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More About This Title The Textbook of Non-Medical Prescribing
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English
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.
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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.
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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
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“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