Advanced level nursing: position statement sets benchmark
November 24, 2010 by admin
The Department of Health (DH) has now published a position statement on advanced level nursing, which highlights the role of prescribing at this level.
In the past, this term has been used inconsistently, leading to confusion. In her foreword, the Chief Nursing Officer Christine Beasley says that the statement defines, “the nature of advanced practice, what it encompasses and how it is different from the level of practice at registration”, and applies to all nurses involved in direct care delivery working at an advanced level.
The statement groups different elements into four themes: clinical/direct care practice; leadership and collaborative practice; improving quality and developing practice; and developing self and others. The first theme will usually include prescribing medication.
Course for NMPs and their teams
November 24, 2010 by admin
A half-day interdisciplinary course for non-medical prescribers (NMPs) and their clinical colleagues including GPs, to prepare for the roll-out or implementation of non-medical prescribing is now available, and has been accredited by the Association for Nurse Prescribing (ANP). The course is delivered locally, can be tailored to meet local needs, and has been developed in association with the Cornwall Partnership NHS Foundation Trust.
The course can cover topics such as: the competencies needed by NMPs, accountability, regulatory body requirements and legal issues, governance compliance, clinical management plans, continuing professional development requirements, and developing prescribing. It is aimed at assisting teams to prepare for change and takes a whole systems approach.
For further information or an informal discussion, please contact: Steve Turner; email: steve@stnov8.co.uk; website: http://www.stnov8.co.uk/; tel: 01726 842583.
Non-medical prescribing in secondary care: more is needed
November 10, 2010 by admin
“When are the other night sisters going to do their prescribing course?” was the question asked of this orthopaedic night sister with a non-medical prescribing qualification working in a centre for elective orthopaedic surgery, by nursing colleagues who felt they were able to provide better care for their patients as a result of her prescribing. This interesting article describes an audit of the author’s prescribing practice and some of her experiences as a prescriber.
The plan for this prescriber had been that she would start by prescribing for patients on the close observation unit within the centre and then after three months to start prescribing for the rest of the centre, but in fact her skills were needed sooner than that by other wards.
An audit was conducted after four months using her prescribing diary, a list of drugs she was allowed to prescribe, annotated to indicate the number of times they were prescribed, and the Trust audit tool. This showed that her prescribing was readable, clear, correct and in line with local policy and guidelines. She was prescribing a mean of 5.4 times a night, with the most common items being analgesia and intravenous fluid The author comments that one issue was that she sometimes had to prescribe and administer medicines to a patient, so would ask another trained nurse to check and co-sign the prescription before administration. She points out also that it is appropriate not to prescribe in situations where the prescriber does not feel confident (an example was requests for night sedation from patients who had already had large amounts of morphine).
It is still unusual to find nurses prescribing in wards, although specialist nurses and nurse consultants are prescribing in hospitals: the author explains the rationale and benefits for introducing nurse prescribing in her particular setting, concluding that more non-medical prescribers are needed in secondary care.
Crew S. Non-medical prescribing in secondary care: an audit. Nurse Prescribing 2010; 8(10): 498-502.
NICE consults on diabetes and glaucoma draft quality standards
November 10, 2010 by admin
New draft quality standards for diabetes in adults and glaucoma have been published by NICE and comments invited.
Traffic light’ system used in UKMi tool
November 10, 2010 by admin
A ‘traffic light’ system which categorises - as red, orange and green - potential risks as consequences of delayed or omitted medicines in hospitals, for different drugs or drug classes from the BNF, has been developed by the UKMi and can be found here. The National Patient Safety Agency (NPSA) published a Rapid Response Report earlier this year on reducing harm from omitted and delayed medicines in hospital which said that organisations need to construct a list of medicines for which timeliness is crucial as well, among the other actions necessary. This tool is designed to help in drawing up local lists, not to replace them, as well as help with the other actions identified.
PGD information updated
November 10, 2010 by admin
New questions and answers have been posted on the NHS Patient Group Directions website including information on the use of PGDs in GP practices, for example by practice nurses.
The future of PGDs - have your say
November 10, 2010 by admin
Do Patient Group Directions (PGDs) prevent professionals getting non-medical prescribing qualifications? Are they now being used to manage planned care? Should they be retained and if so what changes could be made? Do they foster innovation and improvements in care? Are they bureaucratic? Are there other groups of health professionals who should be able to use PGDs? The Medicines and Healthcare products Regulatory Agency (MHRA) has launched an informal consultation about the provisions for PGDs in the NHS and private sector and other related matters and would like responses by 19 November. Revised guidance may accompany any new legislation, as the review offers the opportunity to look at this as well, and to clear up any misunderstandings.
Generic substitution plans dropped
November 10, 2010 by admin
The Department of Health (DH) has announced it will not be going ahead with plans for generic substitution of medicines in primary care in England, following the consultation earlier this year (see here for details and here for responses. It says that professionals will continue to base their prescribing decisions on their assessment of individual patients and their circumstances. Nearly 85% of prescriptions are already for generics and the DH says it will continue to look for ways of supporting the use of generics. Minister Lord Howe said that, as well as listening to concerns, it was also, “not clear whether the proposals would have provided substantial benefit to the NHS, compared to the efforts of frontline staff to implement them”.
CKS topics for October and November
November 10, 2010 by admin
New and updated topics added to the Clinical Knowledge Summaries (CKS) website in October and November include: chronic obstructive pulmonary disease; insulin therapy - type 2 diabetes; pityriasis versicolor; pre-patellar bursitis; sickle cell disease; cervical screening; greater trochanteric pain syndrome (trochanteric bursitis); olecranon bursitis; and temporomandibular joint disorders.
New NICE guidance
November 10, 2010 by admin
NICE published several pieces of new guidance and appraisals in October, including a technology appraisal of liraglutide for the treatment of type 2 diabetes which recommends its use in both dual and triple therapy in some circumstances at a maximum daily dose of 1.2 mg but not 1.8 mg (see here for liraglutide details and here for a list of guidance by date).
Categories
Recent Posts
- Why aren’t mental health nurse prescribers prescribing?
- Prescribing in prisons
- Evidence into practice: key therapeutic topics
- MHRA still working on unlicensed medicines review
- Oral penicillin: children’s dosage recommendations
- RCN indemnity changes - further reactions
- No news is bad news on CD changes
- Where is the evidence base: NMP in primary care?
- Medicines for Children website launched
- NRLS to transfer to NHS Trust
Tags
- ANP ANP conference Carey N CD children CKS Clinical Knowledge Summaries consultation controlled drugs COPD cosmetic treatments Courtenay Courtenay M CPD dermatology DH diabetes district nurse prescriber generic substitution Home Office independent prescribers Matt Griffiths mental health MeReC MHRA Misuse of Drugs mixing medicines National Prescribing Centre NICE NMC non-medical prescribing NPC NPF NPSA Nurse prescribing Patient Group Directions PGD PGDs Prescribing RCN Royal Pharmaceutical Society Stenner Stenner K supplementary prescribers unlicensed medicines
