academic(group:(health(and(human(sciences( … · 1" " "...

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Academic(Group:(Health(and(Human(Sciences(

Non7Medical(Independent(and(Supplementary(Prescribing(

Portfolio(of(Evidence(HE6/HE7(for(AHPs/Nurses/Pharmacists(

C"O"N"F"I"D"E"N"T"I"A"L"

Start"date" "

Student"Number" "

DMP"Name" "

Personal"Tutor" "

Submission"date" "

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Contents'"

Check"List"for"Submission"of"Portfolio"........................................................................."4!Introduction".................................................................................................................."5!Statement"of"Confidentiality"........................................................................................"6!Statement"of"Ownership".............................................................................................."6!Statement"of"Good"Health"&"Good"Character"L"Nurses&Only"......................................"7!NMP"Personal"Development"Plan"..............................................................................."8!Introduction"to"Portfolio"..............................................................................................."1!Learning"Outcome"1"...................................................................................................."2!Learning"Outcome"2"...................................................................................................."3!Learning"Outcome"3"...................................................................................................."4!Learning"outcome"3"+Activity+"......................................................................................"5!Learning"Outcome"4"...................................................................................................."6!Learning"Outcome"5"...................................................................................................."7!Learning"Outcome"6"...................................................................................................."8!Learning"Outcome"7"...................................................................................................."9!Learning"Outcome"7"+Activity+"..................................................................................."10!Learning"Outcome"8".................................................................................................."11!Learning"Outcome"8"(prescribing"for"children)"+Activity+"..........................................."12!Learning"Outcome"9".................................................................................................."14!Learning"Outcome"9"+Activity+"..................................................................................."15!Learning"Outcome"10"................................................................................................"16!Learning"Outcome"10"+Activity+"................................................................................."17!Templates".................................................................................................................."18!NMP"CPD"Action"Plan"..............................................................................................."19!Sample"CMP"............................................................................................................."20!Reflective"Practice"Log".............................................................................................."21!Reflective"Practice"Log".............................................................................................."22!Prescribing"Framework"............................................................................................."23!FP10"Sample"............................................................................................................."25!FP10"Template".........................................................................................................."26!Personal"Formulary"..................................................................................................."27!Patient/Carer"Feedback"Form"..................................................................................."28!NPC"Single"Competency"Framework"for"all"Prescribers"(2012)"..............................."29!Competency"Assessment"Document"........................................................................"30!Achieving"prescribing"competencies"........................................................................."31!

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Domain"A:"The"consultation"......................................................................................"32!NPC"competency"1:"Knowledge"................................................................................"32!NPC"competency"2:"Options"....................................................................................."34!NPC"Competency"3:"Shared"decision"making".........................................................."37!Domain"B:"Prescribing"Effectively"............................................................................."39!NPC"competency"4:"Safe".........................................................................................."39!NPC"competency"5:"Professional".............................................................................."42!NPC"competency"6:"Always"improving"....................................................................."45!Domain"C:"Prescribing"in"context".............................................................................."47!NPC"competency"7:"The"healthcare"system"............................................................."47!NPC"competency"8:"Information"..............................................................................."50!NPC"competency"9:""Self"and"others"........................................................................"52!Statement"of"Competence"–"Allied"Health"Care"Professional"..................................."55!Statement"of"Competence"–"Nurse"..........................................................................."56!Statement"of"Competence"–"Pharmacist"..................................................................."57!"" "

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Check(List(for(Submission(of(Portfolio( Submission"method:"Statement"of"confidentiality""

Evidence"Profile"

Statement"of"ownership""

Evidence"Profile"

Statement"of"good"character"(2,"beginning"and"end"of"course"L""Nurses"only)""

Evidence"Profile"

Personal"Development"Plan""

Electronic"submission"

Introduction"to"Portfolio"""

Electronic"submission"

Web"based"learning"outcome"activities"learning"contracts"and"supporting"evidence:"LO1"Assessment"and"consultation"LO2"History"taking"LO3"Applying"legislation"to"prescribing"practice"LO4"Sources"of"appropriate"supporting"evidence"""LO5"Influences"on"prescribing"practice"LO6"Pharmacology"LO7"Roles"and"responsibilities""LO8"Prescribing"safely:"Three"critical"case"study"reflections"including"for"each"(3"in"total):"Prescription""PLformulary""Completed"assessment"template"Patient/carer"feedback"form""LO8"Children’s"Scenario"–"must"also"include:"Prescription""PLformulary""History"Taking"document""LO9"Professional"accountability"and"responsibility"LO10"Critical"analysis"of"Independent"and"Supplementary"Prescribing"and"sample"CMP""

""Electronic"submission""""""""Electronic"submission"and"signed"paper"copies"within"Evidence"Profile""""""""Electronic"submission"Signed"CMP"within"Evidence"Profile"

OSCE"assessment"documentation"and"copy"of"digital"email"submission"receipt"(LO1,2,4)""

"Evidence"Profile"

Clinical"Skills"Work"Book"(pharmacists"only)""

Evidence"Profile"

Completed"reflective"practice"log"signed"by"DMP"(90"hours)(LO1L10)""

Evidence"Profile"

DMP"verified"Competency"Assessment"Document""

Evidence"Profile"

DMP"verified"Final"Statement"of"Clinical"Competence"""

Evidence"Profile"

Please"ensure"you"have"included"all"the"evidence"outlined"above"when"you"submit"your"Portfolio"for"summative"assessment."This"Portfolio"template"is"available"on"Moodle."" "

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Introduction("The"assessment"of"the"NMP"course"requires"the"submission"of"a"5000"word"(HE6)"or"6000"word"(HE7)"Portfolio"of"Evidence"demonstrating"the"application"of"theory"to"practice"in"meeting"the"learning"outcomesa"regulatory"body"(NMC"/"HCPC/"GPhC)"requirements"and"the"National"Prescribing"Centers"Single"Competency"Framework"for"all"prescribers"(NPC"2012).""""The"Portfolio"of"Evidence"is"marked"and"internally"moderated"by"the"programme"team,"and"then"externally"moderated"by"the"named"External"Examiner."The"programme"team"will"verify"the"portfolio"of"evidence"by"stating"whether"you"have"provided"relevant"and"sufficient"evidence"to"meet"all"the"learning"outcomes"for"the"NMP"programme.""There"are"some"specific"exercises"which"you"must"complete"and"insert"into"this"Portfolio"as"per"the"contents"list"and"following"pages.""""You"are"also"required"to"submit"any"other"appropriate"supporting"evidence"which"helps"to"demonstrate"your"achievement"of"the"learning"outcomes,"for"example:""

•" Up"to"date"research/journal"articles"for"products/conditions"you"will"prescribe"for""

•" Local"and"national"guidelines"(however"complete"copies"of"local"guidelines"or"NICE"guidelines"are"not"required"as"the"reference"will"suffice)"

"•" Copies"of"certificates"of"competence"if"relevant"(not"originals)."

"*The"entire"portfolio"must"be"written"at"the"appropriate"academic"level"ie."HE6/HE7*""Please"note,"the"NMC"stipulate"that"if"you"fail"to"correctly"answer"any"question"that"may"result"in"direct"harm"to"a"patient"/"client,"you"must"be"referred."This"includes"failure"to"ask"about:""

•" medication"history"•" allergies"•" any"over"the"counter"medication"•" incorrect"dosage"

"Furthermore"in"respect"of"prescribing"for"children"and"young"people"if"there"is"any"doubt"about"your"ability"to"demonstrate"knowledge"skill"and"competence"in"any"of"the"areas"stipulated,"further"training"in"relevant"aspects"of"the"legal,"cognitive,"emotional"and"physical"differences"between"children"and"adults"and"in"taking"an"appropriate"history,"undertaking"a"clinical"assessment"and"making"an"appropriate"diagnosis"for"a"child,"will"need"to"be"undertaken"prior"to"completing"a"prescribing"course."" "

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Statement(of(Confidentiality(""I"declare"that"the"contents"of"this"Portfolio"have"been"anonymised"so"as"not"to"compromise"patient/staff"confidentiality.""You"can"provide"supplementary"evidence"to"support"your"competence"(i.e."reflections"from"practice,"prescriptions,"CMPs,"minutes"of"meetings,"audits"etc.),"however"you"must"not"include"Trust"/"employer"documentation"unless"it"is"in"the"public"domain"or"you"have"written"manager"approval."""All"identifying"logos"etc"must"be"removed"before"submission"of"the"portfolio."""Please"refer"to"the"confidentiality"guidelines"provided"in"the"University"Student"Handbook"as"any"breach"of"confidentiality"may"result"in"a"refer/fail.""""""Signed_______________________________________"""Date_________________________________________""""""Statement(of(Ownership(""I"declare"that"the"whole"of"this"work"produced"is"the"result"of"my"own"individual"effort."I"declare"that"no"part"of"this"portfolio"has"been"taken"from"existing"published"or"unpublished"material"without"due"acknowledgement"and"that"all"secondary"material"used"herein"has"been"fully"referenced."This"work"has"not"been"submitted"for"any"previous"award."""""Signed_______________________________________"""Date_________________________________________"" "

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Statement(of(Good(Health(&(Good(Character(7(Nurses&Only(("The"Nursing"&"Midwifery"Council"Good"Health"Good"Character"Guidance"(NMC,"2008"p."10)"states"that,"“Programme"providers"should"have"processes"in"place"to"make"sure"that"all"students"declare"their"good"character"and"good"health"annually"over"the"course"of"their"programme”."""" "“Good"health”"means"that"a"person"must"be"capable"of"safe"and"effective"practice"without"supervision."It"does"not"mean"the"absence"of"any"disability"or"health"condition.”""(NMC,"2008,"p."5L6)""“Good"character”"is"based"on"a"person’s"conduct,"behaviour"and"attitude,"as"well"as"any"conviction"and"cautions"that"are"not"considered"compatible"with"professional"registration"and"that"might"bring"the"profession"into"disrepute."A"person’s"character"must"be"sufficiently"good"for"them"to"be"capable"of"safe"and"effective"practice"without"supervision”"(NMC,"2008,"p.5)""You"are"be"reminded"that"it"is"your"responsibility"to"notify"the"university"if"your"health"or"disability"status"changes"during"the"course"or"you"have"a"charge,"conviction"or"caution"that"may"affect"your"ability"to"practice"safely"and"effectively""(NMC,"2008,"p."9).""""You"are"thus"required"to"self"declare"your"good"health"and"good"character"on"commencement"of"this"programme."""""

(Independent(and(Supplementary(Non(Medical(Prescribing(for(Nurses((V300)(

" NMC PIN Number:.................................................................. Expiry Date:.......................................... " "I ………………………………………………………………………………………………………………..........(Full name of student)" " "declare that my health & character is of a standard that enables me to deliver safe and effective Practice. " " " "Signature……………………………………………………………………………………Date…………………………………….."""""""

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NMP$Personal$Development$Plan"(to"be"completed"to"evidence"how"you"will"meet"CAD"competencies"8"electronic"submission)"

Name/Student"No:" " Trimester:" "

Self8Assessment"Need" Goals"Resources"(What"resources"are"needed?)"

Success"Criteria"(How"will"I"achieve"it?)""

Review"Date"

Results"of"Review"(How"will"I"know"I"have"met"my"plan"successfully?)"

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!1!

Introduction*to*Portfolio**!

Job!Title/Role! !

Prescribing*role!(brief!outline!of!your!proposed!prescribing!role,!conditions!and!products.!Specify!and!provide!a!rationale!for!the!three!conditions!which!you!will!prescribe!for!in!this!portfolio)!!

Evidence!of!competence!to!prescribe!for!the!above!conditions!!(eg.!specific!qualifications,!duration!in!post!etc.)!

!

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Learning*Outcome*1**!HE6:!Assess!and!consult!with!patients/clients,!parents!and!carers.!!HE7:!Integrate!skills!and!knowledge!when!undertaking!a!systematic!assessment!and!consultation!with!patient/clients,!parents!and!carers.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!

Reflection!on!Action!!(what!do!you!now!know!as!a!result!of!this!learning!and!how!will!you!apply!this!to!your!prescribing!in!practice?!Include!supporting!evidence!eg.!legislation,!theory,!guidelines,!research,!protocols!etc)!!

Evidence!Provided!!

•! Digital!recording!of!your!OSCE!in!practice!and!completed!assessment!document!!•! Case!study!reflections!

!! !

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Learning*Outcome*2**!HE6:!Undertake!a!thorough!history,!including!relevant!physical!examination!medication!(including!overUtheUcounter,!alternative!and!complementary!health!therapies)!to!inform!diagnosis.!!HE7:!Undertake!a!thorough!history,!and!physical!examination,!including!medication!history!and!current!medication!(including!overUtheUcounter,!alternative!and!complementary!health!therapies)!and!evaluates!findings!to!inform!diagnosis.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Digital!recording!of!your!OSCE!in!practice!and!completed!assessment!criteria!(place!in!one!sealed!poly!wallet!here)!

•! Case!study!reflections!•! Completed!and!signed!Clinical!Skills!Work!Book!(pharmacists!only)!!

!! !

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Learning*Outcome*3**!HE6:!Understand!and!apply!the!relevant!legalisation!to!the!practice!of!independent!and!supplementary!prescribing.!!HE7:!Critically!discuss!and!evaluate!your!own!prescribing!practice!within!the!relevant!legal,!professional!and!ethical!frameworks!to!the!practice!of!independent!and!supplementary!prescribing.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Case!study!reflections!•! Web!based!NMP!activities!!

!! !

!5!

Learning*outcome*3*!Activity!*!Read!the!following!sections!of!the!Web!based!NMP!programme:!!!

•! Applying!the!Legal!Frameworks!for!NonUMedical!Prescribing!!•! Personal!Accountability!and!Responsibility!as!a!NMP!•! Accountability!and!Responsibility!to!Employing!Organisations!•! Prescribing!safely,!appropriately!and!cost!effectively!•! Decision!making!

!Then!read!your!own!Code!of!Conduct!/!Ethical!standards!and!Frameworks!for!professional!AND!prescribing!practice,!and!answer!the!following!questions!(100!words!each):!!1!U!What!should!you!ensure!if!you!accept!a!referral!from!another!health!professional!for!a!patient!who!requires!a!prescription?!!!

2!U!How!would!you!act!if!there!was!a!significant!or!immediate!risk!to!a!patient’s!life!and!they!refused!to!give!consent!for!treatment?!!!

3!U!What!action!would!you!take!if!you!thought!a!patient’s!safety!was!at!risk!because!of!a!colleague’s!conduct,!performance!or!health?!!!

4!U!What!would!you!do!if!you!had!a!conscientious!objection!that!was!relevant!to!your!professional!practice?!!

! !

!6!

Learning*Outcome*4***HE6:!Critically!appraise,!and!use!sources!of!information/advice!and!decision!support!systems!in!prescribing!practice.!!HE7:!Critically!review!and!utilise!sources!of!information!and!research!evidence!to!support!decision!making!within!prescribing!practice.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Case!study!reflections!•! Supporting!evidence/research!for!conditions!and/or!products!in!case!study!reflections!

•! List!of!useful!prescribing!resources/evidence!!! !

!7!

Learning*Outcome*5*!!HE6:!Understand!the!influences!that!can!affect!prescribing!practice,!and!demonstrate!your!understanding!by!managing!your!prescribing!practice!in!an!ethical!way.!!HE7:!Demonstrate!critical!awareness!of!the!influences!that!can!affect!prescribing!practice,!by!managing!your!prescribing!practice!in!an!ethical!way.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Case!study!reflections!!

! !

!8!

Learning*Outcome*6**!HE6:!Understand!and!apply!knowledge!of!drug!actions!in!prescribing!practice.!!HE7:!Critically!examine!and!apply!knowledge!of!drug!actions!in!prescribing!practice.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Appropriate!prescriptions!attached!to!case!study!reflections!•! PUformularies!attached!to!case!study!reflections!•! Pass!mark!achieved!in!pharmacology!exam!!

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Learning*Outcome*7*!HE6:!Demonstrate!an!understanding!of!the!roles!and!relationships!of!others!involved!in!prescribing,!supplying!and!administering!medicines.!!HE7:!Critically!review!and!demonstrate!an!understanding!of!the!roles!and!relationships!of!others!involved!in!prescribing,!supplying!and!administering!medicines.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Case!study!reflections!•! Completed!activity!!

! !

!10!

Learning*Outcome*7*!Activity!*!Read!the!following!sections!of!the!Web!based!NMP!programme!!

•! Prescribing!in!MultiUProfessional!Teams!•! Factors!that!influence!prescribing!•! Professional!Relationships!in!Prescribing!Partnerships!•! How!will!it!Work!for!Me?!

!Access!the!following!document!by!selecting!them!from!the!Resources!on!the!Course!website,!the!World!Wide!Web!or!a!medical!library!and!then!answer!the!questions!that!follow!below.!!!

•! Supplementary!Prescribing!by!Nurses,!Pharmacists!Chiropodists/Podiatrists,!Physiotherapists!and!Radiographers!within!the!NHS!in!England!U!a!Guide!for!Implementation!updated!May!2005!

•! Improving!patients’!access!to!medicines:!A!guide!to!implementing!nurse!and!pharmacist!independent!prescribing!within!the!NHS!in!England!(April!2006)!!

Further!Reading:!Belbin,!R.M!2000!Beyond!the!Team!(Oxford:!Butterworth!Heinemann)!!Looking!at!your!own!prescribing!team!and!the!relationships!within!it,!please!respond!to!the!following!questions:!(100!words!each)!!1!U!Define!the!role!and!boundaries!of!the!other!members!of!your!prescribing!team!in!relation!to!prescribing,!supplying!and!administering!medicines.!!!

2!U!Do!any!of!the!above!responsibilities!within!your!team!overlap!and!are!there!any!omissions!that!need!to!be!addressed?!!!

3U!What!support!and!advice!do!you!expect!from!the!other!members!of!your!prescribing!team!and!what!support!do!they!expect!from!you!in!return?!!!

! !

!11!

Learning*Outcome*8**!HE6:!Prescribe!safely,!appropriately!and!cost!effectively!for!all!age!groups.!!HE7:!Demonstrate!application!of!safe,!appropriate!cost!effective!prescribing!for!all!age!groups.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Pass!mark!achieved!in!numeracy!exam!!•! Case!study!reflections!•! Patient/client!feedback!forms!!•! Accurate!prescription!writing!•! Appropriate!responses!to!child!scenario!on!next!page!!•! Accurate!child’s!prescription!and!PUformulary!•! !

! !

!12!

Learning*Outcome*8*(prescribing*for*children)*!Activity!(! !When!prescribing!for!children!you!must!provide!evidence!of!your!ability:!!!“to!take!an!appropriate!history,!undertake!a!clinical!assessment!and!make!an!appropriate!decision!based!on!that!assessment!to!either!diagnose!or!refer,!having!considered!the!legal,!cognitive,!emotional!and!physical!differences!between!children!and!adults”.!(NMC!Circular!22/2007).!!Further,!the!assessment!must!demonstrate:!!!“recognition!of!the!unique!implications!and!developmental!context!of!the!anatomical!and!physiological!differences!between!neonates,!children!and!young!people.”!!(NMC!Circular!22/2007).!!Although!this!is!a!specific!NMC!requirement,!all!non!medical!prescribing!students!are!required!to!complete!this!activity!as!a!mark!of!good!practice.!!Before!completing!the!activity,!it!is!recommended!that!you!read!the!NPC!Prescribing!for!Children!bulletin!and/or!any!other!suitable!publication!in!relation!to!prescribing!for!children.!!The!bulletin!is!available!on!this!link:!!!http://www.npc.nhs.uk/merec/other_non_clinical/resources/merec_bulletin_vol11_no2.pdf!!Please!type!your!responses!to!the!following!questions!below,!utilising!appropriate!up!to!date!theory,!research!and!evidence!to!underpin!each!response!(100U150!words!each,!maximum!1000!words).!!CHILD!SCENARIO!!22!month!old!Harry!has!sprained!his!right!ankle!having!jumped!off!a!chair.!!His!xUrays!yesterday!show!no!bony!injury.!He!has!been!fitted!with!an!elastic!stocking!for!support.!!He!weighs!12!kg.!!Mum!has!returned!to!the!clinic!with!Harry!requesting!pain!relief!for!him.!He!complains!of!‘foot!hurting’!and!will!not!walk!or!weight!bear.!He!has!not!slept!all!night.!!On!examination!today!his!right!ankle!is!swollen!and!slightly!bruised.!He!is!apyrexial,!all!other!observations!are!normal.!!–!Diagnosis:!right!ankle!sprain.!!1!U!How!would!you!adapt!your!assessment,!communication!and!consultation!style!in!order!to!gather!appropriate!information!from!the!child?!Underpin!the!rationale!for!your!approach!with!supporting!literature.!!!

2!U!What!key!factors!would!you!need!to!consider!when!undertaking!a!clinical!assessment!of!the!child!and!why?!It!may!help!to!consider!the!legal,!professional!and!ethical!aspects!that!underpin!clinical!assessment!in!respect!of!a!child!of!this!age.!!!

!13!

3U!Explain!how!you!would!confirm!the!diagnosis!in!this!case!in!order!to!make!a!safe!prescribing!decision.!!Underpin!your!explanation!with!reference!to!the!evidence!base.!!!

4!U!What!developmental!and!physiological!factors!do!you!need!to!consider!if!you!are!to!prescribe!for!the!child?!!!!

5!U!What!treatment!could!you!prescribe!for!the!child?!Justify!your!choice,!eg.!what!is!the!evidence!base!supporting!your!decision!making.!!!

6!U!Reflect!on!your!ability!to!prescribe!for!a!child!in!your!area!of!practice,!even!if!this!is!not!currently!part!of!your!role.!!!

7!U!Handwrite!a!prescription!for!the!product!you!are!to!prescribe!using!a!sample!FP10,!and!complete!a!PUformulary!for!the!product!(these!can!be!submitted!in!Evidence!Profile).!!! !

!14!

Learning*Outcome*9**!HE6:!Practice!within!a!framework!of!professional!accountability!and!responsibility.!!HE7:!Critically!review!own!prescribing!practice!within!a!framework!of!professional!accountability!and!responsibility.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Case!study!reflections!•! Appropriate!responses!to!LO9!activities!below!!!

!!

! !

!15!

Learning*Outcome*9*!Activity!**!Find!the!relevant!local/national/legal!guidelines!and/or!policies!in!relation!to!the!following!and!then!respond!to!the!questions!below:!(100!words!each)!!1!U!Make!a!list!of!your!responsibilities!and!organisational!requirements!regarding!prescription/pad!security.!!!

2!U!Locate,!print!or!download!an!example!prescription!use!recording!log/form!that!you!could!use!in!your!role!as!a!prescriber!for!use!when!you!are!a!qualified!prescriber.!!!

3!U!List!the!actions!that!you!and!your!employing!organisation!should!take!to!control!prescription!pad!issue!and!deal!with!loss!or!suspected!theft.!!!

4!U!Articulate!your!understanding!in!relation!to!remote!prescribing!utilising!your!organisational!and!professional!body!requirements/limitations.!!!

5!U!Articulate!your!accountability!when!prescribing!off!label!and!unlicensed!drugs!utilising!your!organisation!and!professional!body!guidelines/standards.!!!

6!U!State!what!actions!you!should!take!in!the!event!a!patient!suffers!a!serious!adverse!reaction/allergy!to!a!product!you!have!prescribed.!!!!!

! !

!16!

Learning*Outcome*10**!HE6:!Develop!a!clinical!management!plan!within!legislative!requirements.!!!HE7:!Critically!review!and!demonstrate!knowledge!of!the!legislation!in!relation!to!independent!and!supplementary!prescribing!and!develop!a!clinical!management!plan.!!Learning!Contract!!Plan!of!action!!(what!will!you!need!to!do!to!achieve!the!learning!outcome,!discuss!with!your!DMP)!!


Evidence!Provided!!

•! Critique!of!Independent!and!Supplementary!Prescribing!and!their!!application!to!your!!own!area!of!prescribing!practice!

•! Completed!sample!CMP!•! Case!study!reflections!!

! !

!17!

Learning*Outcome*10*!Activity!**!Read!the!documents!below!and!then:U!!

•! Write!a!critical!analysis!of!Independent!and!Supplementary!Prescribing!and!their!application!to!your!area!of!practice!(250!words)!!!

!•! Complete!a!sample!legal!CMP!ideally!of!relevance!to!your!own!prescribing!area!using!

the!following!template!(further!guidance!for!completing!this!is!available!on!Moodle).!!Improving!Patients’!Access!to!Medicines:!A!Guide!to!Implementing!Nurse!and!Pharmacist!Independent!Prescribing!within!the!NHS!in!England!Department!of!Health!2006!!http://webarchive.nationalarchives.gov.uk/20130107105354/http://dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4133747.pdf!!Supplementary!Prescribing!by!Nurses,!Pharmacists,!Chiropodists/Podiatrists,!Physiotherapists!and!Radiographers!within!the!NHS!in!England,!A!guide!for!implementation!2005!!http://webarchive.nationalarchives.gov.uk/20130107105354/http://dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4110033.pdf!!! !

!18!

**************

Templates* *

!19!

NMP*CPD*Action*Plan**!Complete!this!towards!the!end!of!your!course!to!demonstrate!how!you!will!maintain!and/or!develop!your!competence!during!the!first!6!months’!post!qualifying!as!a!NonUMedical!Prescriber.!(500!words)!electronic(submission!!

Area!of!competence! Action!plan! Date!of!completion! Evidence!

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

!! !

!20!

Sample*CMP*!You!must!complete!all!fields!as!this!is!a!legal!document,!use!appropriate!pseudonyms,!a!completed!example!is!provided!on!Moodle)!!

Name!of!Patient:! Patient!medication!sensitivities/allergies:!

! !

Patient!identification!e.g.!ID!number!/!date!of!birth:!!!

!

Independent!Prescriber(s):! Supplementary!Prescriber(s)!

! !

Condition(s)!to!be!treated! Aim!of!treatment!

! !

Medicines!that!may!be!prescribed!by!SP:!

!

Preparation! Indication! Dose!schedule! Specific!indications!for!referral!back!to!the!IP!

! ! ! !

Guidelines!or!protocols!supporting!this!Clinical!Management!Plan:!(title,!source!and!date)!

!

Frequency!of!review!and!monitoring!by:!Supplementary!prescriber!

Frequency!of!review!and!monitoring!by:!Supplementary!prescriber!and!independent!prescriber!

! !

Process!for!reporting!ADRs:!

!

Shared!record!to!be!used!by!IP!and!SP:!(State!system!in!use!eg.!Vision!etc)!

!

Agreed!by!independent!prescriber(s)!

Date! Agreed!by!supplementary!prescriber(s)!

Date! Date!agreed!with!patient/carer!!!

! ! ! ! !

!21!

Reflective*Practice*Log***!You!are!required!to!provide!a!reflective!practice!log!of!a!minimum!of!90!hours!(at!least!45!of!these!must!to!be!spent!with!your!DMP,!the!remainder!can!be!spent!with!other!doctors/Advanced!practitioners!of!relevance!to!your!role)!to!reflect!learning!gained!in!practice!and!application!of!theory!to!practice.!!!

•! Use!your!log!as!a!basis!to!evidence!and!reflect!upon!your!learning!as!this!will!help!you!to:!!

!•! Identify!your!achievement!of!the!learning!outcomes!in!University!and!in!practice!

!•! Direct!your!subsequent!learning!(for!example,!through!the!use!of!learning!contracts!and!

independent!study)!!

•! Assist!you!in!evaluating!your!progress,!and!inform!your!DMP’s!final!verification!of!competence!to!prescribe!within!your!area!of!practice!

!These!entries!should!also!form!the!basis!of!reflective!discussions!with!your!DMP.!!You!will!select!three!patients!(in!addition!to!the!child!scenario!above)!whom!you!have!consulted!whilst!under!the!supervision!of!your!DMP!in!practice!on!which!to!write!the!three!case!study!critical!reflections!using!the!templates!provided.!These!case!study!reflections!will!demonstrate!your!competence!to!prescribe!safely,!effectively!and!appropriately!in!your!own!clinical!area.!For!each!of!the!critical!reflections!you!are!required!to!incorporate!the!learning!outcomes!for!the!module!and!use!appropriate!supporting!theoretical!and!clinical!evidence/research.!For!each!of!the!three!reflections!you!must!complete!the!following:!!!!

•! Patient!assessment!template!!

•! Prescription!!

•! PUformulary!!

•! Completed!patient!feedback!form!with!DMP!comments!and!signature.!!

!22!

Reflective*Practice*Log*!!Activity*!Brief!reflection!of!prescribing!experience!/learning!gained!in!practicej!eg.!Conditions!and!products!prescribed!etc.!Minimum!of!90!hours,!45!of!which!must!be!with!your!DMP.!! Le

arning*

outcome*number*

Hours*Running*Total* Date*

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

! ! ! !

Total!Hours!(Please!Submit!a!paper!copy)!

! !

!!Student!signature:!…..................................................................!!!DMP!signature:!….......................................................................!!!Date:!….........................................................................................!! !

!23!

Prescribing*Framework*(NPC!Principles!of!Good!Prescribing!Framework!1999)!*1*R*Consider*the*Patient**(NPC!Principles!of!Good!Prescribe!Framework!1999)!Patient!name!and!dob/age! !

Presenting!Complaint!(PC)! !

History!of!presenting!complaint!(HPC)!(use!appropriate!assessment!tool!eg.!PQRST)!

!

Clinical!findings!and!observations!(signs!and!symptoms,!clinical!observations,!wound!assessment!etc)!

!

Past!medical!history!! !

Past!surgical!history! !

Prescribed!Medication!history!!(Name,!Dose,!Frequency,!Reason!Started,!whether!effective)!

!

Over!the!counter!products!(complementary,!herbal!and!illicit!etc.)!

!

Allergies!!(To!what!and!state!nature!of!reaction)!

!

Adverse!reaction!!(To!what!and!state!nature!of!reaction)!

!

Family!history:!! !

Any!other!issues:!!(e.g.!hepatic!impairment,!renal!impairment)!

!

Social*History*Home!Situation! !

Occupation! !

Hobbies! !

Pets! !

Recent!Travel! !

Alcohol! !

Smoking! !

Recreational!Drugs! !

Sexual!History! !

Systems*Enquiry*(Provide!details!where!appropriate,!or!state!not!applicable!only!if!this!is!the!case)!Cardiovascular! !

Respiratory! !

Gastrointestinal! !

Genitourinary! !

!24!

Nervous!system! !

Endocrine! !

Musculoskeletal! !

Skin!hair!&!Nails! !

Other! !

Working!diagnosis!!(pathophysiology!and!evidence!to!support!diagnosis)!

!

Prescribing*Considerations*2!U!Consider!the!appropriate!strategy:!consider!your!competence!to!prescribe,!legal,!ethical!and!professional!issues.!!!

3!U!Consider!the!choice!of!product/!treatment!plan!!(apply!EASE!to!product,!using!up!to!date!supporting!evidence/guidelines!used)!!

4!U!Negotiate!a!contract!to!achieve!concordance!with!the!patient!!(communication!and!consultation!skills,!how!was!the!patient!involved!in!decision!making,!what!information!was!given!to!the!patient!eg.!dose!schedule,!duration!of!treatment,!when!to!start/stop!the!medication!etc)!!

5!U!Review!and!outcome!!(by!who,!when,!where!and!whyj!was!the!treatment!effective)!!

6!U!Record!keeping!!(where!and!why)!!

7!U!Reflection!on!scenario:!!!(you!may!use!a!reflective!model!of!your!choice!to!structure!your!reflection,!approx.!750U1000!words)!!

Student!signature! !

DMP!signature! !

Date! !

!! !

!25!

FP10*Sample**

Prescriptions!must!demonstrate!100%!accuracy!U!including!numeracy!!Prescribed!indication:!……………….back!pain……………………………….!*

!Age:!!!!!!!21!!D.O.B.!!3.6.1993!Remember:*legal*requirement*to*state*age*in*years/months*and*date*of*birth*if*under*12*years*of*age!!!

!Name:!eg.!Joe!Bloggs!!Address:!!3!Bolton!Parade,!!Bolton,!!BL1!5AB!!!NHS!NO!:!987654321!!No!of!days!treatment! 2!

Remember*PSDRQ:**Product!name*spelt!correctly!and!formulation!*Strength/!size/formulation!available!as!per!BNF!*Dose!schedule*as!per!BNF/local!guidelines!**Route!of!administration!!Quantity!to!be!dispensed!by!pharmacist!!Score!blank!space!through!(if!any)!!!

Example:*!Paracetamol!tablets!!!500mg!tablets!!!2!tablets!to!be!taken!every!4U6!hours!U!Maximum!daily!dose!8!tablets!!Oral!!16!tablets!

Signature:!!A.!Prescriber

Prescriptions(must(be(signed(*

Date:!3.6.1993!(Date( prescription(written(must( tally( with( patients(date(of(birth!

Practice!Code!:!23FFXY001!Independent/Supplementary!Prescriber!!6E5431ZZ!Bolton!Practice!Bolton,!BL3!5AB!Tel:!01200!900300!

! !

!26!

FP10*Template*!

Prescriptions!must!demonstrate!100%!accuracy!U!including!numeracy!!Prescribed!indication:!!

!Age!!!D.O.B.!!!!!!

!Name:!!!Address:!!!!!!NHS!NO!:!987654321!!

No! of! days!treatment!

!

!

Signature:!!!

Date:!!

!Practice!Code!:!23FFXY001!Independent/Supplementary!Prescriber!!6E5431ZZ!Bolton!Practice!Bolton,!BL3!5AB!Tel:!01200!900300!!

!! !

!27!

Personal*Formulary*(Complete!all!fields)!!

Chemical*Name*(Generic)* Brand*Name/s*! !Presentation/Formulation/s**(colour!of!liquid/tablets,!strength,!tablets,!capsules,!lotion,!granules,!cream!etc)!*Indications/Uses**(clinical!condition/s)!!*Dosage*&*Administration**(frequency,!length!of!treatment)!*ContraRindications**(when!the!product!should!not!be!used)!*Cautions**(to!be!considered!if!the!product!can!be!used!with!careful!monitoring!eg.!liver!and/or!renal!failure,!breastfeeding,!pregnancy,!elderly!etc.)!*Interactions**(with!other!medications!the!patient!may!be!taking!including!OTC,!herbal,!illicit)!*Side*Effects!*Package*Quantities!*Cost!*Pharmacodynamic*Properties**(how!the!drug!works!and!the!effect!it!has!on!the!body)!*Pharmacokinetic*Properties**(how!drugs!move!through!the!body!during!Absorption,!Distribution,!Metabolism,!Excretion)!*Additional*Notes**(e.g!special!instructions!for!administration,!storage,!patient!monitoring,!pregnancy,!breastfeeding,!age!(neonate/elderly)!etc)!*References*!*

!! !

!28!

Patient/Carer*Feedback*Form*(Relates!to!Learning!Outcomes!1,!2!and!4)!!Care!delivery!by!students!Please!ensure!that!patients/service!users!are!informed!of!their!right!to!refuse!to!care!being!delivered!by!a!prescribing!student.!!This!form!is!designed!to!enable!you!to!give!your!views!on!how!the!student!NonUMedical!Prescriber!performed!in!their!recent!contact!with!you.!!Whilst!it!is!offered!to!you,!you!do!not!have!to!complete!it.!!However,!your!views!are!very!important!as!they!will!help!the!student!to!learn!about!how!they!develop!successful!working!relationships!with!service!users.!!Please*answer*Yes*or*No*and*add*any*comments*that*you*would*like*at*the*bottom.*!During!the!contact!with!the!student:!!1!U!Did!you!feel!that!the!student!conducted!him/herself!in!an!appropriate!manner?!!!Yes! !No!!

!2!U!Did!the!student!listen!to!what!you!had!to!say?!!!Yes! !No!

!3!U!Were!your!views!taken!into!account!when!considering!treatment!options!and!your!future!care?!!!Yes! !No!

!4!U!Did!the!student!treat!you!with!respect?!!!Yes! !No!

!5!U!Is!there!anything!else!you!would!have!liked!the!student!to!tell!you!about!the!proposed!treatment?!!!!Yes! !No!

!Thank!you!for!your!feedback,!it!is!greatly!appreciated.!!Student!reflection!and!any!identified!new!learning!needs:!!!DMP!comments:!!Date:!!!(Photocopy!as!required,!paper!copies!may!be!submitted)!!! !

!29!

NPC*Single*Competency*Framework*for*all*Prescribers*(2012)*!The!NPC!Single!Competency!Framework!(illustrated!below)!outlines!out!what!good!prescribing!looks!like!and!comprises!three!domains,!each!of!which!has!three!dimensions!of!competency.!!Each!of!the!competency!dimensions!contain!statements!which!describe!the!activity!or!outcomes!all!qualified!prescribers!should!be!able!to!demonstrate.!All!of!the!competences!are!relevant!to!all!prescribers!however!some!of!the!statements!may!be!more!relevant!to!some!prescribers!than!others.!You!should!consider!how!each!of!the!statements!applies!to!your!own!prescribing!area.!!*

!!

!30!

!!!!

Non$Medical,Prescribing,,

Competency,Assessment,Document,,&,,

Statement,of,Competencies,!!!!!

! !

!31!

Achieving,prescribing,competencies,!Read!each!of!the!domains!and!competencies!on!the!following!pages!and!score!yourself!in!relation!to!your!current!prescribing!knowledge!at!the!start!of!the!module!(Start!score)!using!the!table!below.!!This!should!be!completed!within!the!first,week!of!starting!the!module.!!!!Scores!of!1!and!2!will!form!the!focus!for!your!learning!and!Personal!Development!Plan!whilst!on!the!module!(complete!the!PDP!template!provided!at!the!back!of!this!Portfolio!of!Evidence).!You!should!take!this!with!you!to!your!meetings!with!your!Practice!DMP!so!that!you!can!demonstrate!your!progress!and!he/she!can!help!you!to!plan!further!activities/experiences!to!meet!your!learning!needs!whilst!in!practice.!!In!the!last,week!of!the!module!you!are!required!to!score!yourself!again!(End!score)!to!demonstrate!your!achievement!as!a!competent!(level!3)!nonKmedical!prescriber!in!your!own!field!of!practice!within!the!areas!outlined!in!the!introduction!to!your!Portfolio!of!Evidence.!!!(please'submit'a'signed'paper'copy)!!!You,are,required,to,achieve,at,least,level,3,for,each,competency,statement,on,completion,of,the,module.,!!

Taxonomy! Score!Novice! 1!Advanced!beginner! 2!Competent! 3!Proficient! 4!Expert! 5!

(Taken!from!Benner!(1984)!From!novice!to!expert:!excellence!and!power!in!clinical!nursing!practice.!London:!AddisonKWesley)!! !

!32!

Domain,A:,The,consultation,NPC,competency,1:,Knowledge!Has!upKtoKdate!clinical,!pharmacological!and!pharmaceutical!knowledge!relevant!to!own!area!of!practice.!Programme!learning!outcomes:!4,!and!6!!

Competence! Start,score,1$5, End,score,1$5,1! Understands!the!conditions!being!treated,!their!natural!progress!and!how!to!assess!their!severity.!

! !

2! Understands!different!nonKpharmacological!and!pharmacological!approaches!to!modifying!disease!and!promoting!health,!identifies!and!assesses!the!desirable!outcomes!of!treatment.!

! !

3! Understands!the!mode!of!action!and!pharmacokinetics!of!medicines!and!how!these!mechanisms!may!be!altered!(e.g.!by!age,!renal!impairment),!and!how!this!affects!treatment!decisions.!

! !

4! Understands!the!potential!for!adverse!effects!and!how!to!avoid/minimise,!recognise!and!manage!them.!

! !

5! Uses!upKtoKdate!information!about!relevant!products!(e.g.!formulations,!pack!sizes,!storage!conditions,!costs).!

! !

6! Applies!the!principles!of!evidenceKbased!practice,!including!clinical!and!costKeffectiveness.! ! !

7! Aware!of!how!medicines!are!licensed,!sourced!and!supplied,!and!the!implications!for!own!prescribing.!!

! !

8! Knows!how!to!detect!and!report!suspected!adverse!drug!reactions.! ! !

9! Understands!the!public!health!issues!related!to!medicines!and!their!use.! ! !

10!Appreciates!the!potential!for!misuse!of!medicines.! ! !

11!Understands!antimicrobial!resistance!and!the!roles!of!infection!prevention,!control!and!antimicrobial!stewardship!measures.!

! !

!! !

!33!

!NPC,competency,1:,Knowledge,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !

Student!Signature! Student!Signature! Student!Signature!

! ! !

DMP,Comment,!

Date,Student,Comment,!

Date,!! !

!34!

NPC,competency,2:,Options!Makes!or!reviews!a!diagnosis,!generates!management!options!for!the!patient!and!follows!up!management.!Programme!learning!outcomes:!1,!2,!6!and!8!

Competence, Start,score,1$5, End,score,1$5,

1! Takes!an!appropriate!medical!history!and!medication!history!which!includes!both!current!and!previously!prescribed!and!nonKprescribed!medicines,!supplements!and!complementary!remedies,!and!allergies!and!intolerances.!

! !

2! Undertakes!an!appropriate!clinical!assessment!using!relevant!equipment!and!techniques.! ! !

3! Accesses!and!interprets!relevant!patient!records!to!ensure!knowledge!of!the!patient's!management.!

! !

4! Makes,!or!understands,!the!working!or!final!diagnosis!by!considering!and!systematically!deciding!between!the!various!possibilities!(differential!diagnosis).!

! !

5! Requests!and!interprets!relevant!investigations.! ! !

6! Considers!all!treatment!options!including!no!treatment,!nonKpharmacological!interventions!and!medicines!usage.!

! !

7! Assesses!the!effect!of!multiple!pathologies,!existing!medication,!allergies!and!contraindications!on!management!options.!

! !

8! Assesses!the!risks!and!benefits!to!the!patient!of!taking!or,!not!taking!a!medicine!or!treatment.! ! !

9! Where!a!medicine!is!appropriate,!identifies!the!different!options.! ! !

10!Establishes!and!maintains!a!plan!for!reviewing!the!therapeutic!objective,!discharge!or!end!point!of!treatment.!

! !

11!Ensures!that!the!effectiveness!of!treatment!and!potential!unwanted!effects!are!monitored.! ! !

12!Makes!changes!to!treatment!plan!in!light!of!onKgoing!monitoring!and!patient's!condition!and!preferences.!

! !

!35!

!Programme,learning,outcome,10,NPC!competencies!–!supplementary!prescribing!!

Competence, Start,score,1$5, End,score,1$5,

1! Communicates!information!about!medicines!and!what!they!are!being!used!for!when!sharing!or!transferring!prescribing!responsibilities/information.!

! !

2! Reviews!diagnosis!and!generates!management!options!for!the!patient!within!the!clinical!management!plan.!!Always!follows!up!management.!

! !

3! Reviews!medical!history!and!medication!history!which!includes!both!current!and!previously!prescribed!and!nonKprescribed!medicines,!supplements!and!complementary!remedies,!and!allergies!and!intolerances.!

! !

4! Reviews!the!clinical!condition!using!relevant!equipment!and!techniques.! ! !

5! Reviews!the!working!or!final!diagnosis.! ! !

6! Where!a!medicine!is!appropriate,!identifies!the!different!options!in!the!clinical!management!plan.!

! !

7! Makes!changes!within!the!clinical!management!plan!in!light!of!onKgoing!monitoring!and!the!patient’s!condition!and!preferences.!

! !

,, ,

!36!

NPC,competency,2:,Options,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,, ,

!37!

NPC,Competency,3:,Shared,decision,making!(with!parents,!careKgivers!or!advocates!where!appropriate)!Establishes!a!relationship!based!on!trust!and!mutual!respect.!Recognises!patients!as!partners!in!the!consultation.!Programme!learning!outcomes:!1,!2,!5!and!8!

Competence, Start,score,1$5, End,score,1$5,1.!Identifies!and!respects!the!patient’s!values,!beliefs!and!expectations!about!medicines.! ! !

2.!Takes!into!account!the!nature!of!peoples’!diversity!when!prescribing.! ! !

3.!Undertakes!the!consultation!in!an!appropriate!setting!taking!account!of!confidentially,!dignity!and!respect.!

! !

4.!Adapts!consultations!to!meet!needs!of!different!patients!(e.g.!for!language,!age,!capacity,!physical!or!sensory!impairments).!

! !

5.!Deals!sensitively!with!patients'!emotions!and!concerns!about!their!medicines.! ! !

6.!Creates!a!relationship!which!does!not!encourage!the!expectation!that!a!prescription!will!be!supplied.!

! !

7.!Explains!the!rationale!behind!and!the!potential!risks!and!benefits!of!management!options.! ! !

8.!Works!with!patients!to!make!informed!choices!about!their!management!and!respects!their!right!to!refuse!or!limit!treatment.!

! !

9.!Aims!for!an!outcome!of!the!consultation!with!which!the!patient!and!prescriber!are!satisfied.! ! !

10.! When!possible,!supports!patients!to!take!responsibility!for!their!medicines!and!selfKmanage!their!conditions.!

! !

11.! Gives!the!patient!clear!accessible!information!about!their!medicines!(e.g.!what!it!is!for,!how!to!use!it,!where!to!get!it!from,!possible!unwanted!effects).!

! !

12.! Checks!patient’s!understanding!of!and!commitment!to!their!management,!monitoring!and!followKup.!

! !

13.! Understands!the!different!reasons!for!nonKadherence!to!medicines!(practical!and!behavioural)!and!how!best!to!support!patients.!Routinely!assesses!adherence!in!a!nonKjudgemental!way.!

! !

! !

!38!

NPC,competency,3:,Shared,Decision$Making,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,!! !

!39!

Domain,B:,Prescribing,Effectively,NPC,competency,4:,Safe!–!!Is!aware!of!own!limitations.!Does!not!compromise!patient!safety.!Programme!learning!outcomes:!3,!4,!5,!7,!and!9!!

Competence, Start,score,1$5, End,score,1$5,1.! Knows!the!limits!of!their!own!knowledge!and!skill,!and!works!within!them.! ! !

2.! Knows!when!to!refer!to!or!seek!guidance!from!another!member!of!the!team!or!a!specialist.! ! !

3.! Only!prescribes!a!medicine!with!adequate,!upKtoKdate!awareness!of!its!actions,!indications,!dose,!contraindications,!interactions,!cautions,!and!side!effects!(using,!for!example,!the!BNF/BNFC).!

! !

4.! Accurately!calculates!doses!and!routinely!checks!calculations!where!relevant,!for!example!for!children.!

! !

5.! Keeps!up!to!date!with!advances!in!practice!and!emerging!safety!concerns!related!to!prescribing.!

! !

6.! Knows!about!common!types!of!medication!errors!and!how!to!prevent!them.! ! !

7.! Ensures!confidence!and!competence!to!prescribe!are!maintained.! ! !

8.! Makes!accurate,!legible!and!contemporaneous!records!and!clinical!notes!of!prescribing!decisions.!

! !

9.! Effectively!uses!the!systems!necessary!to!prescribe!medicines!(e.g.!medicine!charts,!electronic!prescribing,!decision!support).!

! !

10.!Writes!legible,!unambiguous!and!complete!prescriptions!which!meet!legal!requirements.! ! !

!! !

!40!

!Programme,learning,outcome,10:!!NPC!competencies!–!supplementary!prescribinge!Utilise!a!Clinical!Management!Plan!within!the!context!of!supplementary!prescribing.!

Competence, Start,score,1$5, End,score,1$5,1.! Knows!how!and!when!to!refer!back!to,!or!seek!guidance!from,!the!independent!prescriber,!another!

member!of!the!team!or!a!specialist.!! !

!! !

!41!

NPC,competency,4:,Safe,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,! !

!42!

NPC,competency,5:,Professional,,,Ensures!prescribing!practice!is!consistent!with!scope!of!practice,!organisational,!professional!and!regulatory!standards,!guidance!and!codes!of!conduct.!Programme!learning!outcomes:!3,!4,!5,!and!9!!

Competence, Start,score,1$5, End,score,1$5,1! Accepts!personal!responsibility!for!prescribing!and!understands!the!legal!and!ethical!implications!of!doing!so.!

! !

2.! Makes!prescribing!decisions!based!on!the!needs!of!patients!and!not!the!prescriber’s!personal!considerations.!

! !

3.! Knows!and!applies!legal!and!ethical!frameworks!affecting!prescribing!practice!(e.g.!misuse!of!drugs!regulations,!prescribing!of!unlicensed/off!label!medicines).!

! !

4.! Takes!responsibility!for!own!learning!and!continuing!professional!development.!! ! !

5.! Maintains!patient!confidentiality!in!line!with!best!practice!and!regulatory!standards!and!contractual!requirements.!

! !

!! !

!43!

Programme,learning,outcome,10,NPC!competencies!in!relation!to!supplementary!prescribing!Utilise!a!Clinical!Management!Plan!within!the!context!of!supplementary!prescribing.!

Competence! Start,score,1$5! End,score,1$5!2! Understands!the!scope!of!own!prescribing!responsibility!in!the!context!of!a!shared!clinical!management!

plan.!! !

3! Ensures!that!the!patient!consents!to!be!managed!by!a!prescribing!partnership.! ! !

, ,

!44!

NPC,competency,5:,Professional,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,, !

!45!

NPC,competency,6:,Always,improving!Actively!participates!in!the!review!and!development!of!prescribing!practice!to!optimise!patient!outcomes.!Programme!learning!outcome:!4!and!9!

Competence, Start,score,1$5, End,score,1$5,1! Learns!and!changes!from!reflecting!on!practice.! ! !

2! Shares!and!debates!own!and!others!prescribing!practice,!and!acts!upon!feedback!and!discussion.!!

! !

3! Acts!upon!colleagues’!inappropriate!prescribing!practice!using!appropriate!mechanisms.! ! !

4! Understands!and!uses!tools!to!improve!prescribing!(e.g.!review!of!prescribing!data,!audit!and!feedback).!

! !

5! Reports!prescribing!errors!and!near!misses,!reviews!practice!to!prevent!recurrence.! ! !

6! Makes!use!of!networks!for!support,!reflection!and!learning.! ! !

!! !

!46!

NPC,competency,6:,Always,improving,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,

!


Date,

!47!

Domain,C:,Prescribing,in,context,,NPC,competency,7:,The,healthcare,system!!Understands!and!works!within!local!and!national!policies,!processes!and!systems!that!impact!on!prescribing!practice.!!Sees!how!own!prescribing!impacts!on!the!wider!healthcare!community.!Programme!learning!outcomes:!3,!4,!and!5!

Competence, Start,score,1$5, End,score,1$5,1! Understands!and!works!within!local!frameworks!for!medicines!use!as!appropriate!(e.g.!local!formularies,!care!pathways,!protocols!and!guidelines).!

! !

2! Understands!the!need!to!work!with,!or!develop,!safe!systems!and!processes!locally!to!support!prescribing,!for!example,!repeat!prescribing,!transfer!of!information!about!medicines.!

! !

3! Works!within!the!NHS/organisational!or!other!ethical!code!of!conduct!when!dealing!with!the!pharmaceutical!industry.!

! !

4! Understands!budgetary!constraints!and!prioritisation!processes!at!local!and!national!level!(healthKcare!resources!are!finite).!

! !

5! Understands!the!national!frameworks!for!medicines!use!(e.g.!NICE,!SMC,!AWMSG!and!medicines!management/optimisation).!

! !

6! Prescribes!generically!where!appropriate,!practical!and!safe!for!the!patient.! ! !!! !

!48!

Programme,learning,outcome,10,NPC!competency!in!relation!to!Supplementary!Prescribing!Utilise!a!Clinical!Management!Plan!within!the!context!of!supplementary!prescribing.!

Competence! Start,score,1$5! End,score,1$5!Understands!the!principles!behind!supplementary!prescribing!and!how!they!are!applied!in!practice.!!

! !

,, ,

!49!

NPC,competency,7:,The,healthcare,system,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,, !

!50!

NPC,competency,8:,Information!!Knows!how!to!access!relevant!information.!Can!use!and!apply!information!in!practice.!Programme!learning!outcomes:!4!and!5!

Competence, Start,score,1$5, End,score,1$5,1! Understands!the!advantages!and!limitations!of!different!information!sources!available!to!prescribers.!

! !

2! Accesses!relevant,!upKtoKdate!information!using!trusted!evidenceKbased!resources.!!

!

! !

3! Regularly!reviews!the!evidence!base!behind!therapeutic!strategies.! ! !

,, ,

!51!

NPC,competency,8:,Information,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,, !

!52!

NPC,competency,9:,,Self,and,others!!Works!in!partnership!with!colleagues!for!the!benefit!of!patients.!Is!selfKaware!and!confident!in!own!ability!as!a!prescriber.!Programme!learning!outcome:!7!

Competence, Start,score,1$5, End,score,1$5,1! Thinks!and!acts!as!part!of!a!multidisciplinary!team!to!ensure!that!continuity!of!care!is!developed!and!not!compromised.!

! !

2! Establishes!relationships!with!other!professionals!based!on!understanding,!trust!and!respect!for!each!other's!roles!in!relation!to!prescribing.!

! !

3! Recognises!and!deals!with!pressures!that!might!result!in!inappropriate!prescribing!(for!example,!pharmaceutical!industry,!media,!patient,!colleagues).!

! !

4! Negotiates!the!appropriate!level!of!support!and!supervision!for!role!as!a!prescriber.! ! !

5! Provides!support!and!advice!to!other!prescribers!where!appropriate.! ! !!! !

!53!

Programme,learning,outcome,10,NPC!competencies!in!relation!to!Supplementary!Prescribing!Utilise!a!Clinical!Management!Plan!within!the!context!of!supplementary!prescribing.!

Competence! Start,score,1$5! End,score,1$5!1! Proactively!negotiates!with!the!independent!prescriber!to!develop!clinical!management!plans.! ! !

2! Relates!to!the!independent!prescriber!as!a!partner.! ! !!! !

!54!

NPC,competency,9:,Self,and,Others,–,Sign$off!Initial,Formative,Assessment!, Mid$point,Formative,Assessment, Final,Summative,Assessment,DMP!Signature! DMP!Signature! DMP!Signature!

! ! !


! ! !

DMP,Comment,!


Date,!

! !

!55!

Statement,of,Competence,–,Allied,Health,Care,Professional,!

,Statement,of,Clinical,Competence,to,undertake,prescribing,as,an:,

,Independent,and,Supplementary,Allied,Healthcare,Professional,Prescriber,

!!Student!Prescriber’s!Name:!!(print!and!sign)!………………………………………………………………..………….....................…………!!!Designated!Medical!Practitioner’s!Name:!(print)!……………………………………………………..…………………………………………!!!The!above!named!has!undertaken!the!minimum!supervision!period!of!12!days!(90!hours)!to!complete!the!practice!component!of!the!NonKMedical!Prescribing!programme.!!I!have!assessed!the!above!as!meeting!all!of!the!programme!competencies,!and!to!be!a!safe!Independent!and!Supplementary!prescriber.,!DMP!name!(please!print)!and!signature:!.............................................………………………………………………………………………!!Qualifications:!………………………………………………………………………..................................................................................…!!Date!of!Assessment:!…………………………………………………!!Hospital,or,Practice,Stamp:,!! !

!56!

Statement,of,Competence,–,Nurse,,,

Statement,of,Clinical,Competence,to,undertake,prescribing,as,an:,,

Independent,and,Supplementary,Nurse,Prescriber,!!Student!Prescriber’s!Name:!!(print!and!sign)!………………………………………………………………..………….....................…………!!!Designated!Medical!Practitioner’s!Name:!(print)!……………………………………………………..…………………………………………!!!The!above!named!has!undertaken!the!minimum!supervision!period!of!12!days!(90!hours)!to!complete!the!practice!component!of!the!NonKMedical!Prescribing!programme.!!I!have!assessed!the!above!as!meeting!all!of!the!programme!competencies,!and!to!be!a!safe!Independent!and!Supplementary!prescriber.,!DMP!name!(please!print)!and!signature:!.............................................………………………………………………………………………!!Qualifications:!………………………………………………………………………..................................................................................…!!Date!of!Assessment:!…………………………………………………!!Hospital,or,Practice,Stamp:,!!!! !

!57!

Statement,of,Competence,–,Pharmacist,,,

Statement,of,Clinical,Competence,to,undertake,prescribing,as,an:,,

Independent,Pharmacist,Prescriber,!!Student!Prescriber’s!Name:!!(print!and!sign)!………………………………………………………………..………….....................…………!!!Designated!Medical!Practitioner’s!Name:!(print)!……………………………………………………..…………………………………………!!!The!above!named!has!undertaken!the!minimum!supervision!period!of!12!days!(90!hours)!to!complete!the!practice!component!of!the!NonKMedical!Prescribing!programme.!!I!have!assessed!the!above!as!meeting!all!of!the!programme!competencies,!and!to!be!a!safe!Independent!and!Supplementary!prescriber.,!DMP!name!(please!print)!and!signature:!.............................................………………………………………………………………………!!Qualifications:!………………………………………………………………………..................................................................................…!!Date!of!Assessment:!…………………………………………………!!Hospital,or,Practice,Stamp:,!

!

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