The integration of nurse prescribing: case studies in primary and secondary care

THE INTEGRATION OF NURSE PRESCRIBING IN PRIMARY AND SECONDARY CARE. Nurse independent and supplementary prescribers have legal authority to prescribe all licensed and unlicensed medicines with some minor restriction to prescribing controlled drugs. These prescribing rights are similar to those of doctors. To be effective, the integration of nurse prescribing must be consistent with the legal framework for nurse prescribing and, be acceptable to the nurse, employer, patient and healthcare team. There is little known about how prescribing is integrated in practice but agreements are potentially important to the organisation of professional work and may ultimately affect patient safety. These case studies set out to investigate how nurse prescribers integrate prescribing in primary and secondary care. Each case, a nurse prescriber,had completed the independent and supplementary prescribing course at one university between September 2004 and January 2007. Of the 26 cases recruited 13 had been qualified to prescribe for between 7 and 13 months, and 13 for 14 and 26 months. Data collected through semistructured interviews, field notes and attribute data was drawn together in case summaries. Data analysis showed effective integration to be dependent upon professional relationships and prescribing role agreements. Prescribers outlined three approaches to integrate prescribing. These were; prescribing as the opportunity presents, prescribing for specific conditions and prescribing for individuals. Prescribing as the opportunity presents reflects medical models of prescribing. Condition specific and individual approaches restrict prescribing to specific medical condition(s)or individual patients. These nurse prescribers preferred to use Independent prescribing. Reflecting this, prescribers showed higher levels of dependence on doctors than previously reported. This was most common in the first year of prescribing. Relationships between nurse prescribers and the team were important. New nurse prescribers raised unexpected issues in some intraprofessional relationships. However, it was the inter-professional relationship between nurse and doctor that determined integration. The nurse must believe, trust exists and is reciprocal to integrate prescribing in practice. Where there was an absence of trust or a concern of mistrust the nurse would not integrate prescribing

The integration of nurse prescribing: case studies in primary and secondary care

THE INTEGRATION OF NURSE PRESCRIBING IN PRIMARY AND SECONDARY CARE. Nurse independent and supplementary prescribers have legal authority to prescribe all licensed and unlicensed medicines with some minor restriction to prescribing controlled drugs. These prescribing rights are similar to those of doctors. To be effective, the integration of nurse prescribing must be consistent with the legal framework for nurse prescribing and, be acceptable to the nurse, employer, patient and healthcare team. There is little known about how prescribing is integrated in practice but agreements are potentially important to the organisation of professional work and may ultimately affect patient safety. These case studies set out to investigate how nurse prescribers integrate prescribing in primary and secondary care. Each case, a nurse prescriber,had completed the independent and supplementary prescribing course at one university between September 2004 and January 2007. Of the 26 cases recruited 13 had been qualified to prescribe for between 7 and 13 months, and 13 for 14 and 26 months. Data collected through semistructured interviews, field notes and attribute data was drawn together in case summaries. Data analysis showed effective integration to be dependent upon professional relationships and prescribing role agreements. Prescribers outlined three approaches to integrate prescribing. These were; prescribing as the opportunity presents, prescribing for specific conditions and prescribing for individuals. Prescribing as the opportunity presents reflects medical models of prescribing. Condition specific and individual approaches restrict prescribing to specific medical condition(s)or individual patients. These nurse prescribers preferred to use Independent prescribing. Reflecting this, prescribers showed higher levels of dependence on doctors than previously reported. This was most common in the first year of prescribing. Relationships between nurse prescribers and the team were important. New nurse prescribers raised unexpected issues in some intraprofessional relationships. However, it was the inter-professional relationship between nurse and doctor that determined integration. The nurse must believe, trust exists and is reciprocal to integrate prescribing in practice. Where there was an absence of trust or a concern of mistrust the nurse would not integrate prescribing

Pharmacology as a foreign language: A preliminary evaluation of podcasting as a supplementary learning tool for non-medical prescribing students

<p>Abstract</p> <p>Background</p> <p>Nurses and other health professionals in the U.K. can gain similar prescribing rights to doctors by undertaking a non-medical prescribing course. Non-medical prescribing students must have a thorough understanding of the pharmacology of prescribing to ensure safe practice. Pharmacology education at this level is complicated by the variation in students' prior subject knowledge of, and anxiety about, the subject. The recent advances in technology, particularly the potential for mobile learning, provide increased opportunities for students to familiarise themselves with lecture materials and hence promote understanding. The objective of this study was therefore to evaluate both the subjective (student perception) and objective (student use and exam results) usefulness of podcasts of pharmacology lectures which were provided as an extra learning tool to two cohorts (n = 69) of non-medical prescribing students.</p> <p>Methods</p> <p>The podcasts were made available to students through the virtual learning environment WebCT. Use of podcasts by two successive cohorts of nurse prescribing students (n = 69) was tracked through WebCT. Survey data, which was collected from 44 of these students, investigated patterns of/reasons for podcast use and perceived usefulness of podcasts as a learning tool. Of these 69 students, 64 completed the pharmacology exam. In order to examine any impact of podcasts on student knowledge, their exam results were compared with those of two historical cohorts who did not have access to podcasts (n = 70).</p> <p>Results</p> <p>WebCT tracking showed that 91% of students accessed at least one podcast. 93% of students used the podcasts to revisit a lecture, 85% used podcasts for revision, and 61% used the podcasts when they had a specific question. Only 22% used the podcasts because they had missed a pharmacology session. Most students (81%) generally listened to the entire podcast rather than specific sections and most (73%) used them while referring to their lecture handouts. The majority of students found the podcasts helpful as a learning tool, as a revision aid and in promoting their understanding of the subject. Evaluation of the range of marks obtained, mode mark and mean mark suggested improved knowledge in students with access to podcasts compared to historical cohorts of students who did not have access to pharmacology podcasts.</p> <p>Conclusions</p> <p>The results of this study suggest that non-medical prescribing students utilised podcasts of pharmacology lectures, and have found the availability of these podcasts helpful for their learning. Exam results indicate that the availability of podcasts was also associated with improved exam performance.</p

The integration of nurse prescribing : case studies in primary and secondary care

Nurse independent and supplementary prescribers have legal authority to prescribe all licensed and unlicensed medicines with some minor restriction to prescribing controlled drugs. These prescribing rights are similar to those of doctors. To be effective, the integration of nurse prescribing must be consistent with the legal framework for nurse prescribing and, be acceptable to the nurse, employer, patient and healthcare team. There is little known about how prescribing is integrated in practice but agreements are potentially important to the organisation of professional work and may ultimately affect patient safety. These case studies set out to investigate how nurse prescribers integrate prescribing in primary and secondary care. Each case, a nurse prescriber,had completed the independent and supplementary prescribing course at one university between September 2004 and January 2007. Of the 26 cases recruited 13 had been qualified to prescribe for between 7 and 13 months, and 13 for 14 and 26 months. Data collected through semistructured interviews, field notes and attribute data was drawn together in case summaries. Data analysis showed effective integration to be dependent upon professional relationships and prescribing role agreements. Prescribers outlined three approaches to integrate prescribing. These were; prescribing as the opportunity presents, prescribing for specific conditions and prescribing for individuals. Prescribing as the opportunity presents reflects medical models of prescribing. Condition specific and individual approaches restrict prescribing to specific medical condition(s)or individual patients. These nurse prescribers preferred to use Independent prescribing. Reflecting this, prescribers showed higher levels of dependence on doctors than previously reported. This was most common in the first year of prescribing. Relationships between nurse prescribers and the team were important. New nurse prescribers raised unexpected issues in some intraprofessional relationships. However, it was the inter-professional relationship between nurse and doctor that determined integration. The nurse must believe, trust exists and is reciprocal to integrate prescribing in practice. Where there was an absence of trust or a concern of mistrust the nurse would not integrate prescribing.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The new prescriber: an integrated approach to medicaland non-medical prescribing

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