NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING (V300) - 2018/9

Module code: NUR3214

Module Overview

The Non-Medical Prescribing Module provides an exciting and challenging opportunity for Nurses and Midwives to expand their roles to meet the needs of their patients and service to improve access to appropriate medication.

This module is designed to provide the practitioner with the knowledge and skills to prescribe safely and appropriately within their area of practice and current non-medical prescribing legislation.

On successful completion of all aspects of the module, the University will inform the NMC that the student is eligible to register their qualification. This must be done within 12 months of successful completion. The qualification must be completed within two years of starting the programme.

The length of the programme will a minimum of 26 days, with an additional 12 days of supervised learning in practice. All registrants must undertake both independent and supplementary elements of the programme.

Module provider

School of Health Sciences

Module Leader

BROOKS SF Mrs (Health Sci.)

Number of Credits: 30

ECTS Credits: 15

Framework: FHEQ Level 6

JACs code: B700

Module cap (Maximum number of students): N/A

Module Availability

Year long

Prerequisites / Co-requisites

  Students must provide evidence that they have met the NMC’s criteria for eligibility to undertake a nurse independent / supplementary prescribing programme.  The criteria are: They must be a registered first-level nurse, midwife and/or specialist community public health nurse.They must have a least three years experience as a practising nurse midwife or specialist community public health nurse and be deemed competent by their employer to undertake the programme.  Of these three years, the year immediately preceding application to the programme must have been in the clinical field in which they intend to prescribe, e.g. neonates, mental health.  Part-time workers must have practised for a sufficient period to be deemed competent by their employer. They must provide evidence of their ability to study at Level 6 (degree).   In addition there must be written confirmation from: The employer, to support the student to undertake the module of study. An appraisal of the student’s suitability to prescribe before they apply for a training place must be undertaken by their employer (NMC  2006:10) The module leader, confirming acceptance onto the module A designated medical practitioner who meets eligibility criteria for the supervision of nurse prescribers (NPC 2005) and who has agreed to provide the required term of supervised practice The employer, who is responsible for ensuring the applicant meets specific NMC criteria (NMC 2006:10) including competence in diagnosis and physical assessment and appropriate numeracy skills.

Module content

 

The content is presented within eight themes related to prescribing:

 Consultation, decision making and therapy, including referral

Models of consultation

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

Prescribe, not to prescribe, non-drug treatment or referral for treatment

Numeracy and drug calculations

Stopping medication prescribed by others

Medicines review.

 

Influences on, and psychology of, prescribing

Patient/client demand, and preference v s patient/client need − knowing when to say “no”

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 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

Pharmacology, including pharmaco-dynamics, pharmaco-kinetics, pharmaco-therapeutics

Anatomy and physiology as applied to prescribing practice and community practitioner formulary

Basic principles of drugs to be prescribed, e.g. 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, for example, in elderly people, neonates, children and young people, pregnant or breast feeding women and those with impaired metabolism/organ function.

Pharmaco-therapeutics related to controlled drugs

All drugs from the BNF, using a systems approach will be included with particular emphasis on the cardiovascular, respiratory, neurological and endocrine systems.

 

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; identifying and reporting adverse drug reactions and near misses

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

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 on Human Medicine 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, 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 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 patient/clients and society

Policies regarding the use of antibiotics and vaccines

Inappropriate use of medication, including misuse, under-use and over-use

Inappropriate prescribing including over-prescribing and under-prescribing

Access to health care provisions and medicines

Prescribing in its broadest sense, e.g. exercise.

Assessment pattern

Assessment type Unit of assessment Weighting
Examination NUMERACY EXAM Pass/Fail
Examination PHARMACOLOGY EXAM - 90 minutes Pass/Fail
Pass/Fail competencies PART A - PORTFOLIO Pass/Fail
Coursework PART B - REFLECTION 33
Coursework PART B - CRITICAL DRUG ANALYSIS 33
Coursework PART B - SUPPLEMENTARY PRESCRIBING ESSAY 34

Alternative Assessment

N/A Numeracy exam-100% Pharmacology exam-80% Part A Portfolio of Practice Evidence-Pass/Refer/Fail Part B Portfolio-Reflective essay, critical drug analysis, supplementary prescribing essay-all 40% and 100% of module grade

Assessment Strategy

The assessment strategy is designed to provide students with the opportunity to demonstrate competency in safe and effective prescribing through achievement of passing the numeracy and pharmacology examinations. In addition, the students will demonstrate their knowledge through assessment in practice. This will:-


Enable the student and the designated medical practitioner (DMP) to chart the student’s continuous assessment and progress throughout the period of supervised practice
Record the assessment of the competence and safety of the student in the practice of independent and supplementary prescribing
Provide evidence of the student’s ability to base their practice on the underlying theoretical components of the module.


Thus, the summative assessment for this module consists of:

A summative assessment undertaken towards the end of the module showing competence in each area of practice and an OSCE-signed by the DMP. A recording of the discussion after the OSCE will be submitted on CD or memory stick.

In addition, the University will set and mark:-

Numeracy exam-100%

Pharmacology exam-80%

Part A Portfolio-Pass/Refer/Fail

Part B Portfolio-Reflective essay, critical drug analysis, supplementary prescribing essay-all 40% and 100% of module grade

 

Formative assessment

A formative assessment undertaken within the first 4 weeks of the module, showing the level of competence against each area of practice as students start the module- signed by the DMP

The DMP will give formative feedback on at least one practice OSCE prior to assessment.

 

Feedback

Draft reflective logs will be discussed with personal tutors and verbal feedback given to develop the writing.

Written feedback will be given by personal tutors after receipt of drafts prior to submission of Portfolio section B (3 x 1500 word essays)

Module aims

  • Prepare nurses, midwives and specialist community public health nurses to independently prescribe safely, appropriately and cost effectively, licensed drugs from the British National Formulary and to act as supplementary prescribers.  Professionally develop students in the higher education context of lifelong learning

Learning outcomes

Attributes Developed
001 Understand and apply the relevant legislation to the practice of nurse / midwife prescribing. KCP
002 Understand the influences that can impact on prescribing practice. CPT
003 Demonstrate an understanding of the ethical dimensions of prescribing. CPT
004 Demonstrate an understanding of the roles and relationships of others involved in prescribing, supplying and administering medicines. KCP
005 Critically appraise, use sources of information / advice and decision support systems in prescribing practice. KCPT
006 Understand and apply knowledge of drug actions in prescribing practice. KC
007 Assess and consult with patients / clients and parents / carers. KCPT
008 Undertake a thorough history, including medication history and current medication (including over-the-counter, alternative and complementary health therapies) to inform diagnosis. KCPT
009 Prescribe safely, appropriately and cost effectively. CP
010 Practise within a framework of professional accountability and responsibility. CPT
011 Develop a clinical management plan within legislative requirements. (Supplementary Prescribing only). CPT
012 Demonstrate an awareness of the need for cross-disciplinary working. KCP
013 Use clinical supervision to critically analyse and evaluate their ongoing performance as independent nurse prescribers. KCPT
014 Make a contribution to their portfolio as lifelong learners. KC

Attributes Developed

C - Cognitive/analytical

K - Subject knowledge

T - Transferable skills

P - Professional/Practical skills

Overall student workload

Methods of Teaching / Learning

 

A variety of learning and teaching strategies will be used in the delivery of the module, encompassing the following:

 

Enquiry-based learning, to develop critical thinking in e.g. legal, ethical and professional issues

Lectures by specialist professionals

Case studies/scenarios, to show the application of knowledge of drugs to clinical practice

Student-led seminars, to show the application of knowledge of drugs to clinical practice

Formative Objective Structured Clinical Examinations (OSCES), to develop confidence in assessment and decision-making in the practice setting

Supervised learning in practice, supported by the designated medical practitioner (DMP)

Self-directed workbooks for anatomy and physiology and specialist pharmacology

Indicated Lecture Hours (which may also include seminars, tutorials, workshops and other contact time) are approximate and may include in-class tests where one or more of these are an assessment on the module. In-class tests are scheduled/organised separately to taught content and will be published on to student personal timetables, where they apply to taken modules, as soon as they are finalised by central administration. This will usually be after the initial publication of the teaching timetable for the relevant semester.

Reading list

Reading list for NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING (V300) : http://aspire.surrey.ac.uk/modules/nur3214

Please note that the information detailed within this record is accurate at the time of publishing and may be subject to change. This record contains information for the most up to date version of the programme / module for the 2018/9 academic year.