Independent Prescribing Case Study
Case Study for Independent Prescribing
There are many definitions of Independent prescribing, the Department of Health (2006 para 7 & 8)) working definition is:
‘Independent prescribing is prescribing by a practitioner (e.g. doctor, dentist, nurse, and pharmacist) responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. In partnership with the patient, independent prescribing is one element of the clinical management of a patient. It requires an initial assessment, interpretation of that assessment, a decision on safe and appropriate therapy, and a process for ongoing management. The independent prescriber is responsible and accountable for at least this element of a patients care’
The aim of this case study is to focus on my future role as an independent prescriber. I have applied the seven principles of good prescribing (NMC 1999) and supported the decision making process with the use of Barbers model (Barber1995). As previously stated within the introduction I will reflect on the process using Gibbs model of reflective practice (Gibbs 1988), (appendix 1).
In my role as a specialist nurse I am involved with caring for patients within a community setting and providing a holistic assessment of their needs. This can involve assessing patients as a result of a supported discharge from secondary care or referral from General Practitioners (GP’s) for issues related primarily to their cardiac condition, their general overall health and any other health related issues. These assessments can take place within the patient’s home or within a clinic setting. These assessments are quite commonly carried out with very little prior knowledge regarding the patient and this is currently an area under review. For the purpose of this case study I will look at a lady who attended a clinic session within a GP’s practice.
This lady was referred to the clinic
There are many definitions of Independent prescribing, the Department of Health (2006 para 7 & 8)) working definition is:
‘Independent prescribing is prescribing by a practitioner (e.g. doctor, dentist, nurse, and pharmacist) responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about the clinical management required, including prescribing. In partnership with the patient, independent prescribing is one element of the clinical management of a patient. It requires an initial assessment, interpretation of that assessment, a decision on safe and appropriate therapy, and a process for ongoing management. The independent prescriber is responsible and accountable for at least this element of a patients care’
The aim of this case study is to focus on my future role as an independent prescriber. I have applied the seven principles of good prescribing (NMC 1999) and supported the decision making process with the use of Barbers model (Barber1995). As previously stated within the introduction I will reflect on the process using Gibbs model of reflective practice (Gibbs 1988), (appendix 1).
In my role as a specialist nurse I am involved with caring for patients within a community setting and providing a holistic assessment of their needs. This can involve assessing patients as a result of a supported discharge from secondary care or referral from General Practitioners (GP’s) for issues related primarily to their cardiac condition, their general overall health and any other health related issues. These assessments can take place within the patient’s home or within a clinic setting. These assessments are quite commonly carried out with very little prior knowledge regarding the patient and this is currently an area under review. For the purpose of this case study I will look at a lady who attended a clinic session within a GP’s practice.
This lady was referred to the clinic
References: Anderson, R. (1999) Responsibilities of Prescribing. In Humphries, J.L. Green, J. (2002) Nurse Prescribing 2nd Ed McMillan press Andalo,D Anderson, R. (2002) Responsibilities of prescribing. In Humphries, J.L. Green, J. (2002) Nurse Preacribing 2nd Ed McMillan Press Atkinson, R.L Barber, N. (1995) What Constitutes Good prescribing? British Medical Journal 310 pp 923-925 Bardsley,A Benner (2001) From Novice to Expert Excellence and Power in Clinical Nursing Practice Commemorative ed Prentice Hall. New Jersey Bickley, L.S British National Formulary (2009) British Medical Association. Burnard, P Carlisle,D. (1992) The Scope of Proffessional Practice Nursing Times 88:37 p 26-29 Courtney,M.Griffith,M Department of Health (1989) Report of the Advisory Group on Nurse Prescribing (Crown Report). Department of Health, London. HMSO Department of Health (2000) UK Antimicrobial Resistance Strategy Action Plan The Stationary Office, London Department of Health (2003) Supplementary Prescribing by Nurses and Pharmacists within the NHS in England: A Guide for Implementation. DOH London Department of Health (2004) Choosing Health-Making Healthy Choices Easier Department of Health (2004) www.dh.gov.uk/ Policy and Guidance/Nurse Prescribing (2004) Department of Health (2005) Supporting People with Long Term Conditions- Liberating the Talents of Nurses Who Care for People with Long Term Conditions DOH London Dimmond, B. (2005) Exploring the principles of good record keeping in nursing British Journal of Nursing Vol 14 (8) p460-462 Downie, G Gibbs,G. (1988) Learning by doing. A guide to teaching and learning methods Oxford Polytechnic. Oxford Griffith,S Health Protection Agency (2005) Management of Infection:Guidance for Primary Care HPA. London Hummers-Praider,E Loren, G. Miller, M.D. & Tang, A.W. (2004) Treatment of Uncomplicated Urinary Tracy Infections in an Era of Increasing Antimicrobial Resistence. New England Journal Of Medicine p 32 -37 Marinker,M.Shaw,J MeReC Bulletin (1995) UTI National Prescribing Centre 6pp 29-32 MeReC Bulletin (2001) Prescribing for the elderly patient NPC 11:10 National Prescribing Centre (2003) Maintaining Competency in Prescribing- An Outline Framework to help Nurse Prescribers NPC Nursing and Midwifery Council (2004) The NMC code of professional conduct; standards for conduct, performance and ethics Nursing and Midwifery Council (2005) Guidelines for records and record keeping Nursing and Midwifery council, London Nursing and Midwifery Council (2006) Standards of Proficiency for nurse and midwife prescribers Prodigy (2005) www.prodigy.nhs.uk/guidance (accessed Dec 09) Reddy,B Reveley, S. (1999) The Professional and Legal Framework for the Nurse Prescriber, In Walsh ,M Rowe, JA. (2000) Accountability: a fundamental component of nursing practice. British Journal of Nursing Vol 9 (9) p502-508 Silverman,J Stanton,S.L. and Dwyer, P.L. 2000 in Bardsley, A. Urinary tract infections: prevention and treatment of a common problem Nurse Prescriber 1(13) pp113-117 Taylor, D SMAC (1998) Standing Medical Advisory Committee sub group on Antimicrobial Resistance. The Path of Least Resistance London: DoH While, A WHO (2002) antimicrobial (will slip through our grasp says WHO) The Pharmaceutical Journal 264 (7101) pp 902 Bibliography CSM (1997) Current problems in Pharmacovigilance 23: May 8 Department of Health (2000a) The NHS Plan: a plan for investment, a plan for reform Department of Health (2002) Guidelines for the Implementation of Extended Nurse Prescribing May 2002 HMSO London Nursing and Midwifery Council (2006) Standards of proficiency for Nurse and Midwife prescribers London