School of Health and Community Studies Independent and Supplementary Prescribing for Nurses V300 M Level PROGRAMME SPECIFICATION/ UNIT DIRECTORY Version number: 1.0-0918 Document date: January 2017 1
2011 Bournemouth University Document date: July 2016 Circulation: General Bournemouth University undertakes to encourage the recognition, protection and exploitation of intellectual property rights generated by participants in this programme, to the benefit, as appropriate, of students, staff, industrial/other third parties/partners and the university. School of Health and Community Studies Bournemouth University Poole Dorset BH12 5BB 2
CONTENTS BASIC FRAMEWORK / PROGRAMME DATA AIMS OF THE DOCUMENT PROGRESSION ROUTES ACADEMIC AND PROFESSIONAL CONTEXTS AIMS OF THE FRAMEWORK / PROGRAMME(S) INTENDED LEARNING OUTCOMES LEARNING AND TEACHING STRATEGIES AND METHODS ASSESSMENT STRATEGIES AND METHODS WORK-BASED LEARNING (WBL)/PLACEMENTS ELEMENTS POINTS OF REFERENCE FOR PROGRAMME DESIGN PROGRAMME DIAGRAM ADMISSIONS REGULATIONS ASSESSMENT REGULATIONS PROGRAMME PROFILE 3
Originating institution(s) Award(s) and title(s) External reference points(s) BASIC PROGRAMME DATA Bournemouth University Independent and Supplementary Prescribing for Nursing and Midwives (V300) Nursing and Midwifery Council Professional, Statutory and/or Regulatory Body links Place(s) of delivery Mode(s) of delivery Credit structure Nursing and Midwifery Council accreditation Bournemouth University and University Centre Yeovil Part-time and Part-time distance learning 40 M level credits Duration Date of original approval(s) Minimum six months maximum not normally longer than 12 months September 2003 (reviewed September 2004 and 2007 and 2010 at H level) Date of first intake Student numbers Placements Date and version number of this Programme Specification January 2012 Minimum 12 students maximum 30 optimum 25 x 2 intakes per annum 12 days within students own employment setting January 2017, v1.0-0918 This Programme Specification was approved December 2011 following validation by Academic Standards Committee. The existing level H programme will continue to be provided. 4
AIMS OF THE DOCUMENT The aims of this document are to: Define the structure of the Independent and Supplementary Prescribing programme Identify programme learning outcomes Articulate the regulations governing this programme ACADEMIC AND PROFESSIONAL CONTEXTS The Independent and Supplementary Prescribing programme consists of a single 40- credit unit. It has been developed within the Nursing and Midwifery Council Standards of Proficiency for Nurse and Midwife Prescribers 2006. The focus of the unit is on developing knowledge and skills in prescribing. This programme is currently validated by the University and NMC as a 40 level H credit unit. It is proposed to continue to offer the programme at level H but to add the availability of offering it at level M. This programme consists of a single 40 credit unit. The intended learning outcomes are set out later in this document. The Programme is distinctive because: It has been developed in close collaboration with the Department of Health and has been designed to meet the needs of the workforce. It meets the requirements set by the Nursing and Midwifery Council. The programme places work based learning at its core to ensure the provision of time efficient, relevant education for busy professionals. It aims to further develop professional critical reflective practice to provide a sound preparation for non medical prescribing practice. There are currently no QAA subject benchmarks statements for prescribing AIM OF THE PROGRAMME 5
To prepare nurses and midwives to prescribe safely, appropriately and cost effectively as an independent/supplementary prescriber. In doing so students will be required to evaluate the evidence underpinning the practice of prescribing, critically reflect upon their level of competency in respect of prescribing and develop an individual programme of learning in practice. INTENDED LEARNING OUTCOMES Having completed this programme, the student is expected to demonstrate the ability to: 1. Critically discuss and demonstrate an ability to assess and consult with patients/clients, clients, parents and carers; 2. undertake a thorough history, including medication history and current medication (including over the counter, alternative and complementary health therapies)to inform diagnosis; 3. critique and apply the relevant legislation to the practice of nurse/midwife prescribing; 4. critically appraise sources of information/advice and decision making frameworks in prescribing practice; 5. critically debate the influences that effect prescribing practice and demonstrate understanding by managing prescribing practice in an ethical way; 6. apply knowledge of pharmacodynamics and pharmacokinetics to their own prescribing practice, including the monitoring of response to therapy and justification to modify treatment 7. critically analyse the roles and relationships of others involved in prescribing, supplying and administering medicines; 8. prescribe safely, appropriately and cost effectively; 9. practise within a framework of professional accountability and responsibility; 10. develop clinical management plans within legislative framework; 11. demonstrate the recognition of the unique implications and developmental context of the anatomical and physiological differences between neonates, children and young people 12. demonstrate the ability to calculate drug dosages and prescribing regimes within own area of practice. The Nursing and Midwifery Council (NMC) have stipulated these outcomes LEARNING AND TEACHING STRATEGIES AND METHODS Learning & Teaching Methods (Taught Programme) The taught indicative content will normally be delivered over 26 days in the University plus 12 days of supervised clinical practice. Attendance for the taught days is mandatory. Learning and teaching will take place in both the classroom and in practice. Lectures of factual material will be followed by question and answer sessions including group discussion and analysis of case examples. The programme is supported by materials available on the University s virtual learning environment mybu 6
Teaching and Learning Methods (Blended Programme) The blended programme consists of 8 taught days, 12 days of supervised clinical practice and the equivalent of 10 days open learning utilising web based and electronic open learning material. The taught days will focus on key lectures and discussion and feedback from open learning activity. Attendance at the taught days is mandatory. Each student has access to mybu the University s electronic learning platform; there are specific open learning activities on the professional practice of prescribing, links to materials provided by the National Prescribing Centre and revision activities on path physiology. The open learning material has been developed from the original E Map activities developed in partnership with the NMC and education providers. This material can also be supplied on a CDRom for students with internet connectivity problems. Students are given a suggested timetable of how to plan their open learning time. Students also have access to all of the programme material (both from the blended and taught delivery modes) via mybu. All students will have a personal tutor from the University and the support of a designated medical practitioner as a supervisor in practice. Supervisor workshops are planned to appraise medical supervisors of the learning outcomes expected from the programme and their responsibilities. Students and their supervisors will be provided with information on when their personal tutor is available to be contacted either by telephone or email. ASSESSMENT STRATEGIES AND METHODS Assessment Total assessment workload will not exceed the equivalent of 10,000 words The learning outcomes of the programme will be assessed as follows: 1. A portfolio that demonstrates application of theory to practice, and provides rationale for prescribing decisions and reflective practice. It will also include evidence of numeracy skills, writing prescriptions and a range of scenarios. Linked to learning outcomes 1-12. 2. An Objective Structured Clinical Examination which takes place in a setting relevant to the students area/field of practice or a video consultation in a live practice setting. Linked to learning outcomes 1,2 and 8. 3. Satisfactory completion of the period of practice experience and the sign off by the designated medical practitioner and the employer that the student is competent to prescribe medicines in their area of practice. Linked to learning outcomes 1-11. 7
4. A written examination consisting of 20 short answer/ multi-choice questions. The examination tests pharmacological knowledge and its application to practice. Linked to learning outcomes 6,7 and 8. 5. A numerical assessment within the context of prescribing practice. Linked to learning outcome 11. WORK-BASED LEARNING (WBL) / PLACEMENTS ELEMENTS Students will be employed as a nurse or midwife whilst undertaking this Unit. They will be required to use practice based material to support learning and assessment Although students will remain in their place of employment throughout the programme they will have the equivalent of 12 days of practice supervised by a medical practitioner. The Department of Health has specified that medical supervisors must be a registered medical practitioner who: (i) has normally had at least 3 years recent clinical experience for a group of patients/clients in the relevant field of practice; (ii) is within a GP practice and is either vocationally trained or is in possession of a certificate of equivalent experience from the Joint Committee for Post-graduate Training in General Practice Certificate (JCPTGP); or is a specialist registrar, clinical assistant or a consultant within a NHS Trust or other NHS employer; (iii) has the support of the employing organisation or GP practice to act as the designated medical practitioner who will provide supervision, support and opportunities to develop competence in prescribing practice. (iv) has some experience or training in teaching and \ or supervising in practice. All designated medical supervisors are invited to a briefing session and are provided with a handbook; in addition they are given the contact details of the teaching team which they are actively encouraged to utilise if they encounter any difficulties with their role. 8
Level H PROGRAMME DIAGRAM PROGRAMME STRUCTURE PROGRAMME DIAGRAM Independent and Supplementary Prescribing Exit qualification: Core Units (Compulsory) Independent and Supplementary prescribing (40 Level M Credits) 40 Level M credits for: Independent and Supplementary prescribing Outcomes developed and assessed: Knowledge as indicated by programme title & skills. 9
ADMISSION REGULATIONS The regulations for this programme are the University s Standard Postgraduate Admission Regulations. The University Standard Admission Regulations are available on the portal at http://portal.bournemouth.ac.uk/documents/. In addition, students will need to meet the Nursing and Midwifery Council s criteria for eligibility to undertake a nurse independent/supplementary prescribing programme. The criteria are that the student: Must be a first level registered nurse, midwife and/or specialist community public health nurse. Must have at least three years post registration experience and be deemed competent by the employer to undertake the programme. One 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. The student must provide written confirmation from their employer of their support for this programme. Must have a designated medical practitioner who meets the eligibility criteria for medical supervision of nurse prescribers who has agreed to provide the required form of supervised practice. Where the student has/is not undertaking a programme to prepare them in diagnosis and physical assessment the employer is responsible for confirming that the applicant has been assessed as competent to take a history, undertake a clinical assessment and diagnose within their field of practice. This would normally be a statement from the supporting manager specifying that the student has appropriate assessment and diagnostic skills in their area of practice. The supporting employer has systems in place for monitoring and auditing prescribing practice, for example a clinical governance framework. Prior to attending the programme students must have undergone an enhanced CRB check and their CRB must be available on the first day of the programme Students employed in the independent sector will normally be interviewed to ensure they meet the Nursing and Midwifery Council s criteria for eligibility to undertake the programme. In particular the ability of their employer to provide a system for supporting, monitoring and auditing prescribing practice, for example a clinical governance framework and all staff having access to appropriate clinical supervision. 10
The employer would be required to declare their support for the students and that the student would be enabled to attend all the taught and clinical days and be given adequate time to study. Independent sector employed applicants would also need to verify they have the support of a designated medical practitioner who meets the criteria laid down by the Department of Health. 11
ASSESSMENT REGULATIONS The regulations for this programme conform with the requirements of the nursing and Midwifery Council and the Department of Health, and are the University s Standard Undergraduate Assessment Regulations with the following approved exceptions Period of Registration The maximum period of registration a student may take to complete the programme, from the first registration, is normally 1 year Pass Mark The pass mark for the short answer examination will be 80%( assessed on a pass/fail basis) The pass mark for the numeracy test will be 100% (assessed on a pass/ fail basis. For the portfolio a pass will be awarded where the overall element mark is at least 50%. The record of supervised practice and the OSCE are assessed on a pass/fail basis. Provision for failed candidates If a student in any element of assessment fails to answer correctly any question that may result in direct harm to a patient/client or within written submissions within the portfolio recommends treatment which may result in direct harm to a patient/client, the student will fail that element of the programme. If this occurs where a student is being reassessed, the student will be required to re-register and to re-attend the programme. The University Standard Assessment Regulations are available on the portal at http://portal.bournemouth.ac.uk/documents/. ATTENDANCE The Nursing and Midwifery Council require 100% attendance, the programme team maintain a register. Taught Programme Students who miss one day of the programme are required to undertake work to demonstrate they have met the learning outcomes for the sessions they have missed. Students who miss two days will also have to undertake work to meet the learning outcomes and may be required to attend the sessions they have missed; this may be at a different campus according to when the programme is delivered. Students who miss three days will be required to discuss with the programme leader and their manager their withdrawal or deferment from the programme. Blended Programme Students who miss one day of the programme are required to undertake work to demonstrate they have met the learning outcomes for the sessions they have missed, this may also involve them having to attend the session they have missed with another intake. Students who miss two days will be required to discuss with the programme leader and their manager their withdrawal or deferment from the programme. 12
POINTS OF REFERENCE FOR PROGRAMME DESIGN QAA Qualifications Framework Maintaining Competency in Prescribing, National Prescribing Centre, November 2004 Allied Health professionals prescribing and medicines supply mechanisms scoping project report Department of Health 2009 Non medical prescribing by nurses, pharmacists, physiotherapists, podiatrists and radiographers; a quick guide for commissioners. National Prescribing Centre 2010 13
Date Profile Completed: PROGRAMME 14
PROFILE Originating Institution(s): Bournemouth University School: HSC Place(s) of Delivery: Bournemouth UCY Programme HESA JACS code: Programme Award and Title: Independent and Supplementary Prescribing for nurses and Midwives Mode(s) of study 1 : Part time Expected Length of study 2 : 6months BU Credit Structure & ECTS 3 : 40 level M Assessment Unit no. (given by School) Unit Core HESA Subject Code C C 1 % No of credits Level Exam Supervised practice Element Weightings OSCE Portfolio Numeracy test Independent and supplementary Prescribing for Nurses, & Midwives C B7 05 100 40 M P/F P/F P/F 100% P/F 15
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Unit Directory Unit number 1 Unit title Level Independent and Supplementary Prescribing M Credit value 40 Pre-Requisites and Co-Requisites There are no pre or co requisites Aims To prepare nurses, midwives and specialist community public health nurses to prescribe safely, appropriately and cost effectively from either the community practitioner formulary for nurse prescribers or as an independent/supplementary prescriber. In doing so students will be required to evaluate the evidence underpinning the practice of nurse prescribing, critically reflect upon their level of competency in respect of nurse prescribing and develop an individual programme of learning in practice. Intended Learning Outcomes: Having completed this unit, the student is expected to demonstrate the ability to: 1. Critically discuss and demonstrate an ability to assess and consult with patients/clients, clients, parents and carers; 2. undertake a thorough history, including medication history and current medication (including over the counter, alternative and complementary health therapies)to inform diagnosis; 3. critique and apply the relevant legislation to the practice of nurse/midwife prescribing; 4. critically appraise sources of information/advice and decision making frameworks in prescribing practice; 5. critically debate the influences that effect prescribing practice and demonstrate understanding by managing prescribing practice in an ethical way; 6. apply knowledge of pharmacodynamics and pharmacokinetics to their own prescribing practice, including the monitoring of response to therapy and justification to modify treatment 7. critically analyse the roles and relationships of others involved in prescribing, supplying and administering medicines; 8. prescribe safely, appropriately and cost effectively; 9. practise within a framework of professional accountability and responsibility; 10. develop clinical management plans within legislative framework; 11. demonstrate the recognition of the unique implications and developmental context of the anatomical and physiological differences between neonates, children and young people 17
12. demonstrate the ability to calculate drug dosages and prescribing regimes within own area of practice. The Nursing and Midwifery Council (NMC) have stipulated these outcomes Competencies for Prescribing The NMC competencies for prescribing are laid out in the appendix. Relationship between course outcomes and Prescribing Competencies The learning outcomes of the programme relate to the prescribing competencies as follows: Learning outcome 1 Practice Learning outcome 2 Practice Learning outcome 3 Principles Learning outcome 4 Principles Learning outcome 5 Practice Learning outcome 6 Responsibility Learning outcome 7 Subsumes all the competencies Learning outcome 8 Principles and practice Learning outcome 9 Principles and Practice Learning outcome 10 Principles and Practice Learning Outcome 11 principles and practice Learning outcome 12 Subsumes all the competencies. Learning & Teaching Methods (Taught Programme) The taught indicative content will normally be delivered over 26 days in the University plus 12 days of supervised clinical practice. Attendance for the taught days is mandatory. Learning and teaching will take place in both the classroom and in practice. Lectures of factual material will be followed by question and answer sessions including group discussion and analysis of case examples. Teaching and Learning Methods (Blended Programme) The blended programme will normally consist of 8 taught days and the equivalent of 10 days open learning utilising web based, electronic and printed open learning nurse prescribing programme material. The taught days will focus on key lectures and discussion and feedback from open learning activity. Attendance at the taught days is mandatory. All students will have a personal tutor from the University and the support of a designated medical practitioner as a supervisor in practice. Supervisor workshops are planned to appraise medical supervisors of the learning outcomes expected from the programme and their responsibilities. Students and their supervisors will be provided with information on when their personal tutor is available to be contacted either by telephone or email. 18
Assessment Total assessment workload will not exceed the equivalent of 10,000 words The learning outcomes of the programme will be assessed as follows: 1. A portfolio that demonstrates application of theory to practice, and provides rationale for prescribing decisions and reflective practice. It will also include evidence of numeracy skills, writing prescriptions and a range of scenarios. Linked to learning outcomes 1-12.The pass mark for the portfolio is 40%. 2. An Objective Structured Clinical Examination which takes place in a setting relevant to the students area/field of practice or a video consultation in a live practice setting. Linked to learning outcomes 1,2 and 8. This is assessed on a pass/fail basis. 3. Satisfactory completion of the period of practice experience and the sign off by the designated medical practitioner and the employer that the student is competent to prescribe medicines in their area of practice. Linked to learning outcomes 1-11. This is recorded in the practice profile and is assessed on a pass/fail basis. 4. A written examination consisting of 20 short answer/ multi-choice questions. The examination tests pharmacological knowledge and its application to practice. Linked to learning outcomes 6,7 and 8.The pass mark for the examination is 80%. 5. A numerical assessment within the context of prescribing practice. Linked to learning outcome 12. The pass mark for the numeracy assessment is 100%.and is recorded as a pass/fail. Indicative content 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 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 19
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, 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 pharmaco-therapeutics related to controlled drugs. 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 identify and report adverse drug reactions and near misses prescribing controlled drugs prescribing and administering prescribing and dispensing. Prescribing off label Prescribing unlicensed medication 20
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 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. Indicative Key Learning Resources Books THE BRITISH NATIONAL FORMULARY (B.N.F.) Courtney, M. & Griffiths,M., 2004. Independent and supplementary prescribing; Essential guide. London: Greenwich Medical Media. Crouch,S & Chaplelhow C. 2008 Medicines Management a nursing perspective. Harlow. Pearson Education Department of Health, 1999. Review of prescribing, supply and administration of medicines: final report. Crown I. London. HMSO. Department of Health, 2005. Supplementary prescribing by Nurses, Pharmacists, chiropodists/podiatrists, Physiotherapists and radiographers within the NHS in England: A Guide for Implementation. London: DOH. 21
Dimond, B., 2005 Legal aspects of nursing. 4th ed. London: Prentice Hall. McGavock, H., 2003. How drugs work. Oxford: Radcliffe Medical Press. McGavock,H.2009. Pitfalls in prescribing and how to avoid them. Oxford: Radcliffe Medical Press Neal,J., 2009 Medical Pharmacology at a Glance. 6 th ed. Oxford: Blackwell Science. Shulman,R;Montgomery,H;Ng,J;Keady,S eds 2007 Surviving Prescribing: A practical guide.london. Remedica Trounce, J., 2000. Clinical pharmacology for nurses. 16 th ed. Edinburgh: Churchill Livingstone. Web-based sources www.npc.co.uk National Prescribing Centre web site, provides a range of information to support non medical prescribers, including a competency framework and access to Merck updates, patient group directions www.dh.gov.uk The Department of Health website provides information on non medical prescribing www.mhra.gov.uk The Medicines and Healthcare Products Regulatory Agency website contains information about the legal framework governing prescribing, supply and administration of medicines www.nmc-uk.org The Nursing and Midwifery Council website, publications on standards of professional practice etc www.nelh.org National Electronic Library for Health, latest information on medicines and clinical conditions, as well as useful resource on complementary therapies www.the-shipman-inquiry.org.uk Information on the recommendations from the Shipman Inquiry www.nelm.nhs.uk National electronic library for medicines good links to research, NICE guidance, and latest news page www.druginfozone.nhs.uk Information on medicines, licensed usage, possible interactions www.emc.medicines.org.uk approved information sheets (including details of product licenses) for UK prescription medicines 22
Appendix: NMC Prescribing Competencies The principal areas, knowledge and competencies required to underpin the practice of prescribing: Principal Knowledge Competency areas Principles Legislation that underpins prescribing Works within the legislative framework relevant to the area of practice and locality Team working principles and practice Understands the principles behind supplementary prescribing and how they are applied to practice Philosophy and Able to use the adverse reaction reporting mechanisms psychology of prescribing Awareness of the impact of prescribing in the wider delivery of care. Able to work and communicate as part of a multidisciplinary prescribing workforce Reviews diagnosis and generates treatment options within the clinical treatment management plan Understand the complexity of the external demands and influences on prescribing Practice Up to date clinical and pharmaceutical Makes an accurate assessment and diagnosis and generates treatment options knowledge Relevant to own area of expertise Principles of drug dosage, side effects, Able to prescribe safely, appropriately and cost effectively reactions and Understands how medicines are licensed, monitored interactions Able to work with patients and clients as partners in Communication, consent treatment and concordance Proactively develops dynamic clinical management Relationship of public plans health requirements to Able to assess when to prescribe or make appropriate prescribing referral Able to refer back to a medical practitioner when appropriate. Aware of policies that have an impact on public health and influence prescribing practice Able to articulate the boundaries of prescribing practice in relation to the duty of care to patients and society Accountab ility The Code of professional conduct. Able to apply the principles of accountability to prescribing practice The lines of accountability at all levels Able to account for the cost and effects of prescribing practice for prescribing Regularly reviews evidence behind therapeutic Drug abuse and the strategies potential for misuse Able to assess risk to the public of inappropriate use of Requirements of record prescribed substances keeping Understand where and how to access and use patient / Lines of communication client records Able to write and maintain coherent records of prescribing practice Able to communicate effectively with patients, clients and professional colleagues Responsib Leadership skills Able to advise and guide peers in the practice of 23
ility Roles of other prescribers Relationship of prescribers to pharmacists Clinical governance requirements in prescribing practice Audit trails to inform prescribing practice prescribing Able to articulate and understand the roles of other key stakeholders in prescribing practice Understand the requirements of pharmacists in the prescribing and supply process Link prescribing practice with evidence base, employer requirements and local formularies Demonstrate ability to audit practice, undertake reflective practice and identify continuing professional development needs 24
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