Advancing Non-Medical Prescribing Module Guide (Incorporating Portfolio Document) Module Code: CCH4034-N. Level 7

Advancing Non-Medical Prescribing Module Guide (Incorporating Portfolio Document) Module Code: CCH4034-N Module Leader: Bernadette Martin Level 7 January 2015 0

CONTENTS Page 1 INTRODUCTION 1 2 THE MODULE STRUCTURE 1 3 MODULE LEADER/MODULE TEAM CONTACT DETAILS 2 4 LEARNING AND TEACHING STRATEGIES 2 5 MODULES AIMS AND OUTCOMES 5 6 RESPONSIBILITIES 6 7 ASSESSMENT STRATEGY 7 8 ASSESSMENT CRITERIA 9 9 EVALUATION STRATEGY 11 10 INDICATIVE RESOURCES 12 11 GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO 18 12 PORTFOLIO DOCUMENTS 21 1

1 INTRODUCTION Welcome to the Level 7 Advancing Non-medical Prescribing (V300) module which was developed in response to the Government s Modernisation Agenda. This has extended the range of professionals who can prescribe and medicines that can be prescribed, by independent and supplementary non-medical prescribers. Independent prescribing is becoming a widely integrated feature of health service delivery, with nurses, physiotherapists, podiatrists and radiographers qualified to prescribe in nearly all Trusts in England. This supports the achievement of ambitions set out in Equity and Excellence: Liberating the NHS (Department of Health (DH) 2010). Two to three per cent of the nursing workforce are qualified independent prescribers and are prescribing predominantly in primary care, with substantial numbers also in secondary care settings. The drive for Allied Health Professionals to deliver improved clinical outcomes has meant that physiotherapists and podiatrists have from August 2013 had their supplementary prescribing rights extended to independent prescribing. Nurses, physiotherapist and podiatrists will also gain supplementary prescribing, radiographers will continue to be able to train as supplementary prescribers and prescribe within a Clinical Management Plan (CMP). Supplementary Prescribing legislation in 2005 initially prepared health professionals to expand their roles. Nurses have trained as Independent Prescribers since 2006 and the expansion of Independent Prescribing by physiotherapists and podiatrists supports enhanced patient-centred care. New roles and new ways of working to improve quality of services, deliver safe, effective services focused on the patient experience have been developed across inter-professional working within health care. Non-medical prescribing has facilitated partnership working across professional and organisational boundaries and within the commissioning and provider arena. The benefits of non-medical prescribing to patients with a wide range of conditions have ensured that choice and faster access to medicines are a realistic service improvement. 2 THE MODULE STRUCTURE The length of the module is 18 weeks during which you will undertake 26 days theory time, and 12 days supernumerary supervised practice shadowing a prescribing Designated Medical Practitioner (DMP). You have a week-long induction in week one; this will introduce you to the University and the School of Health & Social Care. You will also be introduced to the principles of non-medical prescribing and be prepared for your supervised practice experience. This will be followed by 16 weekly study days; you will attend the University each Tuesday from 9.30 am 4.30 pm. Week 18 will be block week in which you will prepare for and undertake an Objective Structured Clinical Examination (OSCE). If for any reason you are unable to complete the module in the allocated time it is important that you discuss this with a member of the module team. There are University support mechanisms in place which can support an extension of your studies should you need to use these. The maximum length to complete the module 1

is one academic year from the start; you should however discuss with the team any difficulties in order to ensure we support you appropriately to complete your studies. The Student Essential Guide (School Handbook) provides further detailed information. This can be found at https://sohsc.tees.ac.uk/sites/handbook/ Your organisation has agreed that you will undertake 12 days supernumerary supervised practice. It is necessary to ensure that you and your DMP are able to work together for sufficient time for your DMP to be able to confidently assess that you have met the practice outcomes for the module. It is expected that a programme of experience will allow you to work with other team members in order to experience a variety of non medical prescribing learning opportunities. Your DMP must be the person responsible for verifying that you have met the practice outcomes. 3 MODULE LEADER/MODULE TEAM CONTACT DETAILS The Module Leader for this module is Bernadette Martin and you should initially direct any queries or issues to Bernadette. She is based in Room H1.20 in the Centuria Building, Teesside University, Middlesbrough. Telephone number 01642 384966, email B.Martin@tees.ac.uk. Debbie Osborne supports the module. She is based in Room H1.31 in the Centuria Building, Teesside University, Middlesbrough. Telephone number 01642 738257, email d.osborne@tees.ac.uk Jayne Cornforth is the Lead Midwife for Education (LME) and supports midwives who undertake the module. She can be contacted on 01642 384984, email J.Cornforth@tees.ac.uk The module is supported by an established and experienced team of pharmacists, and non-medical prescribers from both primary and secondary care. You will be offered the opportunity for professional/discipline-specific tutorials by specialist academic mentors in order to enable you to identify individual learning needs and to develop a Learning Contract to guide and facilitate academic learning. You will be directed to the most appropriate academic in week one of the module. All midwives must meet the LME. This will be arranged within week one of the module. 4 LEARNING AND TEACHING STRATEGIES Prescribing requires that you have the knowledge, skills, and professional competence necessary to embrace this new role. It also requires you to demonstrate a comprehensive and detailed understanding of the concepts of accountability and lifelong learning in a significant way. To this end the module aims to incorporate knowledge and reflection in a way that enables the development of self-awareness and for you to build upon previous learning as well as acquiring new competencies for safe and effective prescribing. 2

The module will help you to build upon previous knowledge and experience. This will ensure that you are knowledgeable, flexible and adaptable, and able to embrace both the theory and practice of non-medical prescribing in a comprehensive and critical reflective manner. You will achieve the module aims through the development of a robust knowledge that is based upon the best available evidence, combined with a flexible and adaptable approach to both the theory and practice of non-medical prescribing. The taught component of the module will consist of theoretical preparation to ensure that you develop the knowledge and skills necessary to ensure safe and effective prescribing. The module focuses upon the principles and practice of prescribing and professional accountability, responsibility and ethics required by independent and supplementary non-medical prescribers. Related pathophysiology and pharmacology will be explored alongside the development of the skills required to consider the need to improve service within a prescribing context. In order to facilitate and maximise learning a variety of learning strategies will be employed. You will share your learning with your peers undertaking the module at degree level and students preparing for community prescribing; you will be introduced to strategies for developing the skills required to work at master s level. Taught sessions will include lectures and group discussions. There will be selfdirected study based upon both the indicative content and an assessment of your own learning needs in relation to prescribing. Collaborative working learning sets will facilitate an evaluation of your personal development needs to identify how you can deliver and influence service improvement within contemporary prescribing practice. Professional/discipline-specific tutorials will be offered by specialist academic mentors in order to enable you to identify individual learning needs and to develop a Learning Contract to guide and facilitate your learning. As detailed above if you are a midwife you will be introduced to the LME in week one of the module who will support your learning and assessment preparation. Random case analysis will be used so that you will have the opportunity to analyse treatment situations and examine and comprehensively critically reflect upon the decision-making process in relation to prescribing. The generic nature of the module content will facilitate you to apply your knowledge and understanding to safely prescribe within your own area of practice speciality. This will be further developed with the support and guidance of your DMP. You will be guided in preparing and developing your Portfolio that will provide evidence of your ability to synthesise and critically evaluate a reflection on and in practice. This will include the use of Learning Contracts and evidence of your successful completion of the practice element of the module. Also included will be a reflective analysis of your knowledge underpinning safe prescribing practice, and evidence of understanding the pharmacology, pharmacokinetics, legal aspects, and application to practice of drugs you may prescribe in practice through the development of P-Formularies. You will develop an understanding of the differences between supplementary and independent prescribing and you will undertake learning related to prescribing within a Clinical Management Plan. 3

You will practice examination techniques and will undertake a formative examination which will be peer reviewed in order to prepare you for the examination element of the assessment. Directed study utilising the VLE, e-learning@tees, will enable you to further develop numeracy skills which will support preparation for the examination. To further support formative numeracy development you will be enrolled onto the Standardised Numeracy Assessment Process (SN@P). You will have access to a wide range of web-based resources through the VLE for example News Feeds via the National Institute for Health & Clinical Excellence (NICE) Medicines and prescribing support website and the Medicines and Healthcare Products Regulatory Agency (MHRA) website. You will be encouraged to use a reflective blog of practice experiences; the module team will monitor these and provide advice and guidance as appropriate. You will be working in small groups using scenario-based examples of prescribing practice to prepare you, for example, to take an effective history and make diagnostic decisions which will influence your prescribing decision-making process. The integration of theory and practice will be strengthened by your ability to demonstrate the achievement of the practice outcomes. Learning in practice will be related to the achievement of these practice outcomes, you and your DMP will document progress in three meetings during your supervised practice. These will be included in your Portfolio and verified by your DMP. Registrants who will be prescribing for children must have a Practice Mentor who is experienced and competent in prescribing for children. The LME will support midwifery DMP s this will include attending the DMP mentor preparation workshops. 5 MODULE AIMS AND OUTCOMES Module Aims The aims of the module are to: Facilitate the development of knowledge and skills required by professionals to prescribe as independent prescribers and/or supplementary prescribers. Enable you to apply knowledge to clinical practice demonstrating the ability to prescribe safely and effectively in order to meet prescribing standards set by the Nursing & Midwifery Council/Health & Care Professionals Council. Develop the critical thinking and decision-making skills to support the need to influence the delivery of improvements in prescribing practice. Module Outcomes On completion of this module you will be able to: Knowledge and Understanding 1. Demonstrate a comprehensive and critical understanding of the legal and professional framework for accountability and responsibility in relation to prescribing practice. 2. Demonstrate a systematic and critical understanding of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics). 3. Demonstrate a systematic and critical understanding of the factors impacting upon and influencing safe and ethical prescribing practice. 4

4. Demonstrate a systematic and critical understanding of the breadth and depth of knowledge of non-medical prescribing in order to have a critical awareness of the need to identify and deliver service improvement in professional practice. Cognitive and Intellectual Skills 5. Integrate and synthesise diverse knowledge, evidence, concepts, theory and practice which inform prescribing practice and promote understanding and/or good practice and solve foreseen and unforeseen problems. 6. Challenge orthodoxy and formulate new/alternative hypotheses or solutions related to prescribing practice. Practical and Professional Skills 7 Demonstrate achievement of the regulatory bodies standards of proficiency as applied for independent and supplementary prescribing. 8 Demonstrate the ability to manage the implications of ethical dilemmas whilst recognising the contributions of the multidisciplinary team involved in prescribing, supplying and administering medicines. 9 Demonstrate a systematic and critical understanding of the clinical decisionmaking strategies which underpin autonomous prescribing practice in effective communication, consultation/assessment, diagnosis and treatment, which can include over the counter, alternative and complementary health therapies. 10 Demonstrate a comprehensive and critical understanding of the skills required to prescribe safely, appropriately and cost effectively taking into account individual choice and wishes. 11 Operate ethically within a framework of clinical governance, and have a critical understanding of the issues governing professional accountability and responsibility. 12 Develop and document a Clinical Management Plan within legislative requirements and within the context of a prescribing partnership. 13 Demonstrate the ability to monitor response to medicines and modify treatment or refer as appropriate. 14 Demonstrate a systematic and critical understanding of the importance of record-keeping in the context of medicines management including: accurate recording in patient notes, reporting of near misses, adverse reactions, ability to access patient records and clinical management plans. 15 When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults. 16 Act autonomously in implementing a response to potential risks associated with prescribing of unlicensed medicines. 17 Demonstrate the independent learning ability required for continuing professional development. 18 Collaborate effectively with Independent Prescribers, the wider multidisciplinary teams and organisations to influence and enhance prescribing practice. Key Transferable Skills 19 Competent in the numeracy skills commensurate with the demands of research and scholarship in ways appropriate to prescribing practice. 5

6 RESPONSIBILITIES The Designated Medical Practitioner (DMP) Your DMP has a fundamental role in educating and assessing your practice. They will be invited to a mentor preparation workshop which will support their preparation for the role. The generic nature of the module content will facilitate you to apply your knowledge and understanding to safely prescribe within your own area of practice speciality. Your DMP will be further develop and guide your development. Your DMP is responsible for: Establishing a Learning Contract in partnership with you. Documenting progress on three occasions during supervised practice and provide any additional opportunities if required to achieve outcomes in a timely manner. Planning a learning programme which will provide the opportunity for you to meet your learning objectives and gain competency in prescribing. Facilitating learning by encouraging your critical thinking and reflection. Providing dedicated time and opportunities for you to observe how you conduct a consultation/interview with patient/clients and/or parents/carers and the development of a management plan. Allowing opportunities for you to carry out consultations and suggest clinical management and prescribing options, which are then discussed with you. Helping ensure that you integrate theory with practice. Taking opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient/client care and prescribing behaviour can be examined further. Facilitating, observing and assessing your performance over the continuous period of supervised practice. Assessing and verifying that, by the end of the course, you are competent to assume the prescribing role. It is the DMP s responsibility to decide whether or not you are making satisfactory progress towards meeting your practice outcomes for non-medical prescribing. This decision will be based upon whether or not the practice outcomes have been met. If during the practice days you are deemed by your DMP to be failing to make sufficient progress towards achievement of these outcomes they should inform both you and Bernadette in order to consider if strategies can be put in place to support you. Working in collaboration with LME to support midwife students. Identify and document any cause for concern, e.g. concerns regarding competence acquisition, or conduct, or unsafe practice, and discuss at the earliest possible stage with Bernadette. A Cause for Concern Form should be completed. If you demonstrate any concern relating to patient safety you should be aware that the School of Health & Social Care may consider the Fitness to Practise process. Details of this process can be found in your Student Essential Guide (School Handbook). 6

The contribution of your DMP in relation to providing you with supervision, support, and opportunities to develop competence in practice is therefore crucial. The criteria for fulfilling this role are that the DMP: Have normally had at least three years recent clinical experience for a group of patient/clients in the relevant field of practice. Work within a GP practice and are either vocationally trained or in possession of a certificate of equivalent experience from the Joint Committee for Postgraduate Training in General Practice Certificate or is a specialist registrar, clinical assistant or a consultant within a NHS Trust or other NHS employer. Have the support of the employing organisation or GP practice to act as the DMP who will provide supervision, support and opportunities to develop competence in prescribing practice. Have some experience or training in teaching and/or supervising in practice. Normally work with the student prescriber. If this is not possible (such as in nurse-led services or community pharmacy), arrangements can be agreed for another doctor to take on the role of the DMP, provided the above criteria are met and the learning in practice relates to the clinical area in which the student prescriber will ultimately be carrying out their prescribing role. The Lead Midwife for Education (LME) Jayne Cornforth (LME) will ensure that if you are a midwife you are provided with additional support. You will meet Jayne in week one of the module (if not on application) and will be expected to meet with her on a regular basis. The LME works closely with the module team and contributes to your assessment. The LME may work with your DMP if required and will contribute to the DMP preparation workshops. The Student Your role is to take responsibility for your own learning and demonstrate a willingness to develop both academically and in practice. You will be expected to discuss your own learning needs with your DMP and you should undertake honest self-assessment, articulate you re learning needs, seek and accept formative feedback from your DMP and module team. You are expected to recognise and appraise your own abilities and limitations. Module Team It is recognised that the demands of this module are challenging and that the intensity of the assessment is demanding. The module team will provide substantial support to you and your DMP both in an academic and pastoral capacity. If you require additional support you should discuss this with Bernadette at an early stage who will signpost you to the most appropriate student support. 7

7 ASSESSMENT STRATEGY Formative You will undertake formative assessment through peer debate in the classroom, relevant and relating to prescribing practice, a workshop-based peer review assessment of supplementary prescribing in Week 3 and a peer reviewed formative examination in Week 10. You and will have the opportunity to update, develop, and enhance your numeracy skills by undertaking online calculation testing. This will be monitored by the module team who will identify and support any additional support you require. Summative Component 1 Portfolio (70%) You will complete a Portfolio of Evidence that comprises of: Formulation and completion of a Learning Contract which identifies strategies to meet individual learning needs in relation to the module outcomes. Agreed and verified dates of supervised practice. A practice log that records practice experiences. Six case studies from learning log which demonstrate prescribing and prescription writing in a range of settings one must include demonstration of prescribing for children. A critical reflection and evaluation of episodes from the practice log demonstrating systematic and critical appraisal skills and informed decisionmaking (3,000 words). Completion of three P-Formulary work sheets. Three Clinical Management Plans drawn up whilst in supervised practice. Clinical Management Plans completed within the workshop with peers and peer review feedback sheet. Evidence of achievement in a 2 hour written examination. In order to gain pass grade you must achieve a minimum of 80% in the 20 question pharmacological element and 100% in the five question numerical element. Undertaken in Week 13. There will be two opportunities to meet this essential evidence prior to the submission of your Portfolio (pass/fail). Evidence of satisfactory completion of a period of supervised practice experience. Must be 12 days. Evidence of gaining consent and maintaining confidentiality. You will submit your portfolio in week 18. Please note Registered Nurses must undertake a minimum of 78 hours supervised practice. Allied Health Professionals must undertake a minimum of 90 hours supervised practice. Component 2 Objective Structured Clinical Examination (30%) You will undertake a 15-minute OSCE with an additional 5-minute viva in which you will demonstrate the essential elements required to prescribe or not prescribe safely. 8

You will undertake your OSCE in Week 18. 8 ASSESSMENT CRITERIA Portfolio You will demonstrate the ability to submit a Portfolio of Evidence which includes all essential evidence demonstrating your ability to prescribe safely in practice including: Achievement of the NMC/HCPC requirements for independent and supplementary prescribing/supplementary prescribing. Record of achievement of Non-medical Prescribing practice outcomes. Evidence of achievement in the written examination. Completion of P-Formularies which include evidence of a comprehensive and critical understanding of the pharmacodynamics, pharmacokinetics, legal aspects, and application to practice of drugs which you may prescribe in practice. Six case studies from your Learning Log which demonstrate prescribing and prescription writing in a range of settings including: o Personal development goals. o Recommendations for service development. Critical Reflection 70% of module mark Systematically and critically reflect upon episodes of significant learning highlighted in your learning logs which: o Synthesise and critically evaluate the need to prescribe safely considering issues such as ethical and legal practice, team-working, record-keeping, writing a prescription and numeracy associated with safe prescribing and how these apply to prescribing practice. o Synthesise and critically evaluate the need for personal development within current practice to deliver service improvement in contemporary non-medical prescribing. o Critically evaluate contemporary literature and evidence which informs your appropriate decision-making in prescribing practice. o Adhere to the School of Health & Social Care policy for confidentiality and consent. o Adhere to the School of Health & Social Care guidelines for presentation and referencing. In order to achieve a pass grade you must achieve a minimum of 50%. 9

OSCE including Viva -30% module mark You will demonstrate a comprehensive and critical and safe approach in the following criteria: Communicate effectively incorporating holistic individual needs using a variety of techniques to elicit the information on which to base your diagnosis. Interpret and critically evaluate information gathered during history-taking in a structured and logical way. Critically evaluate the information on which to base a probable diagnosis. Have a systematic and critical knowledge and understanding of the need to consider an appropriate strategy and choice of product in negotiation with the patient. Correctly complete a prescription or provide a critical rationale for advising buying the product of choice or lifestyle changes. Demonstrate a systematic and critical understanding of how to take the product safely and effectively and the need to review the patient appropriately. Synthesise and critically evaluate the following in the viva: o Pharmacology related to drug of choice. o Clinical decision-making strategy employed. o The contemporary literature underpinning your management strategy. o The pathophysiology related to the condition. In order to achieve a pass grade in your OSCE, you must achieve a minimum of 50%. If you demonstrate unsafe practice in any part of the assessment related to patient safety, for example, incorrect diagnosis, incorrect treatment options and incorrect completion of a prescription form you will be referred. Please ensure you also maintain confidentiality and gain informed consent. You will be awarded a mark of 0 for any of the above. It is a requirement that you must pass both components of the module. 10

ASSESSMENT DATES You will have the opportunity to have formative feedback as follows: Clinical Management Workshop Tuesday 27 th January 2015 Formative examination Tuesday 17 th March 2015 OSCE Workshop Monday 18 th May 2015 Summative Assessments Examination 1 st Attempt Tuesday 14 th April 2015 Resit Tuesday 19 th May 2015 Reassessment Will be agreed by the assessment board OSCE 1 st Attempt Wednesday 20 th May 2015 Reassessment Will be agreed by the assessment board Portfolio Submission Friday 22 nd May 2015 Reassessment Will be agreed by the assessment board 9 EVALUATION STRATEGY Informal feedback from students is welcomed throughout the module. You will also have the opportunity to provide formal feedback at the end of each module. There is also the opportunity for evaluation and feedback regarding the module through the student representative system. Please see the School Student Essential Guide for information on this process. Comments that you may have and suggestions for improvement that you may wish to make will be valued and appreciated. Everyone is here to help you successfully complete your programme. If in doubt, please ask. We hope you enjoy your time studying with us. 11

10 INDICATIVE RESOURCES Purchase N/A Essential Beckwith, S. & Franklin, P. (2007) Oxford Handbook of Nurse Prescribing. Oxford: Oxford University Press. Bickley, L.S. & Szilagyi, P.G. (2010) Bates Guide to Physical Examination and History Taking.11 th ed. Philadelphia: Lippincott, William & Wilkins. British National Formulary most recent edition. British National Formulary for Children most recent edition. Chartered Society of Physiotherapy (2013) Practice Guidance for Physiotherapist Supplementary and/or Independent Prescribers in the safe use of medicines. (2 nd Edition) http://www.csp.org.uk/publications/practice-guidance-physiotherapistsupplementary-andor-independent-prescribers-safe-use- [accessed 21st May 2014]. Chartered Society of Physiotherapy (2013) Outline Curriculum Framework for Conversion Programmes to Prepare Physiotherapist and Podiatrist Supplementary Prescribers as Independent Prescribers. http://www.csp.org.uk/documents/outline-curriculum-framework-conversionprogrammes-prepare-physiotherapist-podiatrist-supp [accessed 21st May 2014]. Chartered Society of Physiotherapy (2013) Outline Curriculum Framework for Education Programmes to Prepare Physiotherapists and Podiatrists as Independent/Supplementary Prescribers and to Prepare Radiographers as Supplementary Prescribers. http://www.csp.org.uk/documents/outline-curriculumframework-education-programmes-prepare-physiotherapists-podiatrists-ind [accessed 21st May 2014]. College of Podiatry (2013) Good Practice in Prescribing and Medicines Management for Podiatrists. http://www.scpod.org/practice-andstandards/independent-prescribing-insight/ [accessed 21st May 2014]. Courtenay, M. & Griffiths, M. (2005) Independent and Supplementary Prescribing. Cambridge: Greenwich Medical Media Ltd. Cox, N. & Roper, T.A. (2005) Clinical Skills. Oxford: Oxford University Press. Department of Health (2006) Improving patients' access to medicines: A guide to implementing nurse and pharmacist independent prescribing within the NHS in England This can be found on the Archived site of the DH. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/publicationsandstatis tics/publications/publicationspolicyandguidance/dh_4133743 [accessed 21st May 2014]. 12

Dimond, B. (2009) Legal Aspects of Physiotherapy. 2nd ed. Oxford: Blackwell Science. Dimond, B. (2011) Legal Aspects of Nursing. 6th ed. London: Prentice Hall. Dimond, B. (2002) Legal Aspects of Radiography and Radiology. Oxford: Blackwell Science. Health & Care Professions Council (2013) Standards for Prescribing. http://www.hpc-uk.org/publications/standards/index.asp?id=692 [accessed 21st May 2014]. Health & Care Professions Council (2013) Standards of proficiency Chiropodists / podiatrists. http://www.hpc-uk.org/publications/standards/index.asp?id=41 [accessed 21st May 2014]. Health & Care Professions Council (2013) Standards of proficiency Physiotherapists. http://www.hpc-uk.org/publications/standards/index.asp?id=49 [accessed 21st May 2014]. Health & Care Professions Council (2013) Standards of proficiency Radiographers. http://www.hpc-uk.org/publications/standards/index.asp?id=51 [accessed 21st May 2014]. Health & Care Professions Council (2012) Standards of conduct, performance and ethics. http://www.hpc-uk.org/publications/standards/index.asp?id=38 [accessed 21st May 2014]. Health & Care Professions Council (2012) Standards of education and training guidance. http://www.hpc-uk.org/publications/brochures/index.asp?id=195 [accessed 21st May 2014]. Lymn, J., Bowskill, D., Bath-Hextall, F. & Knaggs, R. (2010) (eds) The New Prescriber: An Integrated Approach to Medical and Non-medical Prescribing. Chichester: John Wiley & Sons. E-Book Markwell, S., Watson, J., Speller, V., Platt, S. & Younger, T. (2003) The Working Partnership.London: Health Development Agency. http://www.nice.org.uk/ [accessed 21st May 2014]. Medicines and Healthcare Products Regulatory Agency website contains information about the legal framework governing the prescribing, supply and administration of medicines. http://www.mhra.gov.uk/#page=dynamiclistmedicines [accessed 21st May 2014]. Munro, J. & Edwards, C. (2009) Macleod's Clinical Examination. 12th ed. London: Churchill Livingstone. National Prescribing Centre (Provided by NICE) (2012) http://www.npc.co.uk/ [accessed 21st May 2014]. NHS and Skills for Health (2008) Public Health Skills and Career Framework. http://www.phorcast.org.uk/page.php?page_id=44 [accessed 21st May 2014]. 13

Nursing & Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife Prescribers. http://www.nmcuk.org/documents/standards/nmcstandardsofproficiencyfornursea ndmidwifeprescribers.pdf [accessed 21st May 2014]. Nursing & Midwifery Council (2008) Standards for Medicines Management. http://www.nmcuk.org/documents/standards/nmcstandardsformedicinesmanagementbooklet.pdf [accessed 21st May 2014]. Nursing & Midwifery Council (2008) Guidance for Continuing Professional Development for Nurse and Midwife Prescribers Annexe 1 NMC circular 10/2008 http://www.nmc-uk.org/documents/guidance/nmc-guidance-for-cpd-fornurse-and-midwife-prescribers.pdf [accessed 21st May 2014]. Rang, H.P., Dale, M.M.& Ritter, J.M. (2012) Pharmacology. 7th ed. Edinburgh: Churchill Livingstone. Straus, S.E. (et al.) (2011) Evidence-based Medicine. 4th ed. Edinburgh: Churchill Livingstone. The Kings Fund (2011) The Future of Leadership and Management in the NHS. No More Heroes. http://www.kingsfund.org.uk/publications/future-leadership-and-management-nhs [accessed 21st May 2014]. Recommended Adams, M.P. & Holland, L.N. (2013) Pharmacology for Nurses. A Pathophysiologic Approach.4th ed. New Jersey. Pearson Education inc. Appelbe, G.E. & Wingfield, J. (2009) Dale and Appelbe s Pharmacy Law and Ethics. 9th ed. London: Pharmaceutical Press. Blair, K. (2010) Medicines Management in Children s Nursing. Exeter. Learning Matters Ltd. Chartered Society of Physiotherapy (2002) Code of Professional Contact. http://www.csp.org.uk/ [accessed 21st May 2014]. Glasby, J. & Dickinson, H. (2008) Partnership Working in Health and Social Care. Bristol: The Policy Press. Haylock, D. & Warburton, P. (2013) Mathematics explained for Healthcare Practitioners. London. SAGE Publications Ltd. Hutton, M. (2009) Essential Calculation Skills for Nurses and Midwives and Healthcare Practitioner. Maidenhead: Open University Press. Institute of Chiropodists and Podiatrists (2011) Code of Ethics. http://www.iocp.org.uk [accessed 21st May 2014]. 14

Lapham, R. & Agar, H. (2009) Drug Calculations for Nurses: A Step-by-Step Approach. 3rd ed. Hodder Arnold: London. McFadden, R. (2013) Introducing Pharmacology for nursing and healthcare. 2 nd ed. Harlow: Pearson Education Ltd. McKimm, J. & Phillips, K. (eds) (2009) Leadership and Management in Integrated Services. Exeter: Learning Matters Ltd. Nursing and Midwifery Council (2010) Nurse and Midwife Independent Prescribing of Unlicensed Medicines. NMC Circular 04/2010 http://www.nmcuk.org/documents/circulars/2010circulars/nmccircular04_2010.pdf [accessed 21st May 2014]. Nursing and Midwifery Council (2008) Remote Assessment and Prescribing. NMC Circular 16/2008. http://www.nmcuk.org/documents/circulars/2008circulars/nmc%20circular%2016_2 008.pdf [accessed 21st May 2014]. Nursing and Midwifery Council (2007) Additional Requirements to Include Within the Indicative Content of Nurse Independent Prescribing Education and Training Programmes. NMC Circular 30/2007. http://www.nmcuk.org/documents/circulars/2007circulars/nmc%20circular%2030_2007.pdf [accessed 21st May 2014]. Nursing and Midwifery Council (2007) Prescribing for Children and Young People. NMC Circular 22/2007. http://www.nmcuk.org/documents/circulars/2007circulars/nmc%20circular%2022_2007.pdf [accessed 21st May 2014]. NMC Circular 30/2007. Training Programmes. http://www.nmcuk.org/documents/circulars/2007circulars/nmc%20circular%2030_2007.pdf [accessed 21st May 2014]. Nuttall, D. & Rutt-Howard (2011) The Textbook of Non-Medical Prescribing. Chichester. Wiley-Blackwell. Schein, E. (2010) Organisational Culture and Leadership. 4th ed. San Francisco: Jossey Bass. Society of Radiographers (2008) Code of conduct and Ethics. http://www.sor.org/ [accessed 21st May 2014]. Society of Chiropodists and Podiatrists (2001) Code of Conduct. http://www.feetforlife.org [accessed 21st May 2014]. Starkings, S. & Krause, L. (2013) Passing Calculations Tests for Nursing Students. 2 nd ed. London. Learning Matters. 15

Storey, J. (2011) Leadership in Organisations: Current Issues and Key Trends. London: Taylor and Routledge. Walker, R. & Whittlsea, C. (2011) Clinical Pharmacy and Therapeutics. 5 th ed. Edinburgh: Churchill Livingstone. Wallace, M. & Wray, A. (2011) Critical Reading and Writing for Postgraduates. 2 nd ed. London: Sage Publications Ltd. E-Book Washer, P. (2009) Clinical Communication Skills. (ed) Oxford: Oxford University Press. Wedderburn-Tate, C. (2008) Leadership in Nursing. London: Churchill Livingstone. Yukl, G. (2009) Leadership in Organisations. 7th ed. London: Pearson Education Ltd. Journals this is not an exhaustive list other relevant journals will be applicable to your practice. British Medical Journal The Lancet Nurse Prescriber Nurse Prescribing Pharmacology and Pharmacy Pharmacology & Therapeutics Electronic British National Formulary (BNF) http://bnf.org/bnf/index.htm [accessed 21st May 2014]. Clinical Knowledge Summaries NICE produce patient information leaflets and lists drugs recommended and links them to the condition and situation in which they are recommended http://cks.nice.org.uk/ [accessed 21st May 2014]. Chartered Society of Physiotherapy http://www.csp.org.uk/ [accessed 21st May 2014]. CIPD (2008) Engaging Leadership. London: Chartered Institute of Personal Development. http://www.cipd.co.uk/shapingthefuture/_leadershipreport.htm [accessed 21st May 2014]. 16

Department of Health - Non-medical Prescribing Programme now archived on DH site. http://collections.europarchive.org/tna/20100509080731/http:/dh.gov.uk/en/healthcar e/medicinespharmacyandindustry/prescriptions/thenon- MedicalPrescribingProgramme/index.htm [accessed 21st May 2014]. Gov.uk Department of Health https://www.gov.uk/government/organisations/department-of-health [accessed 21st May 2014]. Health Professions Council (HPC) http://www.hpc-uk.org/ [accessed 21st May 2014]. Leaders Improvement Guides - a set of toolkits for leaders of modernisation (Archived but useful) http://www.institute.nhs.uk/ [accessed 21st May 2014]. Medicines and prescribing support from NICE - MeReC publications http://www.nice.org.uk/mpc/ [accessed 21st May 2014]. Medicines and prescribing support from NICE - now holds the National Prescribing Centre (NPC) information - useful for prescribing competency frameworks http://www.nice.org.uk/mpc/ [accessed 21st May 2014]. MeReC publications are high quality resources useful to a wide range of healthcare professionals. They provide concise, evidence based information about medicines and prescribing related issues. http://www.npc.nhs.uk/merec/ [accessed 21st May 2014] - the National Prescribing Centre website is now achieved but is still available as a resource to support your learning. National Institute for Health and Care Excellence (NICE) provides national guidance on drugs http://www.nice.org.uk/ [accessed 21st May 2014]. NHS National Patient Safety Agency http://www.npsa.nhs.uk/ [accessed 21st May 2014]. NHS Improving Quality. The Productive Series http://www.theproductives.com/ [accessed 21st May 2014]. NHS Leadership Academy http://www.leadershipacademy.nhs.uk/discover/leadershipmodel/ [accessed 21st May 2014]. Nursing & Midwifery Council (NMC) http://www.nmc-uk.org/ [accessed 21st May 2014]. Skills for Care http://www.skillsforcare.org.uk/ [accessed 21st May 2014]. 17

Society of Chiropodists and Podiatrists http://www.scpod.org/ [accessed 21st May 2014]. Society of Radiographers http://www.sor.org/ [accessed 21st May 2014]. The Human Medicines Regulations 2012 and Control Drugs legislation at gov.uk http://www.legislation.gov.uk/all?title=controlled%20drugs [accessed 21st May 2014]. There are many links to information in your Web links section on Blackboard. 18

11 GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO The purpose of your Portfolio is to provide a framework through which you can record and demonstrate your progress and achievements whilst studying Advancing Non-medical Prescribing. In order to demonstrate achievement of the module, you are required to present a Portfolio of Evidence that provides a documentary record of your learning and how this relates to the module outcomes. The portfolio-keeping process includes: Reflection upon existing knowledge and skills. Exploration of the module outcomes. Identification of learning needs. Identification of learning opportunities in your supervised practice area and who can support you. Matching learning opportunities to learning needs. Development of a plan or Learning Contract to meet learning needs. Implementation of the plan/learning Contract and collection of supporting evidence. Keeping a practice Learning Log. Reflection upon learning and achievement of practice module outcomes. Presentation of the Portfolio at the end of the module. How to Compile your Portfolio Stage 1 - Identifying Your Learning Needs The first step is to look at the practice outcomes and consider what you need to learn to achieve each one. You must have time aside with your DMP at the beginning of the practice placement and review the practice outcomes, consider how these can be achieved and consider your own self-assessment and how your learning needs can be met. A Learning Contract will be developed to show how these outcomes can be achieved. This contract can also be used as a framework for your critical reflection of learning. This meeting must be documented by both you and your DMP on the initial meeting form. The Learning Contract template can be found in in the Portfolio document section. Stage 2 - Feedback You must both set aside time to review progress and provide feedback on progress. This should be undertaken regularly and should involve discussing cases from practice experiences and reflecting upon and critically analysing. It is important that you consider how theoretical concepts are used to inform these discussions. This stage also includes assessment of your progress towards competence in relation to practice outcomes and you and your DMP must document this using the intermediate meeting form. 19

Stage 3 Final Sign Off At the end of the module, you will submit your Portfolio for verification of the award. Your DMP must sign and date the practice outcomes have been met. It is important that you provide a short statement on how you have achieved each outcome on the table of practice outcomes in the Portfolio. You should both also provide evidence of a final meeting using the final meeting form and final sign-off point. Your Portfolio must include the following: Formulation and completion of a Learning Contract which identifies strategies to meet your individual learning needs in relation to the module outcomes. Personal development goals. Recommendations for service development. Agreed and verified dates of supervised practice. A practice log that records practice experiences. Six case studies from learning logs which demonstrate prescribing and prescription writing in a range of settings one must include demonstration of prescribing for children. An arrangement should be made for you to spend time with a prescriber who does prescribe for children if your DMP does not. Throughout the assessment registrants who will prescribe for children must also demonstrate recognition of the unique implications and developmental context of the anatomical and physiological differences between neonates, children and young people. Reflective analysis of episodes from your practice logs demonstrating critical appraisal skills and informed decision-making. Completion of three P-Formulary work sheets. Three Clinical Management Plans drawn up whilst in supervised practice this should be undertaken in consultation with your DMP on successful completion of the module if you are a nurse, physiotherapist or podiatrist you will be able to prescribe independently and on a supplementary basis. Radiographer students can currently only prescribe on a supplementary basis. Clinical Management Plans completed within the workshop with peers and peer review feedback sheet. Evidence of achievement of the written examination. Evidence of satisfactory completion of a period of supervised practice experience. Must be 12 days. Your DMP must document progress on at least three occasions during the practice learning and provide a final sign off of competence. Your manager must sign the declaration which is detailed at the end of the practice outcomes document. Evidence of gaining consent and maintaining confidentiality. It is likely that you will include evidence which relates to particular individuals, informed consent must be obtained, anonymity must be ensured, and the School of Health & Social Care Consent Form completed. Your DMP is responsible for ensuring and verifying that consent has been agreed and that confidentiality is maintained. You have a professional responsibility to ensure that consent has been agreed and that confidentiality is maintained. Verification of your Disclosure and Barring Service (DBS) status. 20

All the practice outcomes must be achieved by the end of the module and the Portfolio forwarded to Bernadette for verification. If you are referred on one or more of the practice outcomes you must demonstrate achievement of this outcome at the designated point of negotiated re-assessment. If this is the case you must devise a Learning Contract and action plan with your DMP and Bernadette in order to address the outcomes involved. The decision regarding whether or not you have achieved this Learning Contract will be made by your DMP. The practice log can also be used as a tool to guide reflection on practice. By recording experiences, in particular those that create uncertainty and conflict, an opportunity for reflection on action can be created. Such reflection articulates the factors that underpin decision-making and facilitates the identification of alternative approaches. However it is also essential that sustained observation in the practice environment is used to provide evidence of competence in practice. It is important that you should collect your Portfolio of Evidence on an on-going basis to demonstrate achievement of the practice outcomes. All Portfolio components must be submitted. Your Portfolio will be submitted to the module team at the end of the module. You will complete a receipt for submission of assignment form. This form will be signed by the member of the module team receiving the Portfolio and the carbon copy retained by you. 21

12 PORTFOLIO DOCUMENTS 1. Record of Supervised Practice Meetings 2. Record of Achievement of Practice Outcomes 3. Learning Logs 4. Case studies 5. Practice Placement Prescribing Support Information 6. Signature Sheet 7. Agreed Supervised Practice Hours 8. Learning Contract 9. P-Formulary Worksheet Framework 10. Clinical Management Plan Template 11. Level 7 University Generic Marking Criteria 12. Consent & Confidentiality 13. Personal Development Plan 14 DBS Verification 22

RECORD OF SUPERVISED PRACTICE MEETINGS Initial Meeting Designated Medical Practitioner comments: Signature: Date: Student comments: Signature: Date: 23

Intermediate Meeting Designated Medical Practitioner comments: Signature: Date: Student comments: Signature: Date: 24

FINAL ASSESSMENT SIGN-OFF Final Meeting Designated Medical Practitioner comments: Competent/Not Competent (please delete as appropriate) I am satisfied/not satisfied (please delete as appropriate) that the student has met the outcomes of the module. This has been evidenced through observation, question and answer discussion throughout the practice experience Signature: Date: Student comments Signature & Date 25

RECORD OF ACHIEVEMENT OF PRACTICE OUTCOMES Assessment of your prescribing within your area of clinical practice Learning Outcomes Evidence By the end of the module the student will be able to: Demonstrate a systematic and critical understanding of drug actions in prescribing practice (pharmacodynamics and pharmacokinetics) Demonstrate a systematic and critical understanding the factors influencing safe and ethical prescribing practice at individual, local and national Integrate and synthesise sources of information/advice and decision support systems in prescribing practice Have a critical awareness of the need to identify and deliver service improvement within prescribing practice Demonstrate the ability to manage the implications of ethical dilemmas whilst recognising the contributions of the roles and relationships of others involved in prescribing, supplying and administering medicines DMP Signature & Date Student Signature 26

Learning Outcomes By the end of the module the student will be able to: Demonstrate and have a systematic and critical understanding of the need for effective consultation/ assessment skills including: Evidence DMP Signature & Date Student Signature Ability to communicate effectively with patient/clients, clients, parents and carers Ability to conduct a relevant physical assessment/ examination of patients with those conditions for which they may prescribe Ability to undertake a thorough history, including medication history and current medication (including over the counter, alternative and complementary health therapies) to inform decision-making Ability to engage in the process of effective clinical decision-making Ability to assess patients needs for medicine taking account of their wishes, values, ethnicity, and the choices they may wish to make Demonstrate and have a comprehensive and critical understanding of the need prescribe safely, appropriately and cost effectively Practice within a framework of professional accountability and responsibility Incorporate patients' choice into the decision-making process 27