NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING (V300) - 2019/0
Module code: NURM129
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.
School of Health Sciences
BROOKS Susan (Health Sci.)
Number of Credits: 30
ECTS Credits: 15
Framework: FHEQ Level 7
JACs code: B700
Module cap (Maximum number of students): N/A
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 M( Masters) level. 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.
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|
|Pass/Fail competencies||PART A - PORTFOLIO||Pass/Fail|
|Coursework||PART B - REFLECTION||33|
|Coursework||PART B - CRITICAL DRUG ANALYSIS||33|
|Coursework||PART B - SUPPLEMENTRAY PRESCRIBING ESSAY||34|
Not applicable 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 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:-
Part A Portfolio-Pass/Refer/Fail
Part B Portfolio-Reflective essay, critical drug analysis, supplementary prescribing essay-all 40% and 100% of module grade
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.
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)
- 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.
|001||Critically 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 in-depth understanding of the ethical dimensions of prescribing||CPT|
|004||Demonstrate a critical 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)||KCP|
|012||Demonstrate critical 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||CP|
|014||Make a contribution to their portfolio as lifelong learners.||P|
C - Cognitive/analytical
K - Subject knowledge
T - Transferable skills
P - Professional/Practical skills
Overall student workload
Personal Tutorial Hours: 6
Workshop Hours: 8.5
Clinical Placement Hours: 90
Independent Study Hours: 48
Lecture Hours: 110
Practical/Performance Hours: 3
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 for NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING (V300) : http://aspire.surrey.ac.uk/modules/nurm129
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.