The Textbook of Non-Medical Prescribing is an authoritative and accessible overview of the vital skills, contemporary issues and essential knowledge relevant to both students and healthcare practitioners. Written as a response to the growing emphasis placed on prescribing in the modern health service, this text provides up-to-date information on safe and effective prescribing. This wide-ranging book helps students and trainees develop foundational knowledge of the key areas and prescribing competencies and provides healthcare professionals with a continued source of current information.
Now in its third edition, this text has been fully updated and revised to reflect changes in legislation, current practices and new guidelines. New and updated topics include independent prescribing for therapeutic radiologists, supplementary prescribing for dietitians, paramedics working in advanced roles to independently prescribe and the Royal Pharmaceutical Society's Competency Framework for all Prescribers.
Provides up-to-date information essential to safe and effective prescribing in a clear, easy-to-understand style
Discusses current issues and practices in pharmacology, prescribing and therapeutics and medicine management
Links to the Royal Pharmaceutical Society's Competency Framework for all Prescribers for non-medical prescribers
Presents learning objectives, key theme summaries, activities and numerous case studies
Offers access to additional online resources including interactive exercises, quizzes, self-assessment tests and web links
The Textbook of Non-Medical Prescribing is an essential resource for students, nurses, dieticians, pharmacists, and allied health practitioners pursuing a prescribing qualification or looking for an updated refresher on the subject.
Acknowledgements xiii
Notes on Contributors xiv
About the Companion Website xvi
Introduction xvii
Dilyse Nuttall and Jane Rutt-Howard
1 Prescribing in Context 1
Dilyse Nuttall
The prescribing journey 1
Defining non-medical prescribing 2
The non-medical prescribing vision 3
Attitude shifts 3
Non-medical prescribing, medical prescribing or prescribing 5
Changes in clinical practice 6
The role of non-medical prescribing 6
Compassion in practice, the 6 Cs and leading change 7
The economic context 7
The private sector 8
The public health context 9
UK public health policy 9
Need and expectations 10
Differentiating between prescribers 11
Independent prescribing 11
Assessment 12
Supplementary prescribing 14
Nurse non-medical prescribers 19
Pharmacist non-medical prescribers 22
Allied health professional non-medical prescribers 23
PGDs 26
Access to education programmes 28
Summary of the context of prescribing 28
References 30
2 Professional, Legal, and Ethical Issues in Prescribing Practice 35
Ruth Broadhead
Part 1: Professional issues 36
Part 2: Legal issues 48
Part 3: Ethical issues 80
Conclusion 86
Table of cases 87
References 87
Acts and statutory instruments 91
3 Factors Influencing Prescribing 93
Georgina Louise Ritchie and Val Lawrenson
The prescriber 93
The patient 101
The product 107
References 114
4 The Consultation Umbrella Supporting Effective Consultations 117
Jane Rutt-Howard
Presenting the consultation umbrella 118
The value of therapeutic communication 119
Consultation models in context 126
The consultation umbrella - a consultation model 130
Clinical decision-making 141
Conclusion 147
References 148
5 Essential Pharmacology for Non-medical Prescribers 152
Janice Davies
Pharmacology as part of prescribing practice 153
Example of potential pharmacokinetic impact on patient care 153
Example of potential pharmacodynamic impact on patient care 154
Brief introduction to pharmacological terms 154
Guide through processes to build and develop one's own formulary, with examples 167
BNF: practise using this essential resource 169
Prescribing in co-morbidity 170
Management and avoidance of drug interactions 172
Management and avoidance of ADRs 174
Drugs with a narrow therapeutic index or range 178
Other resources to support your learning 180
References 181
6 The Multidisciplinary Prescribing Team 183
Dawn Eccleston
Defining 'the multidisciplinary prescribing team' 183
Confusion in terminology 184
The drivers in multidisciplinary team working 184
The benefits to prescribing within a team 185
Models for the multidisciplinary approach 185
Putting the 'P' in MDT 188
Understanding roles 188
Pharmacists 188
Nurse and midwife prescribers 189
Allied health professionals 190
Physiotherapists 191
Radiographers 191
Optometrists 192
Podiatrists 193
Dietitians (Nutritionists) 194
Paramedics 194
Non-medical prescribing lead 195
The multidisciplinary non-medical prescribing team 195
Benefits to patients and clients 196
Commissioning and the MDPT 198
Problems with multidisciplinary team working! 199
Education and learning 201
Conclusion 201
References 204
7 Clinical Skills 207
Jane Rutt-Howard and Kathryn Smyth
Holistic assessment and initial impressions 208
The national early warning score 209
Vital signs 211
Clinical examination 222
Examination of body systems 228
Conclusion 231
References 235
8 Prescribing for Specific Groups 238
Janice Davies and Dilyse Nuttall
Introduction 238
Prescribing in liver disease 238
Renal 244
Prescribing in pregnancy 248
Prescribing in breastfeeding 253
Prescribing for older people 255
Prescribing for children and young people 260
Other groups 266
References 270
9 Enhancing Non-medical Prescribing Through Reflective Practice, Evidence-based Prescribing and Continuing Professional Development 274
Janice Davies and Charlotte Smith
Introduction: non-medical prescribing - a success story 274
What is reflective practice? 276
Evidence-based prescribing practice 280
Medicines management and medicines optimisation 282
Medication review 286
Polypharmacy 288
Medicines at the interface 291
Medicines reconciliation 292
Building concordance 293
Continuing professional development 296
Numeracy and NMP 299
NMP: into the future 299
References 303
Patient Case Studies 309
Case study 1: Harold 309
Case study 2: Barbara 310
Case study 3: Meihui 310
Case study 4: Julie 311
Case study 5: Annette 311
Case study 6: Yasmin 311
Case study 7: Amy 312
Case study 8: Louis 312
Case study 9: Viktor (with clinical management plan) 312
Case study 10: Joanne 314
Case study 11: Mrs Elliott 314
Case study 12: Miss Richards 314
Health Professional Case Studies 315
Case study A: Debbie 315
Case study B: Mark 316
Case study C: Sabina 316
Case study D: Farhad 317
Case study E: David 317
Case study F: Andrew 318
Case study G: Andrea 318
Case study H: Lisa 318
Case study I: Christine 319
Case study J: Simon and Janice 319
Case study K: Lucja 319
Case study L: Katy 320
Case study M: Emyr 320
Index 321
