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Courses

NQCG3110 Independent and Supplementary prescribing: Prescribing in practice

Module Overview

This module, in conjunction with the module Applied pharmacology and medicines management comprises the HEI level 6 Independent and supplementary prescribing programme. To register as an Independent and/or Supplementary Prescriber students must, therefore, have successfully completed the afore mentioned module. Successful completion of both modules is normally required within two years. As stipulated by the Department of Health (DOH 2004, 2005 and 2006), and Nursing and Midwifery Council (NMC 2006), 12 days (12 X 6.5 hours) 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. You 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

This module, in conjunction with the module Applied pharmacology and medicines management comprises the HEI level 6 Independent and supplementary prescribing programme. To register as an Independent and/or Supplementary Prescriber students must, therefore, have successfully completed the afore mentioned module. Successful completion of both modules is normally required within two academic year. As stipulated by the Department of Health (DOH 2004, 2005 and 2006), and Nursing and Midwifery Council (NMC 2006), 12 days (12 X 6.5 hours) 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. You must be employed in a clinical role and provide evidence of competence in assessing the client group with which they work.

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

  • Demonstrate the ability to use consultation and assessment skills to undertake a comprehensive client history and assessment to inform diagnosis and to promote concordance.
  • Demonstrate knowledge of pharmacology and therapeutics and critically apply this knowledge to prescribing practice (including the use of Clinical Management Plans) to ensure safe and effective outcomes.
  • Critically analyse and evaluate sources of information which inform prescribing practice and influences on prescribing.
  • Discuss the roles and relationships of others involved in prescribing and identify strategies to ensure safety, efficacy and cost effectiveness in prescribing.
  • Identify effective frameworks for prescribing with reference to relevant legislation regarding legal, ethical and professional accountability.

Syllabus

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.

Special Features

DMPs will be contacted by the university team and provided with: Information regarding the programme and their role prior to start. All relevant course materials and DMP Handbook posted to them prior to course commencement. A group meeting is offered. Support for their role is offered on an individual basis. University policy/ placement guidelines apply. A member of the programme team will attend the systematic assessment of practice with the DMP. The DMP is the primary assessor.

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.

TypeHours
Completion of assessment task90
Tutorial6
Independent Study64
Lecture12
Placement Hours78
Total study time250

Resources & Reading list

Standards of Proficiency for Nurse and Midwife Prescribers..

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

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

Signposts for prescribing nurses – general principles of good prescribing. Prescribing Nurse Bulletin. ,1 , pp. 1-4.

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

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

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

Promoting Safety of Medicines for Children, World Health Organisation.

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

A Single Competency Framework for all Prescribers.

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

Assessment

Summative

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