INDEPENDENT/SUPPLEMENTARY PRESCRIBING (NMC/HCPC V300) - 2019/0
Module code: NUR3325
The independent and supplementary prescribing V300 module provides an exciting and challenging opportunity for nurses, midwives, physiotherapists, therapeutic and diagnostic radiographers, dietitians and podiatrists to support and improve clinical outcomes for patients.
The independent and supplementary prescriber may prescribe any medicine, within national and local guidelines for any condition within the practitioner’s area of expertise and competence. (dietitians and diagnostic radiographers practising as supplementary prescribers only). This module is designed to provide these health care professionals (HCPs) with the knowledge and skills to prescribe safely and appropriately within their area of practice and current non-medical independent and supplementary prescribing legislation.
Successful completion of the module will empower these HCPs to improve access to appropriate medication in a timely manner in line with the NHS Five Year Forward View (NHS England, 2014 and 2017)
It will facilitate inter-professional working, maximising the benefits for patients and support for
healthcare services identified in the Multi-professional framework for advanced clinical practice in England (NHS England, NHS Improvement, Health Education England, 2017).
On successful completion of all aspects of the module, the University will inform the NMC/HCPC that the student is eligible to register their qualification. This must be done within 12 months of completion. The qualification must be completed within two years of starting the programme.
The length of the programme will be 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.
School of Health Sciences
BROOKS Susan (Health Sci.)
Number of Credits: 30
ECTS Credits: 15
Framework: FHEQ Level 6
Module cap (Maximum number of students): N/A
Prerequisites / Co-requisites
- be registered with Nursing and Midwifery Council/ Health and Care Professions Council
- be professionally practising in an environment where there is an identified need for the individual to regularly prescribe
- be able to demonstrate support from their employer/sponsor (unless self-employed)
- have identified:
- For nurses and midwives, the practice supervisor and practice assessor must be 2 different people (NMC, 2018) unless exceptional circumstances apply.
- Nurses and Midwives must have been qualified for a minimum of a year,
- Physiotherapists, podiatrists, and therapeutic radiographers, dietitians and diagnostic
- evidence of a DBS check or a signed statement of good character
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
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
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)
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 type||Unit of assessment||Weighting|
|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|
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
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 supervisor/practice assessor (NMC students) or practice educator (HCPC) 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 supervisor/practice assessor (NMC students) or practice educator (HCPC). 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 - Pass/Fail (100% pass mark)
- Pharmacology exam - Pass/Fail (80% pass mark)
- Part A Portfolio - Pass/Fail
- Part B Portfolio -
- PART B - REFLECTION - 33% module credit weighted (40% pass mark)
- PART B - CRITICAL DRUG ANALYSIS - 33% weighted (40% pass mark)
- PART B - SUPPLEMENTRAY PRESCRIBING ESSAY - 34% weighted (40% pass mark)
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 supervisor/practice assessor (NMC students) or practice educator (HCPC).
A recording of the discussion after the OSCE will be submitted on CD or memory stick.
The supervisor/practice assessor (NMC students) or practice educator (HCPC) will give formative feedback on at least one practice OSCE prior to assessment.
- 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.Â Professionally develop students in the higher education context of lifelong learning
|005||Assess the patient Undertake a thorough history, including medication history and current medication (considering OTC, alternative and complementary therapies) to inform diagnosis||KCPT|
|006||Consider the options Understand the influences that can impact on prescribing.||CPT|
|007||Reach a shared decision Critically appraise, use sources of information/advice and decision support systems in prescribing practice including clinical management plans where appropriate.||KCPT|
|008||Prescribe Understand and apply knowledge of drug actions in prescribing practice and monitor response||KC|
|009||. Provide information Assess, consult and communicate information to patients/clients, parents and carers.||KCPT|
|010||Monitor and review Monitor and respond to drug actions and recognise unsafe practice/systems acting accordingly.||KCPT|
|011||Prescribe safely Prescribe safely, appropriately and cost effectively||CP|
|012||Prescribe professionally Practise within a framework of professional accountability and responsibility in relation to the relevant legislation for the registered health care professional body.||CPT|
|013||Improve prescribing in practice Use clinical supervision and reflective practice to critically analyse and evaluate their ongoing performance as independent prescribers and continuing professional development||KCPT|
|014||Prescribe as part of a team Demonstrate an understanding of the roles and responsibilities of others involved in prescribing, supplying and administering medicines and the need for inter-professional working and shared decision making. (C,KT,P)||KCPT|
C - Cognitive/analytical
K - Subject knowledge
T - Transferable skills
P - Professional/Practical skills
Overall student workload
Personal Tutorial Hours: 6
Workshop Hours: 8
Clinical Placement Hours: 90
Independent Study Hours: 48
Lecture Hours: 110
Practical/Performance Hours: 3
Methods of Teaching / Learning
The learning and teaching strategy is designed to utilise innovative and creative approaches to learning.
The module utilises blended learning technologies such as computer assisted learning on the Surrey Learn platform. This provides the flexibility to maximise the student experience, using face to face teaching and self-directed work. This will encourage the student to gain key transferrable skills, such as information literacy to support learning in their area of practice.
The concept of inter-professional learning is integral to the teaching and learning strategy of the module and the students will be taught in multi-professional groups.
The learning and teaching methods include:
A variety of learning and teaching strategies which 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 and Formative Objective Structured Clinical Examinations (OSCEs), to develop confidence in assessment and decision making.
- Supervised learning in practice, supported by the practice supervisor
- Assessment in practice from a practice assessor/educator
- Assessment: a) Written final examination (MCQ)
b) Numeracy assessment plus Portfolio Part A and Part B
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 for INDEPENDENT/SUPPLEMENTARY PRESCRIBING (NMC/HCPC V300) : http://aspire.surrey.ac.uk/modules/nur3325
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 2019/0 academic year.