Explaining why medication has been prescribed, side effects and other relevant information to enable patient choice and achieve a shared understanding in order to negotiate a plan of action. Prescribing in a team context • Understanding the role and functions of other team members, including: 1. Accurate, effective communication and team working with other prescribers and members of the health care team. 2. Documentation, with particular reference to communication between team members, including electronic prescribing and Interpretation of documentation including medical records, clinical notes and electronic health records. 3. The importance of communicating prescribing decisions with all those involved in a patient’s care including the GP. • How to manage the interface between multiple prescribers and recognise the potential conflict and how that might be managed. • The professional relationship between independent prescriber/supplementary prescriber and all prescribers involved in the patient’s care, those responsible for dispensing and the patient’s GP. • Auditing, monitoring and evaluating prescribing practice • The financial considerations of prescribing: national and local policy/guidance, budgetary constraints at local and national level, and cost effectiveness • Dispensing practice issues Principles of Evidence-based practice and clinical governance in relation to prescribing • Continuing professional development - role of self and role of the organisation • Management of change, including impact of changes in area/scope of practice. • Risk assessment and management, including safe storage, handling and disposal • Clinical supervision • Reflective practice/peer review • Critical appraisal skills • Auditing, monitoring, scrutinising and evaluating prescribing systems and practice including the use of outcome measures • Prescribing controlled drugs • Prescribing and administering • Prescribing and dispensing Legal, policy and ethical aspects • Legal basis for independent prescribing practice, liability and indemnity • Legal basis for prescribing, supply and administration of medicines. • Legal basis and safe practice for storage, dispensing and disposal of medicines. • Legal and regulatory aspects of controlled drugs and the practical application of these. • Legal implications of advice to self-medicate including the use of alternative therapies, complementary therapy and over-the-counter (OTC) medicines • Medicines regulatory framework including Marketing Authorisation, the use of unlicensed medicines and “off-label” use - Drug licensing • Manufacturer’s guidance relating to literature, licensing and off-label • Issues related to prescribing botulinum toxin and related products • Prescription pad security, procedures if lost, or stolen • Writing prescriptions in a range of settings including private prescriptions • Record keeping, documentation and professional responsibility • Suspicion, awareness and reporting of fraud (recommendations from the Shipman Inquiry, Fourth Report), or criminal behaviour, knowledge of reporting and ‘whistle blowing’ procedures. • Yellow Card reporting to the Committee of Safety on Medicines (CSM) and reporting patient/client safety incidents to the National Patient Safety Agency (NPSA) • Prescribing in the policy context • Ethical basis of intervention • Informed consent, with particular reference to client groups in learning disability, mental health, children, critically ill people and emergency situations • Confidentiality, Caldicott and Data Protection. • IT developments and their impact on prescribing including electronic patient records and e-prescribing • Legal implications and their application to supplementary prescribing Professional accountability and responsibility • Professional judgement in the context of the NMC and HCPC codes of conduct and professional body practice guidance; • NMC and HCPC standards for prescribing practice • Roles and responsibilities in respect of prescribing including the recommendations of the Fourth Report of the Shipman Inquiry on controlled drugs and other relevant reports such as the report of the Airedale Inquiry. • Ethical recommendations from the Shipman Inquiry, Fourth Report • Accountability as an independent/supplementary prescriber and responsibility for assessment, diagnosis and prescribing • Recognising personal limitations including the limits to personal scope of practice and working autonomously. • Maintaining professional knowledge and competence in relation to prescribing and the conditions for which the prescriber may prescribe: negotiating support for this • Accountability and responsibility to the employer or commissioning organisation in the context of prescribing • Prescribing in the context of the local health economy. Prescribing in the public health context • Duty to patient/clients and society • Access to health care provisions and medicines • Prescribing in its broadest sense, eg. exercise

Learning and Teaching

Teaching and learning methods

The module will be delivered using a work based/blended learning approach. You will be supported in your learning by tutorial support from a member of the prescribing team, through the use of electronic resources and by a Designated Medical Prescriber (DMP) in practice. Through a process of self-analysis and evaluation you will be expected to identify areas in which you are already competent, and those which require further learning and development. Using a comprehensive, detailed and clearly defined learning contract, you will be expected, in conjunction with your DMP, to plan your learning so that on completion of the module you are able to meet each of the learning outcomes and the relevant practice. This contract will be agreed with the module lead. You will also take part in Lectures Case based learning The use of technology to enhance learning Collaborative sharing of clinical practice and experiential learning.

TypeHours
Lecture12
Wider reading or practice2
Wider reading or practice62
Completion of assessment task96
Tutorial2
Work based learning78
Total study time252

Resources & Reading list

British Medical Association and Royal Pharmaceutical Society of Great Britain (2011). British National Formulary & or BNF for Children. 

Medicines Adherence: Involving Patients in decisions about prescribed medicines and supporting adherence. NICE clinical Guidelines 76.

Outline Curriculum Framework for Education Programmes to Prepare Physiotherapists and Podiatrists as Independent/Supplementary Prescribers and to Prepare Radiographers as Supplementary Prescribers.

Interventions for enhancing medication adherence.. ,Issue 2. Art. No CD000011 , pp. 0.

Signposts for prescribing nurses – general principles of good prescribing.

Safety in Doses: Medications safety incidents in the NHS..

Seedhouse, D. (2009). Ethics: The Heart of Health Care. 

Adherence to Long-Term Therapies: Evidence for Action. Geneva.

A Single Competency Framework for all Prescribers.

Promoting Safety of Medicines for Children, World Health Organisation.

Standards of Proficiency for Nurse and Midwife Prescribers..

Dimmond, B (2011). Legal Aspects of Medicines. 

Standards for Prescribing Available.

Assessment

Formative

Assessment of Practice

Summative

MethodPercentage contribution
Portfolio of Learning 100%

Referral

MethodPercentage contribution
Assessment of Practice %
Designated Medical Supervisor’s Intermediate and Final Report %
Drug calculation examination %
Portfolio of Learning 100%

Repeat Information

Repeat type: Internal & External

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