Independent Non-medical Prescribing Research Articles

Extension of controlled drug prescribing rights to independent prescribers

After a wait of three years, the Home Office has finally made good on its promise to end the confusion over the range and use of controlled drugs by independent non-medical prescribers (NMPs). Since 23 April 2012, both nurse and pharmacist independent prescribers are able to prescribe a far broader range of controlled drugs as part of their practice. In a follow up to their article from November (Griffith and Tengnah, 2011) setting out the limits on prescribing controlled drugs by NMPs, Richard Griffith and Cassam Tengnah discuss the changes introduced by the Misuse of Drugs (Amendment No. 2) (England, Wales and Scotland) Regulations 2012 and consider the implications of the changes on practice.

An audit of independent nurse prescribing in a critical care outreach team

In 2006, legislative changes enabled independent prescribers to prescribe any licensed medication within their field of expertise. This has transformed nurse prescribing and opened up more opportunities for nurses to develop their practice in acute care settings. The need for further evaluation in this developing area of advanced practice was highlighted in the British Association of Critical Care Nurses (BACCN) position statement published in 2009. The aims of this audit were to describe the prescribing practices of nurses working in a critical care outreach (CCO) team by exploring: which medications were prescribed; the number of prescribing decisions being made and if prescribing practice changed during the out of hours period. The findings can be used to inform practice, develop CCO services, provide a basis for further research, and contribute to the debate in this developing area of CCO practice. The prescribing practices of two independent non-medical prescribers in a CCO team were audited from January to April 2011. The findings showed that; there were a wide range of medications prescribed, that prescribing decisions increased over time and that the majority of prescriptions were written out of hours. This preliminary audit has shown that prescribing in a CCO setting which covers a wide patient population is manageable. By evaluating drug prescribing patterns, a 'critical care outreach formulary' can be developed to guide individuals and the team in their continuing professional and service development. The CCO teams ability to prescribe could have the potential to improve the patients' experience and outcome, and positively affect the efficiency of service delivery; however, an increase in CCO referrals can have an impact on the CCO service resource. Further evaluation and study are needed to explore this developing area of critical care delivery.

A Nurse’s Survival Guide to Drugs in PracticeA Nurse’s Survival Guide to Drugs in Practice

I wish this book had been available when I took the pharmacology/prescribing course for independent non-medical prescribers. I could therefore have avoided buying so many other more complex and technical texts.

Non-medical prescribing in a neonatal intensive care unit – 4 years experience

Supplementary prescribing (SP) allows nurses and pharmacists to prescribe ongoing treatments following diagnosis by medical staff. It is “a voluntary partnership between an independent prescriber (IP) and a supplementary prescriber...

An audit of independent non-medical prescribing in inflammatory bowel disease

Nurse independent prescribing allows nurses and pharmacists to prescribe any licensed medicine for any medical condition that they are competent to treat, meaning they are responsible and accountable for the assessment of patients including decisions about their clinical management. The introduction of non-medical independent prescribing has pushed the traditional boundaries of nursing. An audit was undertaken by Kay Greveson to assess the safety and efficacy of nurse independent prescribing within the inflammatory bowel disease (IBD) service at a teaching hospital with a large cohort of IBD patients. The results indicate that prescribing decisions are guided by evidence-based research, although variations in prescribing practice have been highlighted and addressed. With significant implications for practice, further research needs to be undertaken.

Simple acronym may help with drug calculations

I recently completed an independent non-medical prescribing module as part of my master’s degree, so I was interested to read the article on the formula used by nurses calculating drug doses (art&science May 14, letters May 21).

Attitudes of patients towards mental health nurse prescribing of antipsychotic agents

We examined the attitudes of patients with schizophrenia towards unrestricted independent non-medical prescribing of antipsychotic agents by mental health nurses. Data were collected using the Factors Influencing Neuroleptic Medication Taking Scale with a sample of 81 patients with schizophrenia who lived in the community. The results showed that a small majority supported mental health nurses having prescriptive authority. Younger participants were more likely than older participants to favour these clinicians being permitted to discontinue prescribed medication. Most considered their relationships with mental health nurses as satisfactory, and were satisfied with the way these clinicians responded to their concerns regarding antipsychotic agents. Beliefs about prescribing were positively associated with perceived knowledge of medications. The findings draw attention to patient support for non-medical prescribing by these nurses. They highlight the need for mental health nurses to be properly educated to assume this important role, and the requirement for further research.

A judicious way forward

As we adopt a new perspective on independent non-medical prescribing, we should reflect on how best to prepare experienced nurses for this challenging role. Cautious but critical deliberations are vital if the growing demands on nurses are to be rationalised and adapted to cope with the overwhelming advances in pharmaceutical and health care practice.