| Module Code: NUR3040 |
Module Title: COMMUNITY PRACTITIONER NURSE PRESCRIBING (NMC V100) |
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Module Provider: Health & Social Care
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Short Name: NUR3040
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Level: HE3
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Module Co-ordinator: HUTCHINSON K Mrs (HSC)
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Number of credits: 10
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Number of ECTS credits: 5
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| Module Availability |
| Semester 2 |
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| Assessment Pattern |
The assessment is designed to demonstrate the integrative nature of the learning and its application in practice. It consists of three parts:
a) An Examination 50% Weighting
The written examination will consist of a total of twenty, short answer and multi-choice questions (MCQ) to test pharmacological knowledge and its application to practice. If a registrant fails to correctly answer any question that may result in direct harm to a patient/ client they will be referred.
Date of examination 13.04.10 at 9.15
Pass mark: General paper 80% Numeracy paper 100%
b) Evidence of prescribing practice ` 50% Weighting
• A critical account of a prescribing incident, following the 7 steps of prescribing demonstrating understanding of ethical issues, legal issues, team working, record keeping, writing a prescription and numeracy – and how these apply to prescribing practice 1,500 words
• Two prescriptions relevant to the area of practice should be included.
Pass mark: 40%
c) Practice log
• A log of 18 hours of prescribing related practice
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| Module Overview |
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| Prerequisites/Co-requisites |
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| Module Aims |
Educational preparation for first level registered nurses with Specialist Practitioner Qualifications (SPQ) including Specialist Community Public Health Nurses (SCPHN).
This module is intended for nurses with specialist practitioner qualifications (SPQ) and registered Specialist Community Public Health Nurses (SCPHN), to equip them with the principles of prescribing to enable them to be safe, effective and cost-effective prescribers,
in a primary care setting.
The module also aims to enable students to understand the principles of good prescribing, the law relating to prescribing, their accountability in prescribing and to understand the pharmacokinetics and pharmacodynamics of drugs. It will also enable participants to become familiar with the nurse prescribing formulary and to be aware of current developments in nurse prescribing in the UK.
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| Learning Outcomes |
Subject knowledge and understanding
• Understand and apply the legislative framework to nurse prescribing
• Demonstrate knowledge of clinical pharmacology and apply knowledge of drug actions in prescribing practice
• Demonstrate knowledge and skills in prescribing for children
• Understand the influences that can affect prescribing practice in an ethical way
Cognitive skills
• Make decisions on management of presenting conditions, and consider whether to prescribe or not
• Critically appraise, use sources of information/advice, and decision support systems that are used in prescribing practice
Practical skills
• Assess and consult with patient/clients, clients, patients and carers
• Undertake a thorough history, including medication history and all forms of current medication to inform diagnosis
• Prescribe safely, appropriately and cost effectively
• Practice within a framework of professional accountability and responsibility
• Work collaboratively within a multi-professional team in the prescribing, supplying and administering of medicines.
Key / transferable skills
• Provide advice to patients/client on effects and risks
• Provide lifestyle advice in the context of prescribing
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| Module Content |
Consultation, decision making and therapy, including referral
• Assessment, history taking, communication and consultation with patients/clients and their parents/carers
• Developing management plans
• Diagnosis
• Prescribing and not prescribing, non drug treatment and referral for treatment
• Numeracy and drug calculations
Influences on and psychology of prescribing
• Patient/client demand and preference vs patient/client need – knowing when to say, “No”
• External influences eg companies and colleagues
• Patient/client partnerships in medicine-taking, including awareness of cultural and ethnic needs
• Concordance as opposed to compliance
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
Clinical pharmacology, including the effects of co-morbidity
• Anatomy and physiology as applied to prescribing practice and community practitioner formulary
• Basic principles of drugs to be prescribed- absorption, distribution, metabolism and excretion, including adverse drug reactions (ADR)
• Interactions and reactions
• Patient/client compliance, concordance and drug response
• Impact of physiological state on drug responses and safety eg in elderly people. Neonates, children and young people, pregnant or breast feeding women
Evidence-based practice and clinical governance in relation to nurse prescribing
• Rationale, adherence to and deviation from national and local guidelines, protocols, policies, decision support systems and formulae
• 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
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
• Safe-keeping of prescription pads, action if lost, writing prescriptions and record keeping
• Awareness of 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
Personal accountability and responsibility
• The NMC code of professional conduct, standards for conduct, performance and ethics
• NMC Standards for prescribing practice
• 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
Prescribing in the public health context
• Duty to patients/clients and society
• Inappropriate use of medication including misuse, under-use and over-use
• Inappropriate prescribing, over-prescribing, and under-prescribing
• Access to health care provision and medicines
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| Methods of Teaching/Learning |
Taught: 18 hours
Self directed study: 82 hours
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| Selected Texts/Journals |
Association for the British Pharmaceutical Industry (ABPI) (2006) Code of Practice for the Pharmaceutical Industry ABPI Free copy available or view on line at www.abpi.org.uk
Beauchamp T. & Childress J. (1994) Principles of Biomedical ethics (4th edn) Oxford University Press, Oxford
Blenkinsopp, A and Paxton, P (1998) Symptoms in the Pharmacy: A guide to the management of common illness. (3rd edn) Blackwell Scientific, Oxford
British Medical Association/Royal Pharmaceutical Society, Most recent version of British National Formulary (BNF) British Medical Association/Royal Pharmaceutical Society, London or view on line at www.bnf.org
* British Medical Association/Royal Pharmaceutical Society of Great Britain, in association with Community Practitioners’ and Health Visitors’ Association and Royal College of Nursing (2009-2011) Nurse Prescribers’ Formulary (NPF) British Medical Journal Group and Royal Pharmaceutical Society of Great Britain, London Provided
* British Medical Association/Royal Pharmaceutical Society Most recent edition The British National Formulary for Children www.bnfc.org
* Clyne W. Granby T & Picton C (2007) A competency framework for shared decision making with patients [on line] NPC plus, Liverpool Available from www.npc.co.uk
* Courtenay, M and Butler, M (1999) Nurse Prescribing Principles and Practice.
Greenwich Medical Media, London or view on line through UniS library
Courtenay M. (2008) Nurse prescribing, policy, practice and evidence base British Journal of Community Nursing 13 12 pp 563 – 566
Department of Health (1986) Neighbourhood Nursing: A Focus for Care
HMSO, London
Department of Health (1989) Report of the Advisory Group on Nurse Prescribing HMSO, London
Department of Health (2004) National Service Framework for Children, Young People and Maternity Services DH, London
Department of Health (2004) Every Child Matters The stationery Office, London
Dimond, B. (2005) Legal Aspects of Nursing (4th edn) Pearson Longman, Harlow
Humphries J. and Green J. (2002) Nurse Prescribing (2nd ed) Macmillan, London
Hopkins S. (1999) Drugs and Pharmacology for Nurses Churchill Livingstone, Edinburgh
Luker K. & Kenrick M. (1992) An exploratory study on the sources of influence on the clinical decisions of community nurses Journal of Advanced Nursing, 17 457-466
NMC (2008) Standards for Medicines Management. NMC, London available on line
Nursing and Midwifery Council (2008) Standards for Medicines Management Nursing and Midwifery Council, London
Nursing and Midwifery Council (2006) Standards of proficiency for nurse and midwife prescribers. Nursing and Midwifery Council, London
Nursing and Midwifery Council (2008) The Code Standards of conduct, performance and ethics for nurses and midwives. Nursing and Midwifery Council, London
Nursing and Midwifwery Council (2009) Guidelines for records and record keeping. Nursing and Midwifery Council, London
Royal College of Nursing (1990) The Dynamic Standard Setting System RCN, London
Trounce J. (1999) Clinical Pharmacology for Nurses Churchill Livingstone
While A. & Rees K. (1993) The knowledge base of health visitors and district nurses regarding products in the proposed formulary for nurse prescription
Journal of Advanced Nursing 18 1573-1577
USEFUL WEBSITES
www.abpi.org.uk
* www.bnf.org
www.drugtariff.com
www.dh.gov.uk/nonmedicalprescribing
www.npc.co.uk (National Prescribing Centre. Contains resources)
www.npa.co.uk (National Pharmacy Association)
www.ic.nhs.uk/psu (Prescribing support unit. Information on popular drugs and costs and a report on nurse prescribing from 1998 – 2001)
www.druginfozone.nhs.uk (Now accessed via National Electronic Library for Medicines)
www.mhra.gov.uk (Medicines and Healthcare Products Regulatory Agency. Contains information on the legal framework covering prescribing)
www.medicines-partnership.org
www.prodigy.nhs.uk
www.bandolier.co.uk
Prescribing for children
www.bnfc.org
www.rcpch.ac.uk/publications (Royal College of Paediatrics and Child Health)
www.sign.ac.uk
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| Last Updated |
| 29TH JULY 2010 |
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