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The University of Southampton

HLTH6138 Independent and Supplementary Prescribing Part 2: Prescribing in Practice - Neonatal

Module Overview

A module enabling experienced professionals to learn about prescribing in neonatal care.

Aims and Objectives

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 nurse/midwife 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.


The indicative content has been determined according to Department of Health (DH 2006) guidance and the Nursing and Midwifery Council specifications within the document ‘Standards of Proficiency for Nurse and Midwife Prescribers’ (NMC2006). Consultation, decision-making and therapy, including referral - Accurate assessment, history taking, communication and consultation with patients/clients and their parents/carers. - Concepts of working diagnosis or best formulation. - Development of a management plan and/or clinical management plan. - Confirmation of diagnosis/differential diagnosis - further examination, investigation, referral for diagnosis. - Medications review. Influences on, and psychology of, prescribing - Patient/client demand, and preference opposed to evidence based need – to prescribe or not to prescribe. - Other external influences, e.g. companies or colleagues. - Patient/client partnership in medicine-taking, including awareness of cultural and ethnic needs. - Concordance as opposed to compliance. - Achieving shared understanding and negotiating a plan of action. Prescribing in a team context - rationale, adherence to, and deviation from national and local guidelines, local formularies, protocols, policies, decision support systems and formulae - understanding the role and functions of other team members - documentation, with particular reference to communication between team members, including electronic prescribing - auditing, monitoring and evaluating prescribing practice - interface between multiple prescribers and management of potential conflict - budgets and cost effectiveness - dispensing practice issues Evidence-based practice and clinical governance in relation to prescribing - Continuing professional development - role of self and role of the organisation. - Management of change. - Risk assessment and management, including safe storage, handling and disposal. - Clinical supervision. - Reflective practice/peer review. - Critical appraisal skills. - Auditing practice and scrutinising data, systems monitoring. - Identify and report adverse drug reactions and near misses and learn from mistakes. - Prescribing controlled drugs. - Prescribing and administering. - Prescribing and dispensing. Legal, policy and ethical aspects - Sound understanding of legislation that impacts on prescribing practice. - Legal basis for practice, liability and indemnity. - Legal implications of advice to self-medicate including the use of alternative therapies, complementary therapy and over the counter (OTC) medicines. - issues related to prescribing botulinum toxin and related products - Safe-keeping of prescription pads, action if lost, writing prescriptions and record keeping. - Awareness and reporting of fraud (recommendations from the Shipman Inquiry, Fourth Report). - Drug licensing. - 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. - Manufacturer’s guidance relating to literature, licensing and off-label. - Ethical basis of intervention. - Informed consent, with particular reference to client groups in learning disability, mental health, children, critically ill people and emergency situations. - Legal implications and their application to supplementary prescribing. Professional accountability and responsibility - The NMC code of professional conduct; standards for conduct, performance and ethics. - NMC (2006) 21 Standards of proficiency for nurse/midwife prescribers. - Ethical recommendations from the Shipman Inquiry, Fourth Report. - Accountability and responsibility for assessment, diagnosis and prescribing. - Maintaining professional knowledge and competence in relation to prescribing. - Accountability and responsibility to the employer. In addition students will demonstrate the achievement of the NMC competencies.

Learning and Teaching

Teaching and learning methods

The module employs a range of learning approaches including key lectures, tutorials, on line resources, problem based learning activities, experiential learning, focused learning and collaborative sharing of practice and self-directed learning. A Designated Medical Practitioner (DMP) will facilitate practice learning for those working towards the prescribing qualification.

Wider reading or practice150
Completion of assessment task15
Preparation for scheduled sessions15
Follow-up work25
Total study time250

Resources & Reading list

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

A Single Competency Framework for all Prescribers.

Promoting Safety of Medicines for Children, World Health Organisation.

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

Nursing and Midwifery Council.

Signposts for prescribing nurses – general principles of good prescribing. 1(1), pg.1-4.

National Institute for Health and Clinical Excellence (2009). Medicines Adherence: Involving Patients in decisions about prescribed medicines and supporting adherence. NICE clinical Guidelines 76.. 

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

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

Standards of Proficiency for Nurse and Midwife Prescribers. 

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

British National Formulary & or BNF for Children Oxford.


Assessment Strategy

Referral Method: Linked with referral process on HLTH 6137


Personal Formulary


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

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