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The University of Southampton
Courses

HLTH6219 Pharmacology and prescribing in clinical practice

Module Overview

On successful completion of the module, practitioners are eligible to register as an independent and/or supplementary prescriber in accordance with current professional standards and regulations. Please see special features section below for detailed entry requirements. Students are required to fulfil all current professional requirements for course entry in accordance with the Nursing and midwifery council (NMC) 2018, and the Health and Care Professions Council (HCPC 2013) and will normally have completed the History taking and Physical Assessment and Diagnostic Assessment and Decision Making modules, or equivalent prior to commencing programme Nurses, Midwives will normally be qualified for three years, and working in the area in which they will be prescribing for at least one year, prior to commencing the module. AHPs are required to be working in the area where they will prescribe for 3 years (HCPC) Paramedics are required to be qualified for five years and have undertaken or are working towards an advanced practice qualification (as defined by Health Education England, usually an MSc) (College of Paramedics 2018, annex F). Nurses and midwives must have a Practice Supervisor and Practice Assessor (NMC Standards for Student Supervision and Assessment 2018). The supervisor would normally be a medical prescriber, a pharmacist independent prescriber or an experienced Nurse Independent Prescriber working in a similar area of practice, who holds an MSc level qualification. The practice assessor would normally be a medical doctor. AHPs are required to have a designated prescribing practitioner (DPP) in practice who facilitates 12 days (90) hrs learning in practice. This time can also be spent with experienced pharmacists and NMPs while retaining the DPP as the key assessor. All practice supervisors and practice assessors will be invited to an introduction to programme, to develop an understanding of the programme, the programme outcomes, their role as a practice supervisor and/or practice assessor, and to support them in practice. This will also be an opportunity to engage with other practice supervisors and practice assessors and share experiences. For those who are unable to attend there will be access to Blackboard for information, and a podcast of the introduction session available. All relevant course materials and programme handbook will be emailed to them prior to course commencement. Support for their role can be offered, on an individual basis, if required. University policy/ placement guidelines apply.

Aims and Objectives

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • Demonstrate a comprehensive knowledge of pharmacology and related clinical sciences and critically apply this to your assessment and management of patients/clients
  • Critically evaluate the evidence underpinning the prescribing of drugs in their area of practice, and demonstrate expertise in applying this knowledge to prescribing practice and/or medicines management.
  • Apply advanced consultation and assessment skills to undertake a comprehensive client history, assessment, and diagnosis, in your area of practice.
  • Demonstrate an understanding of professional, legal accountability in prescribing and apply a critical ethical dimension to practice, working with others to formulate solutions
  • Undertake a patient centred approach to prescribing, including shared decision making, information sharing, monitoring and reviewing, to promote a concordant partnership.

Syllabus

Summary of Indicative Syllabus/Module Content, where applicable. The indicative content is guided by the required content for Nurse and AHP Independent/Supplementary Prescribing (NMC 2018, HCPC 2016, OCF 2018) 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: • 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. • 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

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 Supervisor 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 DPP/Supervisor, 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
Placement Hours90
Teaching57
Independent Study103
Total study time250

Resources & Reading list

Dimmond, B (2015). Legal Aspects of Medicines (2nd Edition). 

Neal, M (2015). Medical Pharmacology at a Glance. (8th edition). 

Ritter JM, Flower R, Henderson G, Loke YK, MacEwan D and Rang HP (2019). Rang and Dale’s Pharmacology (9th ed.). 

Pharmaceutical Press. British National Formulary (BNF and/or BNFc) Current edition. 

Seedhouse, D. (2009). Ethics: The Heart of Health Care (3rd Edition). 

Preston, CL (2015). Stockley's Drug Interactions Pocket Companion. 

Assessment

Assessment Strategy

Formative assessment Pharmacology exam: - MCQ - Short answer questions Summative assessment Part 1: Pharmacology exam (2.5 hours) (A) Multiple choice questions designed to test pharmacological knowledge and short answer questions to test pharmacology knowledge and application to professional practice. Pass mark 80%. Weighting 60% (B) A compulsory seen question, given to students a minimum of 4 weeks prior to exam. Pass mark 50%. Weighting 40% Part 2: Numeracy exam (30 mins) Drug calculations. Pass mark 100% Part 3: Portfolio Comprising of: (A) Signed off completed Royal Pharmaceutical Society (RPS 2016) competency document (B) A personal formulary (C) A log of 90 hours supervised learning in practice (D) A clinical management plan (E) Two completed patient/user/carer surveys

Formative

Exam

Summative

MethodPercentage contribution
Exam  (2.5 hours) 100%
Exam 
Portfolio 

Referral

MethodPercentage contribution
Exam  (2.5 hours) 100%
Exam  ( minutes)
Portfolio 

Repeat Information

Repeat type: Internal & External

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