Non-Medical Nurse Prescribing Essay

(DoH, 2005, p8). A diagnosis and treatment plan is agreed on by the independent prescriber and from this the supplementary prescriber can review and amend doses as seen appropriate with the patient. DoH (2005) initially suggested supplementary prescribing was more appropriate for a longer-term setting because an agreed CMP is required prior to prescribing. Nuttall & Rutt-Howard (2011) states many professionals often feel limited in supplementary prescribing as they are boundaried by the CMP. By adopting this outlook, patient’s presentations in the longer-term setting would then be classed as all being uncomplicated and predictable. DoH (2005) reports supplementary prescribing allows clinicians to develop their confidence. By understanding not all patients are the same and that complex cases are common, the supplementary prescriber can therefore exercise skills in observing and reviewing any changes in clients and report back to the independent prescriber in a safe manner and develop their

* Registers may only be kept electronically if safeguards are built into the software to ensure the following:

It should be made mandatory for the nurses to read back the documented prescription to the doctor. It should be signed by the doctor for confirmation after been reviewed by the druggist.

Whiles weighing Ella, I observed that Ella had red and inflamed rash on her face and in the creases of both hands. According to Beckwith and Franklin (2011), to prescribe safely a holistic assessment of the patient has to be completed and the seven steps of the prescribing pyramid was used which are ,examining the patient’s holistic needs, considering an appropriate strategy, considering a choice of product, negotiating a ‘contract’ and achieve concordance with the patient, reviewing the patients on a regular basis, ensuring all record keeping is both accurate and up to date and reflecting on your prescribing for future reference.(NPC, 1999) were used as a decision making

‘Independent prescribing is prescribing by a practitioner (e.g. doctor, dentist, nurse, and pharmacist) responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. In partnership with the patient, independent prescribing is one element of the clinical management of a patient. It requires an initial assessment, interpretation of that assessment, a decision on safe and appropriate therapy, and a process for ongoing management. The independent prescriber is

I feel it is important for the purpose of my scenario to acknowledge the new skills which I have acquired whilst undertaking the V150 and explain the background to Nurse Prescribing. The Cumberledge Report (DHSS, 1986) made the initial recommendations for nurses to

The role of a family nurse practitioner is a fundamental portion of the future of healthcare. The role is clearly not as understood by other healthcare professionals as needed which results in the disagreement if the role of a family nurse practitioner is even required for primary care. As people are getting older, the need for medical professionals that can provide patient care to our ever growing population increases. The need for the role of family nurse practitioners will grow too. The role of the family nurse practitioner, the ability of the FNP to be able to transition into their role.

The scope of practice for non-medical prescribers (NMP) has expanded greatly over the last 2 decades, with legislation now allowing NMP’s to prescribe from the whole BNF (with the exception of treatment in addiction and within the prescribers competency). Since the introduction of the Medicines Act in 1986 there have been over 15 different governmental reports and legislative changes (see Appendix 1 timeline) that have allowed for the development and growth of the NMP role. Initiated by The Cumberledge report of 1986 and followed by advisory group report in 1989 legislation was introduced with the Medicinal products: Prescription by nurses act of 1992 which allowed primary care nurses to prescribe from a limited formulary (V100 & V200). This advancement in legislation recognised previous recommendations and placed the improvement of patient care and effective use of resources at the core of its practice. However these acts did not reflect on other areas like secondary care or pharmacist and it wasn’t until 1998 The Crown Report and its second report published a year later that led to supplementary and independent prescribing (V300). In 2003 legislation was passed allowing some prescribing of controlled drugs in palliative care with restricted circumstances (amendment to Misuse of drugs Act 1971). In May 2006 nurses were empowered to prescribe from the whole BNF with the exception of some controlled drugs, and in 2009 further legislative changes were made to include the

Easy access to the drugs is another important factor contributing to nurses who substance abuse. As stated by Serghis (1999) the availability of medications in the workplace has been linked to substance abuse among nurses (as cited in Talbert, 2009, p.17). Part of the nurse’s duty every day is to give medication to their patients, which exposes them to have easy access to drugs. Nurses who take medication from their patients for their own personal use are "always using the maximum PRN dosage when other nurses use less" (DeClerk, 2008, p. 12). The healthcare field accepts the use of medication and so nurses may perceive the wrong idea by making use of patients drugs themselves. "Medications are easily accessible to nurses, who may believe erroneously that they have the ability to control their own medications use because of their experience with administering medication to patients" (Talbert, 2009, p. 17). In the case

The Medicines Act 1968:- The Medicines Act controls the manufacture and supply of medicines for human and veterinary use. The act defines three categories of the supply of drugs; Prescription only medicines, Pharmacy Medicine, and General sales list medicines the act controls

1. There are a number of types of materials and equipment needed for the administration of medication via the different routes. They all serve a type and purpose these include:

Traditionally, pharmacists had no power of questioning any order made by the physician. It was also stated that a pharmacist had no power of advising the patient on the usage of medication. Currently, pharmacists have been given more power and therefore have the mandate of questioning any prescription from the physician. It has been observed that pharmacist can today share information with the doctor and ensure that patients get the right medication. Laws have allowed pharmacists to be consulted on some medications by patients, allowing patients to trust pharmacist on some simple questions that they do not need to visit their doctor. Pharmacists play a significant role in advising the patient today on the type of medication they are taking they are also held to the same standard when it comes to rules and

Prescribing in Australia is authorised by individual state and territory legislations that deal with drugs and poisons. These legislations allow various levels of health professionals to administer/supply medications under an assortment of protocols or direct order agreements. Any prescriber must also follow processes that have been determined by their professional bodies, which is legally binding in Australia. Legally, prescribers must also maintain all confidentiality and privacy clauses. Also, the patient’s health and wellbeing should be the focus of all decision making so that no-harm should come to the patient. The knowledge and skills obtained from the required training should be used to optimise patient’s health.

According to Kanneh, six “rights” of medication administration need to be implemented with every patient. Drugs are not always one hundred percent safe, but observing the six rights will make administration safer (Kanneh, 2011). These rights include the right person, drug, dosage, time, route, and documentation (Kanneh, 2011). It is more likely for an adverse reaction to occur if a drug is given to the wrong patient because of his or her own allergies and appropriate age of a child for a dose needs to be taken into consideration (Kanneh, 2011). A child’s age is important because metabolism of drugs is different for each year of childhood (Kanneh, 2011).

Deglin, J.H., & Vallerand, A.H. (2005). Davi’s Drug Guide for Nurses 9th Edition. Philadelphia, PA: F.A. Davis Company.