Evaluating the impact of non-medical prescribing

Nuttall, Dilyse

doi:10.12968/npre.2017.15.6.272

Cited by 3 publications

(3 citation statements)

References 1 publication

(1 reference statement)

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“…The trigger which led to Alice consuming the overdose of paracetamol was a phone conversation with her mother and she volunteered that their relationship was emotionally complex. Nuttall and Rutt-Howard (2011) introduced the theory of ego-states which can be applied to consultation, namely adult, parent and child. Performing consultations with an adult ego state creates effective and supportive communication whereas a parental ego state often generates a barrier to the interaction leaving the patient feeling ultimately disempowered and frustrated, effectively taking on the child persona (Morris et al, 2018).…”

Section: Consultationmentioning

confidence: 99%

Prescribing within clinical toxicology

MacVicar

Osinski

2020

Journal of Prescribing Practice

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In 2020, the first clinical toxicology advanced nurse practitioner and independent prescriber post was introduced in the United Kingdom. This article discusses the remit of clinical toxicology and the integration of nurse prescribing into this service by following a patient journey from admission to discharge. The case study describes an acute paracetamol poisoning presentation following intentional self-harm. Paracetamol is widely available and safe in therapeutic dosages; however, it is the drug most commonly taken in intentional overdose and the toxic effect can result in hepatic failure and fatality. The nurse prescriber conducted a holistic consultation, assessed pharmacological management and instigated timely treatment. Current research on the benefits and disadvantages of paracetamol antidote regimes are discussed. Long-term physical and mental wellbeing following intentional overdose require interprofessional liaison with access to psychological support, arranged prior to patient discharge.

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Section: Consultationmentioning

confidence: 99%

Prescribing within clinical toxicology

MacVicar

Osinski

2020

Journal of Prescribing Practice

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“…Cost-effective prescribing is not always about prescribing the cheapest option for patients, but more concerned with maximising drug efficacy and medicines optimisation (Nuttall, 2020). There are finite resources available to prescribers within the NHS and the lower cost product may not be the most appropriate choice for the patient (King's Fund, 2018).…”

mentioning

confidence: 99%

Cost-effective prescribing and health economics

Broadhead¹

2021

Journal of Prescribing Practice

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Developing an awareness of cost is a fundamental feature of prescribing practice and the Royal Pharmaceutical Society (RPS) (2016) includes this principle within the 'Consultation domain' as a definitive competency for all prescribers. Within the framework, (Competency 2: Consider the options), sub-competency 2.8 states that the prescriber: 'Stays up-to-date in own area of practice and applies the principles of evidence-based practice, including clinical and cost-effectiveness'. The General Pharmaceutical Council (GPhC) (2019) stipulate that pharmacist independent prescribers should attain minimum prescribing standards against specific learning outcomes. The 'professionalism domain', learning outcome 13, within the GPhC document requires that pharmacists "apply an understanding of health economics when making prescribing decisions" (GPhC, 2019, pg. 8). Similarly, the Nursing & Midwifery Council (2018) and the Health & Care Professions Council (2019) alert their prescribing registrants to prescribe cost-effectively using the RPS competency framework.The National Prescribing Centre (NPC) (1999) devised the mnemonic EASE to alert the prescriber to consider that prescribed medications should be Effective, Appropriate, Safe and cost-Effective. In terms of cost, the use of EASE during the prescribing process prompts the prescriber to consider whether their prescribing decisions take account of budgetary constraints and health economics. Haycox (2009) defines health economics as a valuable tool for improving clinical decisions whereby the prescriber identifies alternative, cost-based options for their patients in respect of drug choice and maps this against clinical efficacy, available resources and patient outcomes.

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“…As with many practitioners in similar roles, the decision to become a prescriber was made with the idealism of someone who is a relative expert in their field of practicebut a novice to this exciting new skill. It is generally perceived that having the ability to prescribe will enable you to provide a more efficient service to your patients, manage your time more effectively, and reduce the need to 'pass on' work to other professionals (Nuttall and Rutt-Howard, 2011).…”

mentioning

confidence: 99%

Becoming an independent prescriber: a personal reflection

2018

British Journal of Cardiac Nursing

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Evaluating the impact of non-medical prescribing

Cited by 3 publications

References 1 publication

Prescribing within clinical toxicology

Prescribing within clinical toxicology

Cost-effective prescribing and health economics

Becoming an independent prescriber: a personal reflection

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