Non-medical Prescribing
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1 MODULE DESCRIPTOR Non-medical Prescribing TITLE MODULE CODE S LEVEL 7 CREDITS 30 ECTS CREDITS VALUE FACULTY Health and Well Being DEPARTMENT Nursing and Midwifery SUBJECT GROUP Nursing DATE APPROVED May 2016 MODULE AIM This module aims to prepare practitioners as Independent and/or Supplementary Prescribers in accordance with appropriate Professional Regulatory Body (General Pharmaceutical Council, Nursing and Midwifery Council, and Health Professions Council) and Department of Health guidance LEARNING OUTCOMES 1. Undertake effective history taking, consultation and physical assessment skills with patients, clients and carers, including medication history and current medication (including over the counter alternative and complementary health therapies), to critically explain accurate diagnosis and clinical decision making 2. Analytically evaluate autonomous, safe, appropriate and cost effective prescribing practice, in partnership with Independent prescribers and the wider care team, including accurate record keeping in the context of medicines management 3. Reflect critically upon aspects of the law and the professional framework of accountability relevant to the practice of independent and supplementary prescribing, including the prescribing of unlicensed medicines 4. Identify, select and synthesise sources of information, advice and decision support systems which underpin the practise of independent prescribing, and communicate the ethical management of influences on prescribing practice 5. Utilise knowledge of pharmacology to critically explain pharmacokinetics and pharmacodynamics in relation to the disease process and apply to the monitoring of response to medicines and complex situations, treatment modification and referral 6. Critically appraise the roles and relationships of others involved in prescribing, supplying and administering medicines and develop and document a clinical management plan (CMP) within the context of a prescribing partnership 7. Practice autonomously in the management of complex situations, using advanced problem solving skills, and critically reflect upon the importance of continuing professional development within a framework of professional accountability and responsibility 8. Distinguish the unique implications and developmental context of the anatomical and physiological differences between neonates, children and young people INDICATIVE CONTENT Consultation, Decision-Making, Assessment and Review
2 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 calculations Stopping medication prescribed by others Medicines review Influences on, and Psychology of, Prescribing Patient/client demand and preferences vs. 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 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 Pharmacology, including pharmaco-dynamics, pharmaco-kinetics, pharmacotherapeutics 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 breastfeeding women Pharmaco-therapeutics related to controlled drugs Evidence-based Practice and Clinical Governance in relation to nurse prescribing Rational, 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
3 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 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 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 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 Royal Pharmaceutical Society A competency Framework for all prescribers HCPC- The standards for prescribing Health and Care Professions council 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 LEARNING, TEACHING AND ASSESSMENT STRATEGY
4 1. A 2 hour, two part examination, that focuses upon short and multiple choice questions designed to assess the students knowledge of numeracy (Part A) and pharmacology, prescription writing and the principles and legal issues central to prescribing practice(part B). The pass mark for Part A (numeracy) is 100% The pass mark for Part B (pharmacology) is 80% (In module retrieval is possible for this assessment task only. If students fail to achieve the required pass marks for either or both parts of the examination, ONE further attempt can be undertaken within 4 weeks of the examination. Subsequent failure to achieve the required pass marks for either or both parts following this attempt would result in referral of the module, with ONE final reattempt permitted. (SHU Standard Assessment Regulations , Regulation 4.2, pg 6)) If a registrant fails to answer correctly any question that may result in direct harm to a patient/client they must be referred 2. The Portfolio (50% weighting) requires the student to demonstrate achievement of the module learning outcomes by providing confirmation of: satisfactory completion of a period of 90 hours practice learning and assessment of competence by a Designated Medical Practitioner through a completed practice assessment booklet satisfactory completion of an Objective, Structured, Clinical Assessment, undertaken in practice, by a Designated Medical Practitioner. a 4,500 word reflective commentary supported by evidence to confirm achievement of practice learning, including a Clinical Management Plan and examples of prescription writing ASSESSMENT INFORMATION Task No. Description of Assessment Task Assessment Task Type Coursework (CW) Written Exam (EX) Practical (PR) Word Count or Exam Duration Task Weighting % 1 Exam EX 2 hours 80% Pharmacology) P/F 100% Numeracy ) 2 Portfolio CW 4,500 50% (50% weighting) Please list assessment tasks in the order they will be completed by students. The last task listed will be classed as the final task for external reporting purposes. Further guidance on assessment design is available online at Assessment Essentials Students will be supported in their learning, to achieve the above outcomes by a focus on the development of critical and analytical skills, clinical reasoning, independent and problem solving skills and the competency required through self-direction. Competence and capability are key aspects of professional practice and are fundamental to safe care for patients. The foundations for the knowledge required are provided in a variety of forms including seminars,
5 tutorials, lectures and online resources. It is intended that students will become fit for practice and develop continuing professional development and life-long learning skills for future career development and to improve the service to patients. The approach to learning and teaching aims to facilitate active and independent learning to provide integration of the health care professional's experience. Therefore a blended approach to teaching and learning is adopted harnessing a wide range of learning and teaching strategies. More specifically this will take the form of: Key note lectures delivered by experts in the field, utilising a variety of professionals, from secondary and primary care. Opportunities to consolidate learning with tutorial support alongside input from Learning and IT Services. Peer review and feedback via Blackboard or PebblePad. Guidance to ensure assessments are completed in a timely manner. ASSESSMENT INFORMATION Task No. Description of Assessment Task Assessment Task Type Coursework (CW) Written Exam (EX) Practical (PR) Word Count or Exam Duration Task Weighting % 1 2 Please list assessment tasks in the order they will be completed by students. The last task listed will be classed as the final task for external reporting purposes. Further guidance on assessment design is available online at Assessment Essentials FEEDBACK TO STUDENTS Formative assessment will be take place throughout the module, with participation in group discussions, workshop activities to enhance group problem solving, e-learning tasks, tutorial support and via Designated Medical Practitioner supervision. Self evaluation and peer support will be an integral part of formative feedback throughout the module The OSCA is an integral part of practice assessment, and students will be introduced to patient assessment and consultation theories and strategies early and throughout the module. Upon submission of the Portfolio, students will be given summative feedback within four weeks. LEARNING RESOURCES FOR THIS MODULE (insert hyperlink to Reading Lists Online or RLO Home Page) The module descriptor should include a hyperlink to an online resources list using the Reading Lists Online (RLO) system. Further information on RLO and guidance on linking Reading Lists Online to the Module Blackboard site is available here. L3S advises Module Leaders to send new RLOs for review when the list is complete. L3S will check the resources and purchase the appropriate number of copies for the library. NB: this section applies to SHU courses only - the RLO system is not applicable to modules delivered only at, and by, collaborative partner organisations.
6 MODULES INCLUDING RESEARCH PROJECTS AND/OR TEACHING-RELATED RESEARCH PROJECTS Will the assessment for this module require approval by Faculty Research Ethics Committee? If YES, please detail below how students will seek approval for their research YES / NO NOTIONAL STUDY HOURS FOR THIS MODULE Module Study Hours by Type (see KIS definitions) hours of Practice Learning Scheduled Learning and Teaching Activity No. of Hours KIS category Lecture Seminar 110 Tutorial Project Supervision with tutor Demonstration Practical classes and workshops Supervised time in studio/workshop/laboratory Fieldwork External visits Scheduled Learning and Teaching Activities sub-total 110 Guided Independent Study 190 Independent Placement or Work-based Learning** 90 Placement TOTAL NUMBER OF NOTIONAL STUDY HOURS FOR MODULE 300 Guidance Notes on Notional Study Hours and Key Information Sets Notional Study Hours The total number of hours associated with a module should be based on a minimum of 10 notional study hours per credit, e.g. a 20 credit module involves 200 notional study hours. This applies to UG and PG modules. Modules should only exceed the minimum number of notional study hours where this is necessary to meet an external requirement for course accreditation. Key Information Sets (KIS) For UG provision where a KIS is applicable, the information given above on notional study hours will be used to inform the Key Information Set to be published for an individual course. The information in the module descriptor must be accurate and align with information included in Student Handbooks and with the KIS information stored in SITS. Further guidance is available online at Sandwich Years, Study Abroad and KIS ** Hours related to sandwich year placements and/or study year abroad should not be included in the notional study hours for an individual module. These hours will be identified and recorded separately, as part of the KIS for the individual course.
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