The Textbook of Non-Medical Prescribing
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English

The Textbook of Non-Medical Prescribing addresses all the key issues relevant to non-medical prescribing, bringing together essential knowledge, key issues, and skills in a single text.

This accessible, engaging and comprehensive resource explores the history of non-medical prescribing; prescribing in context; ethical, legal and professional issues in relation to prescribing practice; factors influencing prescribing; effective consultations; essential pharmacology; the role of the multi-disciplinary team; clinical skills; prescribing for specific groups; and the future of nurse prescribing. With case studies throughout, The Textbook of Non-Medical Prescribing is essential reading for all students on non-medical prescribing courses. It is also of use to qualified health professionals, be they prescribers themselves or interested in the concepts of non-medical prescribing.

English

Dilyse Nuttall is Senior Lecturer in the School of Nursing and Caring Sciences at The University of Central Lancashire, where she is course leader for the Non-medical Prescribing programme.

Jane Rutt-Howard is Senior Lecturer in the School of Nursing and Caring Sciences at The University of Central Lancashire, where she is course leader for both MSc Professional Practice (Nurse Practitioner) and BSc (Hons) Nurse Practitioner programmes.

English

Contributor list ix

Acknowledgements xi

Introduction xiii
Dilyse Nuttall and Jane Rutt-Howard

1 Prescribing in Context 1

The prescribing journey 1

Defining non-medical prescribing 2

The non-medical prescribing vision 3

Changes in clinical practice 6

The economic context 8

The private sector 9

The public health context 10

Need and expectations 11

Differentiating between prescribers 12

Nurse non-medical prescribers 21

Pharmacist non-medical prescribers 25

Allied health professional non-medical prescribers 26

Access to education programmes 30

Summary of the context of prescribing 31

References 33

2 Professional, Legal and Ethical Issues in Relation to Prescribing Practice 37

PART 1: PROFESSIONAL ISSUES 38

The regulatory framework for prescribing 38

PART 2: LEGAL ISSUES 49

The UK legal system 49

Legal aspects of autonomy and gaining consent 61

The importance of consent 66

PART 3: ETHICAL ISSUES 84

Consequentialism 85

Deontology 85

Virtue ethics 85

Doctrine of double effect 88

Conclusion 90

Table of cases 90

References 91

Acts 94

3 Factors Influencing Prescribing 95

The prescriber 95

The patient 103

The product 110

Other professionals 117

References 119

4 Effective Consultation and ‘the Consultation Umbrella’ 123

Jane Rutt-Howard

Presenting the consultation umbrella 124

Consultation models in context 125

The value of therapeutic communication 129

The consultation umbrella – explained 137

Clinical decision-making 151

Conclusion 158

References 159

5 Essential Pharmacology, Therapeutics and Medicines Management for Non-medical Prescribers 162

Anne Fittock, Jane Alder, Alison Astles, David Kelly, Joseph Quinn and Samir Vohra

Pharmacology as part of prescribing practice 163

Brief introduction to pharmacological terms 164

Guide through processes to build and develop one’s own formulary, with examples 175

BNF: practise using this essential resource 180

Prescribing in co-morbidity 181

Management and avoidance of drug interactions 183

Management and avoidance of adverse medicine reactions 185

Drugs with a narrow therapeutic index or range 190

Medicines management 193

Other resources to support your learning 194

References 195

6 The Multidisciplinary Prescribing Team 198

 Defining ‘the multidisciplinary prescribing team’ 198

The benefits to prescribing 200

Understanding roles 204

Non-medical prescribing lead 210

The multidisciplinary non-medical prescribing team 211

Commissioning and the MDPT 214

Education and learning 216

Conclusion 217

References 219

7 Clinical Skills 222

Vital signs 223

Conscious level 223

Respirations 225

Temperature 227

Pulse 229

Blood pressure 230

Additional vital signs 232

Clinical examination 234

Examination of body systems 236

Numeracy skills 254

Conclusion 257

References 259

8 Prescribing for Specific Groups 261

Prescribing in liver disease 261

Prescribing in renal disease 267

Prescribing in pregnancy 272

Prescribing for older people 279

Prescribing for children and young people 283

Other groups 291

References 295

9 Enhancing Non-medical Prescribing 298

Current practice in prescribing 298

UK history of prescribing 299

Non-medical prescribing in other countries 302

The impact of prescribing 302

Issues emerging from the introduction of non-medical prescribing 305

Medicines management 320

Conclusion 321

References 322

Patient Case Studies 327

Case study 1: Harold 327

Case study 2: Barbara 328

Case study 3: Clare 328

Case study 4: Julie 329

Case study 5: Annette 329

Case study 6: Yasmin 329

Case study 7: Amy 330

Case study 8: Louis 330

Case study 9: Callum (with CMP) 330

Health Professional Case Studies 332

Case study A: Debbie 332

Case study B: Mark 333

Case study C: Rebecca 333

Case study D: Gail 334

Case study E: David 334

Case study F: Andrew 335

Case study G: Andrea 336

Case study H: Lisa 336

Case study I: Christine 336

Case study J: Simon and Janice 336

Index 337

English

“All in all a really informative and applicable book, which is well written by two authors who are also nurses and nurse prescribers.”  (Nursing Times, 18 July 2012)

"This is an excellent book for nonprescribing health professionals. The authors broadly cover the topics of safe and ethical prescribing while providing extensive information about functioning as part of an interdisciplinary team. This is an excellent comprehensive book that is well organized and clearly written. This is a valuable addition to the library of novice students and experienced health professionals." (Doody's, 2 March 2012)

"Because of the way in which it is written, it could potentially be used as part of undergraduate teaching as well as, of course, for its intended purpose of teaching students on non-medical prescribing courses ... On a practical level, the book will certainly be useful to those studying a non-medical prescribing syllabus that matches the text ... This book certainly has the potential to grow if future editions incorporate feedback and peer review." (PJ Online, 16 November 2011)

"A great all encompassing book at the correct level for nurse and non medical prescribers undertaking their course.” Jeannette Sandiford, Lecturer, University of Bolton

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