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©TU-SOHSC (2016)

PRESCRIBING FROM THE COMMUNITY PRACTITIONER

FORMULARY

MODULE GUIDE AND

PORTFOLIO DOCUMENT

JANUARY 2017

MODULE CODE: CCH3062-N MODULE LEADER: DEBBIE OSBORNE

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CONTENTS

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1 INTRODUCTION 1 2 THE MODULE STRUCTURE 1 3 MODULE LEADER/MODULE TEAM CONTACT DETAILS 2 4 LEARNING AND TEACHING STRATEGIES 2 5 MODULE AIMS AND OUTCOMES 4 6 RESPONSIBILITIES 5 7 ASSESSMENT STRATEGY 7 8 ASSESSMENT CRITERIA 8 9 EVALUATION STRATEGY 9 10 INDICATIVE RESOURCES 9 PRACTICE PORTFOLIO DOCUMENT 11 GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO 10 12 PORTFOLIO DOCUMENTS 12


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1 INTRODUCTION The roles of community nurses are undergoing a period of major change in response to many drivers, such as the introduction of community matrons (Department of Health (DH), 2005), assistant practitioners, relocation of services from secondary to primary care, greater choice of where and when patients can receive care and, not least, the reconfiguration of services across the National Health Service (NHS). Non-medical prescribing, including community practitioner nurse prescribing, has been one of the major enablers for many of these developments. In response to these developing needs in practice this module has been designed as part of the non-medical prescribing suite of modules. The module meets the NMC Standards of Proficiency for Nurse Prescribers without a Specialist Practice Qualification to prescribe from the Community Practitioner Formulary (V150). 2 THE MODULE STRUCTURE The length of the module is 18 weeks, during which you will undertake 13 University contact and self-directed study days and 10 supernumerary supervised days working alongside a Practice Mentor who is a practising community practitioner nurse prescriber. You have a week-long induction in Week 1; this will introduce you to the University and the School of Health & Social Care (SOHSC). You will also be introduced to the principles of community nurse prescribing and be prepared for your supervised practice experience. This will be followed by a further eight study days as detailed in the timetable which you will find on the Virtual Learning Environment (VLE) e-learning@tees site. University days will be a Tuesday from 9.30 am-4.00 pm spread over a further 17 weeks. This information will be detailed on the timetable you will be given on day one of the module. This will also be on the VLE. If for any reason you are unable to complete the module in the allocated time it is important that you discuss this with a member of the module team. There are University support mechanisms in place which can support an extension of your studies should you need to use these. The maximum length to complete the module is one academic year from the start; you should however discuss with the team any difficulties in order to ensure we support you appropriately to complete your studies. The SOHSC Student Essential Guide provides further detailed information. The link to this can be found on the module VLE. Your organisation has agreed that you will undertake 10 days’ supervised practice. This should not be undertaken within your working day and does not include any organisational or external education days. It is necessary to ensure that you and your Practice Mentor are able to work together for sufficient time for your Practice Mentor to be able to confidently assess that you have met the practice outcomes for the module. It is expected that a programme of experience will allow you to work with other team members in order to experience a variety of learning opportunities. Your Practice Mentor must be the person responsible for verifying that you have met the practice outcomes.


You must attend all theory sessions as agreed at application. Your mentor must have the recordable V100 or V150 prescribing qualification. It is vital that you use this document in conjunction with your own professional standards for prescribing; these can be found on the module VLE site. You must develop a working knowledge of your specific prescribing standards alongside the NMC Code. 3 MODULE LEADER/MODULE TEAM CONTACT DETAILS The Module Leader is Debbie Osborne; Debbie is based in room H1.31 in the Centuria Building, Teesside University. She can be contacted on 01642 738257 and email: [email protected] and you should initially direct any queries or issues to her. Bernadette Martin supports the module and is based in room H1.20 in the Centuria Building, Teesside University. She can be contacted on 01642 384966 and email: [email protected] Christine Robinson is the Lead Midwife for Education (LME) and supports midwives who undertake the module. She can be contacted on 01642 738293 and email [email protected] The module is supported by an established and experienced team of pharmacists, and non-medical prescribers from both primary and secondary care. You will be offered the opportunity for discipline-specific tutorials by specialist Academic Mentors in order to enable you to identify individual learning needs and to develop a Learning Contract to guide and facilitate academic learning. You will be directed to the most appropriate academic in Week 1 of the module. 4 LEARNING AND TEACHING STRATEGIES Prescribing requires that you have the knowledge, skills, and professional competence necessary to embrace this new role. It also requires you to demonstrate a comprehensive and detailed understanding of the concepts of accountability and lifelong learning in a significant way. To this end, the module aims to incorporate knowledge and reflection in a way that enables the development of self-awareness and for you to build upon previous learning as well as acquiring new competencies for safe and effective prescribing. The module will help you to build upon previous knowledge and experience. This will ensure that you are knowledgeable, flexible and adaptable, and able to embrace both the theory and practice of community prescribing in a critical and reflective manner. You will achieve the module aims through the development of a robust knowledge that is based upon the best available evidence, combined with a flexible and adaptable approach to both the theory and practice of community prescribing.

mailto:[email protected]




The taught component of your module will consist of theoretical preparation to ensure that you develop the knowledge and skills necessary to ensure safe and effective prescribing. The module focuses upon the principles and practice of prescribing and professional accountability and responsibility required by community prescribers. Related pathophysiology and pharmacology will be explored. In order to facilitate and maximise learning a variety of learning strategies will be employed. You will share your learning with your peers undertaking the non-medical prescribing (V300) modules, as well as undertaking specific learning associated with developing competence in community prescribing. Taught sessions will include lectures and group discussions. There will be self-directed study based upon both the indicative content and an assessment of your own learning needs in relation to prescribing. Discipline-specific tutorials will be offered by specialist Academic Mentors in order to enable you to identify individual learning needs and to develop a Learning Contract to guide and facilitate your learning. If you are a midwife you will be introduced to the LME in Week 1 of the module who will support your learning and assessment preparation.

Random case analysis will be used so that you will have the opportunity to analyse treatment situations and examine and critically reflect upon the decision-making process in relation to prescribing. The generic nature of the module content will facilitate you to apply your knowledge and understanding to safely prescribe within your own area of practice speciality. This will be further developed with the support and guidance of your Practice Mentor. You will be guided in preparing and developing your Portfolio that will provide evidence of your ability to critically reflect on and in practice. This will include the use of Learning Contracts and evidence of your successful completion of the practice element of the module. Also included will be a reflective analysis of your knowledge underpinning safe prescribing practice and evidence of understanding the pharmacology, pharmacokinetics, legal aspects, and application to practice of drugs or products you may prescribe in practice through the development of a P-Formulary. You will practice examination techniques and will undertake a formative examination which will be peer reviewed in order to prepare you for the examination element of the assessment. Directed study utilising the VLE, e-learning@tees, will enable you to further develop numeracy skills which will support preparation for the examination. To further support formative numeracy development you have access to the Library Succeed @ Tees drug calculations workshops at the following link: http://tees.libguides.com/drug_calculations and the Standardised Numeracy Assessment Process (SN@P). You will have access to a wide range of web-based resources through the VLE for example News Feeds via the National Institute for Health & Care Excellence (NICE) Medicines and prescribing support website and the Medicines and Healthcare Products Regulatory Agency (MHRA) website. You will be working in small groups using scenario-based examples of prescribing practice to prepare you, for example, to take an effective history and make diagnostic decisions which will influence your prescribing decision-making process.

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The integration of theory and practice will be strengthened by your ability to demonstrate the achievement of the practice outcomes. Learning in practice will be related to the achievement of these practice outcomes, you and your Practice Mentor would must be a practising community prescriber will document process in three meetings during your supervised practice. These will be included in your Portfolio and verified by your Practice Mentor. Registrants who will be prescribing for children must have a Practice Mentor who is experienced and competent in prescribing for children. The LME will support midwife Practice Mentors and will attend the Practice Mentor preparation workshops if appropriate. 5 MODULE AIMS AND OUTCOMES Module Aims The aims of the module are to:

Enable you to develop the knowledge and skills required to become a community practitioner prescriber.

Enable you to demonstrate a comprehensive and detailed ability to prescribe safely and effectively in order to meet prescribing standards set by the Nursing and Midwifery Council (NMC).

Module Outcomes On completion of this module you will be able to:

Knowledge and Understanding 1. Synthesise and critically appraise the influences that can affect prescribing

practice, and demonstrate understanding by managing prescribing practice in an ethical way.

2. Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice.

3. Analyse and evaluate the legal and professional framework for accountability and responsibility in relation to prescribing practice.

4. Evaluate the factors involved in effective history-taking, including medication history and current medication that will inform the diagnostic process.

Cognitive and Intellectual Skills

1. Demonstrate a comprehensive and detailed knowledge of the relevant legislation to the practice of nurse/midwife prescribing.

2. Critically appraise and synthesise sources of information/advice and decision support systems in prescribing practice.

3. Demonstrate a critical reflective approach to continuing professional development of prescribing practice.

Practical and Professional Skills 1. Prescribe safely, appropriately and cost-effectively. 2. Practice within a framework of professional accountability and responsibility. 3. Assess and consult with patients/clients, parents and carers. 4. Demonstrate the ability to monitor response to medicines and modify

treatment or refer the patient as appropriate.


5. Demonstrate a comprehensive and detailed knowledge of the importance of record-keeping in the context of medicines management including: accurate recording in patient notes; reporting of near misses; adverse reactions.

6. Demonstrate a comprehensive and detailed knowledge of the roles and relationships of others involved in prescribing, supplying, and administering medicines.

7. Demonstrate effective partnership-working with independent prescribers and the wider care team.

8. When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional, and physical differences between children and adults.

Key Transferable Skills 1. Demonstrate appropriate numeracy skills. 6 RESPONSIBILITIES Practice Mentor Your Practice Mentor has a fundamental role in educating and assessing your prescribing practice. They will be invited to a mentor preparation workshop which will support their preparation for the role. The generic nature of the module content will facilitate you to apply your knowledge and understanding to safely prescribe within your own area of practice speciality. This will be further developed with the support and guidance from your Practice Mentor. Your Practice Mentor is responsible for:

Establishing a Learning Contract with you.

Documenting progress on three occasions during supervised practice and provide any additional opportunities if required to achieve outcomes in a timely manner.

Planning a learning programme which will provide the opportunity for you to meet your learning objectives and gain competency in prescribing.

Facilitating your learning by encouraging critical thinking and reflection.

Providing dedicated time and opportunities for you to observe how they conduct a consultation/interview with patient/clients and/or parents/carers and the development of a management plan.

Allowing you opportunities to carry out consultations and suggest clinical management and prescribing options, which are then discussed with your Practice Mentor.

Helping ensure that you integrate theory with practice.

Taking opportunities to allow in-depth discussion and analysis of clinical management using a random case analysis approach, when patient/client care and prescribing behaviour can be examined further.

Facilitating, observing, and assessing your performance over the continuous period of supervised practice.

Facilitating the opportunity to gain service user/carer feedback using the practice-based 360° interpersonal skills assessment tool (one assessed tool).


Assessing and verifying that, by the end of the module, you are competent to assume the prescribing role. It is your Practice Mentor’s responsibility to decide whether or not you are making satisfactory progress towards meeting the practice outcomes for community practitioner prescribing. This decision will be based upon whether or not the practice outcomes have been met. If during the practice days you are deemed by your Practice Mentor to be failing to make sufficient progress towards achievement of these outcomes they should inform both you and Debbie in order to consider if strategies can be put in place to support you.

Working in collaboration with LME to support midwife students.

Identify and document any ‘cause for concern’, e.g. concerns regarding competence acquisition, or conduct, or unsafe practice, and discuss at the earliest possible stage with Debbie. A Cause for Concern Form should be completed. If you demonstrate any concern relating to patient safety you should be aware that the SOHSC may consider the Fitness to Practise process. Details of this process can be found in your SOHSC Student Essential Guide.

Reconfirming and verifying competence has been maintained should you interrupt or delay your studies.

Your Practice Mentor’s contribution in relation to providing supervision, support, and opportunities to develop competence in practice is therefore crucial. The criteria for fulfilling this role is that they:

Be a practising community practitioner nurse prescriber who has agreed to provide supervision for the duration of the programme.

A sign-off mentor.

Be responsible for facilitating and supporting your learning in practice and assessing your competence to prescribe safely and effectively.

The Lead Midwife for Education (LME) Jayne Cornforth will ensure that if you are a midwife you are provided with additional support. You will meet Jayne in Week 1 of the module and will be expected to meet with her on a regular basis. The LME works closely with the module team and contributes to your assessment. The LME may work with your Practice Mentor if required; and will contribute to the Practice Mentor preparation workshops. The Student Your role is to take responsibility for your own learning and demonstrate a willingness to develop both academically and in practice. You will be expected to discuss your own learning needs with your Practice Mentor and you should undertake honest self-assessment, articulate your learning needs, seek, and accept formative feedback from your Practice Mentor and module team. You are expected to recognise and appraise your own abilities and limitations. There is a requirement that you attend 100% of the module, if you are unable to attend a theory day due to sickness you must inform Debbie.


Important Information If for any reason you do not complete the module in the specified time, for example in the case of an interruption, reassessment or delayed submission your mentor MUST reconfirm and verify that you have maintained your competency in the practice area. They will need to confirm this by signing your practice outcomes at the point at which you submit your final assessed work. On successful completion of this programme you are not initially legally able to prescribe and therefore must not do so. You can only prescribe once you have received notification from the NMC that your prescribing qualification has been recorded on the professional register. You must record your prescribing qualification within 12 months of completing your programme. Module Team It is recognised that the demands of this module are challenging and that the intensity of the assessment can be demanding. The module team will provide substantial support to you and your Practice Mentor both in an academic and pastoral capacity. If you require additional support you should discuss this with Debbie at an early stage who will signpost you to the most appropriate student support. 7 ASSESSMENT STRATEGY Formative You will undertake formative assessment through peer debate in the classroom, relevant and relating to prescribing practice. You will undertake a peer-reviewed formative examination in Week 10 and will have the opportunity to update, develop, and enhance your numeracy skills by undertaking online calculation testing. This will be monitored by the module team who will identify and support any additional support you require.

Summative Portfolio (100%) You will complete a Portfolio that comprises of:

A Learning Contract which identifies individual learning needs and strategies to meet these.

A Learning Log that identifies prescribing experiences.

A critical reflection on episode/s from your learning log (maximum 2,000 words).

Completion of one P-Formulary.

Four case studies from your Learning Log.

Evidence of satisfactory completion of a period of practice experience.

Evidence of achievement of a two-hour written examination. In order to gain pass grade you must achieve a minimum of 80% in the 20-question pharmacological element and 100% in the five numerical questions element (pass/fail). Undertaken in Week 13. There will be two opportunities to meet this essential evidence prior to the submission of the Portfolio.


You will submit your Portfolio in Week 18. You must complete a minimum of 65 hours’ supervised practice. 8 ASSESSMENT CRITERIA Portfolio of Evidence A Portfolio of Evidence which includes all essential evidence including a critical reflective analysis and evaluation of prescribing practice from the Learning Logs which demonstrate:

Evidence of a comprehensive and detailed understanding of the pharmacodynamics, pharmacokinetics, legal aspects, and application to practice of a drug or product they may prescribe in practice.

Evidence of analysis and evaluation of the relevant literature and informed decision-making.

A comprehensive and detailed knowledge of ethical issues, legal issues, team-working, record-keeping, writing a prescription and numeracy - and how these apply to prescribing practice.

Evidence of having passed the written examination.

Adhere to the SOHSC policy for presentation and referencing.

Adhere to the SOHSC guidelines for confidentiality and consent.

If you demonstrate unsafe practice in any part of the assessment related to patient safety, for example, incorrect diagnosis, incorrect treatment options and incorrect completion of the prescription form you will be referred. Please ensure you also maintain confidentiality and gain informed consent. You will be awarded a mark of 0 for any of the above. It is a requirement that you must pass both components of the module. Assessment Dates You will have the opportunity to have formative feedback as follows: Formative examination Tuesday 21 March 2017 Summative Assessments Examination 1st Attempt Tuesday 11 April 2017 Resubmission Tuesday 16 May 2017 Reassessment Will be agreed by the assessment board Portfolio Submission Thursday 25 May 2017 Reassessment Will be agreed by the assessment board


You will submit your 2,000-word critical reflection electronically via the VLE by Wednesday 24 May 2017. The Role of the External Examiner Students often ask questions about how we know that their award is broadly of the same standard as those awarded for similar courses by other universities. In the UK we have a system called external examining which is one of several ways that we confirm that standards are met. An External Examiner is generally an experienced lecturer from another University who offers an independent view as to whether the work of students on the course is of the correct standard. The External Examiner does this by looking at a sample of work (e.g. assignments, exam answers, and dissertations), discussing the work with your lecturers and attending the assessment boards to endorse results. They then produce an annual report which tells us about any concerns they have and any good practice they have identified. The External Examiners’ reports are made available to students via the ‘courses’ tab in e-vision.

The External Examiner for your module is Barbara Novak and she works at City University London.

Please note that students are not permitted to contact External Examiners directly and External Examiners will not respond to any communication from individual students. If you have any concerns about your module then please speak to Debbie. 9 EVALUATION STRATEGY Informal feedback from students is welcomed throughout the module. You will also have the opportunity to provide formal feedback at the end of each module. There is also the opportunity for evaluation and feedback regarding the module through the student representative system. Please see the SOHSC Student Essential Guide for information on this process. Comments that you may have and suggestions for improvement that you may wish to make will be valued and appreciated. Everyone is here to help you successfully complete your programme. If in doubt, please ask. We hope you enjoy your time studying with us. 10 INDICATIVE RESOURCES

These can be found in the Reading List section of the VLE. You should also link into the web links and Twitter Feeds sections on the VLE.


PRACTICE PORTFOLIO DOCUMENT

11 GUIDELINES FOR COMPLETION OF YOUR PORTFOLIO The purpose of this Portfolio is to provide a framework through which you can record and demonstrate your progress and achievements whilst studying Prescribing from the Community Practitioner Formulary. In order to demonstrate achievement of the module, you are required to present a Portfolio of Evidence that provides a documentary record of your learning and how this relates to the module outcomes. The Portfolio-keeping process includes:

Reflection upon existing knowledge and skills.

Exploration of the module outcomes.

Identification of learning needs.

Identification of learning opportunities in your supervised practice area and who can support you.

Matching learning opportunities to learning needs.

Development of a plan or Learning Contract to meet learning needs.

Implementation of the plan/Learning Contract and collection of supporting evidence.

Keeping a practice Learning Log.

Reflection upon learning and achievement of practice module outcomes.

Presentation of the Portfolio at the end of the module. How to Compile your Portfolio Stage 1 - Identifying your Learning Needs The first step is to look at the practice outcomes and consider what you need to learn to achieve each one. You must have time aside with your Practice Mentor at the beginning of the practice placement and review the practice outcomes, consider how these can be achieved and consider your own self-assessment and how your learning needs can be met. A Learning Contract will be developed to show how these outcomes can be achieved. This contract can also be used as a framework for your critical reflection of learning. This meeting must be documented by both you and your Practice Mentor on the initial meeting form. Stage 2 - Feedback You must both set aside time to review progress and provide feedback on progress. This should be undertaken regularly and should involve discussing cases from practice experiences and reflecting upon and critically analysing. It is important that you consider how theoretical concepts are used to inform these discussions. This stage also includes assessment of your progress towards competence in relation to practice outcomes and you and your Practice Mentor must document this using the intermediate meeting form.


Stage 3 – Sign Off At the end of the module, you will submit your Portfolio for verification of the award. Your Practice Mentor must sign and date the practice outcomes have been met. It is important that you provide a short statement on how you have achieved each outcome on the table of practice outcomes. You should both also provide evidence of a final meeting using the final meeting form which you find in the Portfolio document section and final sign-off point. Please remember the information detailed above relating to any delayed submission/interruption/referral at first attempt and the need to have your mentor verify that you have maintained competence in all practice outcomes. Your Portfolio must include the following:

A Learning Contract which identifies individual learning needs and strategies to meet these.

A Learning Log that identifies prescribing experiences and meets the learning outcomes as detailed above.

Reflection on episode/s from the learning log that demonstrate an understanding of ethical issues, legal issues, team-working, record-keeping, writing a prescription and numeracy - and how these apply to their prescribing practice.

Completion of one P-Formulary.

Evidence of achievement in the written examination.

Four case studies from the Learning Log which demonstrate prescribing and accurate prescription writing.

Evidence of satisfactory completion of a period of practice experience.

One fully completed practice-based 360° interpersonal skills assessment tool.

Adhere to the SOHSC policy for confidentiality and consent and adhere to the SOHSC guidelines for presentation and referencing.

Practice placement prescribing support information.

All your practice outcomes must be achieved by the end of the module and the Portfolio forwarded to your Academic Mentor for verification. If you are referred on one or more of the practice outcomes you must demonstrate achievement of this outcome at the designated point of negotiated re-assessment. If this is the case you must devise a Learning Contract and Action Plan with your Practice Mentor and Debbie in order to address the outcomes involved. The decision regarding whether or not you have achieved this Learning Contract will be made by your Practice Mentor. Your practice log can also be used as a tool to guide reflection on practice. By recording experiences, in particular those that create uncertainty and conflict, an opportunity for reflection on action can be created. Such reflection articulates the factors that underpin decision-making and facilitates the identification of alternative approaches. However, it is also essential that sustained observation in the practice environment is used to provide evidence of your competence in practice. It is important that you should collect your Portfolio of Evidence on an ongoing basis to demonstrate achievement of the practice outcomes. All Portfolio components must be submitted.


Your Portfolio will be submitted to the module team at the end of the module. You will complete a receipt for submission of assignment form. This form will be signed by the member of the module team receiving the Portfolio and the carbon copy retained by you. 12 PORTFOLIO DOCUMENTS 1. Record of Supervised Practice Meetings 2. Record of Achievement of Practice Outcomes 3. P-Formulary Worksheet Framework 4. Learning Contract 5. Agreed dates for Practice Hours 6. Learning Logs 7. Case studies – complete 4 8. Practice Placement Prescribing Support Information 9. Signature Sheet 10. Non-medical community prescribing practice-based 360° interpersonal skills

assessment tool. 11. Level 6 University Generic Marking Criteria 12. Consent and Confidentiality 13. DBS Verification


RECORD OF SUPERVISED PRACTICE MEETINGS

Initial Meeting

Practice Mentor comments:

Signature: Date:

Student comments:

Signature: Date:


Intermediate Meeting

Practice Mentor comments:

Signature: Date:

Student comments:

Signature: Date:


FINAL ASSESSMENT SIGN-OFF

Final Meeting

Practice Mentor comments: Competent/Not Competent (please delete as appropriate) I am satisfied/not satisfied (please delete as appropriate) that the student has met the outcomes of the module. This has been evidenced through observation, question and answer discussion throughout the practice experience.

Signature: Date:


Student comments: Signature: Date:


RECORD OF ACHIEVEMENT OF PRACTICE OUTCOMES

Practice Outcome By the end of the module the student will be able to:

Evidence (to be completed by the student)

Practice Mentor

Signature & Date

Student Signature

Demonstrate a comprehensive and detailed knowledge of drug actions in prescribing practice

Critically appraise and synthesise the factors influencing safe and ethical prescribing practice at individual, local and national levels

Synthesise and evaluate sources of information/ advice and decision support systems in prescribing practice

Demonstrate a detailed and comprehensive understanding of the roles and relationships of others involved in prescribing, supplying and administering medicines

Prescribe safely, appropriately and cost-effectively

Practice within a framework of professional accountability and responsibility

Demonstrate effective partnership working with Independent Prescribers and the wider care team


Practice Outcome By the end of the module the student will be able to:

Evidence (to be completed by the student)

Practice Mentor

Signature & Date

Student Signature

Demonstrate a comprehensive and detailed knowledge of the importance of record-keeping in the context of medicines management including: accurate recording in patient notes reporting of near misses adverse reactions ability to access patient records

Demonstrate the ability to monitor response to medicines and modify treatment or refer the patient as appropriate

Assess and consult with patients/clients, parents and carers incorporating the patients' choice into the decision-making process

When working with children take an appropriate history, undertake a clinical assessment, and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults

Employer endorsement of the student’s competence to prescribe in their defined area of practice: Signature…………………………………………………………………. Name…………………………………………………………. Position…………………………………………………………………… Date……………………………………………………………

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P-FORMULARY WORKSHEET FRAMEWORK

Choose one drug or suitable product that you will prescribe when qualified as a community nurse prescriber and complete the following worksheet in relation to your choice. You should, where relevant, demonstrate application of the product/drug to your practice. This must be from the Community Formulary. If you use these headings to form your worksheet it will allow you to follow a logical pattern. For your choice ensure that you fully understand:

Approved or generic name

Drug/product class to which the drug/product belongs Basic Pharmacology

The general mechanism of action of the drug/product at a molecular, cellular, tissue and organ level

The ways in which these actions produce therapeutic and adverse effects

Clinical Pharmacokinetics

How the drug/product is absorbed, distributed, metabolised and excreted

Cautions, contra-indications and side effects

The half-life of the drug

The optimal route, dose and frequency of administration Therapeutic Drug Monitoring

How drug/product therapy can be monitored

The drugs/products therapeutic window

Adverse Drug Reactions

How to recognise adverse drug/product reactions and how these can be minimised

Drug Interactions

The potential for drugs/product to interact and to cause beneficial and harmful side effects

The ways in which interactions can be predicted and avoided Legal Aspects

Legal category of the drug/product

License implications Altered Physiology Special measures to be taken when prescribing drug/product to individuals including:


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Elderly patients

Children

Women of child bearing potential

Pregnant and breastfeeding women

Patients with renal disease

Patients with liver disease


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LEARNING CONTRACT

Name: Practice Mentor: Negotiated Learning Outcomes: Strategies: Resources: Date of Contract: To be completed by: Student Signature: Practising Community Prescribing Mentor Signature:


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AGREED DATES FOR SUPERVISED PRACTICE MUST BE 65 HOURS MINIMUM

No of hours completed (excluding breaks) Date 1 2 3 4 5 6 7 8 9 10

Total number of hours AGREED Student Signature: NMC PIN Practising Community Prescribing Mentor Signature: NMC PIN


LEARNING LOGS

Date Patient/Practice Experience

Description of Event Module Outcome

Number Met

Significant Learning


CASE STUDY- PATIENT…………………………………………………………..

History (including findings from examination)

Diagnosis

Strategy (including product choice)

Information given

Monitoring arrangements

Include a Prescription


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Practice Placement Prescribing Support Information

Placement type – i.e. ward/community/practice setting

Practice Mentor

Student

Availability of other health care professionals working in the placement who can provide for prescribing student support

Specialist expertise or interest offering learning opportunities

for prescribing students

Number of Prescribing

Professionals

Other Community Prescribers

Non-medical Independent/supplementary Prescribers

Medical Practitioners

Pharmacy


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Prescribing from the Community Practitioners Formulary

Practice Experience Signature list

Please sign and print your name in the table below if you are involved in supporting the practice education of the Community Prescribing student, or provide any written information within this Portfolio. It is important not to identify areas by name.

Date Type of Placement Name Signature


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CONFIDENTIAL

NON-MEDICAL COMMUNITY PRESCRIBING PRACTICE-BASED 360°

INTERPERSONAL SKILLS ASSESSMENT TOOL TO BE COMPLETED BY SERVICE USER/and/or CARER/PARENT

Teesside University greatly values the involvement of service users/patients and carers in the learning and development of registered health professionals undertaking a non-medical community prescribing qualification. This form helps us to assess their learning. These students must demonstrate a safe and competent approach to non-medical community prescribing which reflects their understanding of your needs as a service user/patient and as a person and that they have prioritised these preferences where at all possible. It is important to all service users and carers or parents that health professionals are skilled in communication and by completing this questionnaire you are adding your contribution to the assessment process of the student. If you consent to completing this form, the person who has given it to you will write their name and sign in the box below to indicate that you have given your informed consent.

Thank you for agreeing to help assess the student’s progress in managing your prescribing needs. If you wish, please ask the community prescribing mentor (the person who gave you this form) or your family to help you complete this form. All questions are optional and the student will not know who has been asked to complete the form. The student will see your comments, however, please be assured that your identity will remain confidential.

The health professional who has given this form to you should explain the purpose of this request with you before you complete it. It is essential that your informed consent is given freely.

I confirm that informed consent has been obtained from the service user/carer/parent (delete as appropriate) completing this form. Name of Community Prescribing Mentor ……........................................................... Signature of Community Prescribing Mentor…….....................................................

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Please rate how effective you/and /or your carer/parent felt the student was in relation to the following areas by ticking one box for each statement:

Poor OK Good

Excellent N/A

You were greeted in a friendly manner which you felt was appropriate, the student’s whole approach made you feel at ease.

You felt you were included and able to engage in the process of your prescribing consultation.

You felt you were listened to and that your carer/parent were included and involved in discussion and decision making.

You were given the opportunity to explain your thoughts and feelings about your treatment and any way this maybe affecting you and what was important to you.

You were given clear, understandable and accessible information about your medicines (e.g. what it is for, how to use it, possible unwanted effects and how to report them, expected duration of treatment) and these were where possible in a format you preferred.

The words and language used ensured you understood and made you feel valued, empowered to be involved in and in control of your treatment with medicines.

The student guided you on how to identify reliable sources of information about your medicines and treatments.

You were given the opportunity to ensure that you understood and could re-cap what had been agreed. The student checked your understanding of and commitment to managing, monitoring and any follow-up treatment/assessment. This may have included referral to another prescriber.


Please see the next page

You felt supported and empowered in your decisions and made to feel that your views and choices were respected.

If appropriate you felt the student encouraged and supported you to take responsibility for your medicines and self-manage your condition.

You had confidence in the students overall ability to meet your treatment with medicines with dignity and compassion.


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Is there anything the non-medical community prescribing student did particularly well?

Are there any areas where you feel the student could develop?

Thank you for your help in supporting the learning of this student - it is greatly

appreciated


31 ©TU-SOHSC (2016)

NON-MEDICAL COMMUNITY PRESCRIBING PRACTICE-BASED 360° INTERPERSONAL SKILLS ASSESSMENT TOOL

To be completed by Community Prescribing Mentor

This tool should facilitate assessment of the student non-medical community prescriber’s ability to communicate with the service users/and/or carers/parents in their care. Underpinning evidence to support the areas assessed include:

NMC (2015) The Code

DH (2015) NHS Constitution

HCPC (2013) Standards for Prescribing

NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers

RPS (2016) A Competency Framework for all Prescribers Please use the table below to provide an assessment of the student’s abilities in the areas identified. You can reflect on either one individual interaction or a combination of interactions by the student non-medical community prescriber. Please ensure that you assess them towards the time of their intermediate meeting so that discussion of this form within that meeting reflects their performance at that time. Name of Student Non-medical Community Prescriber…………………………………… Module being studied: ……………………………………………………………………….. Date of completion of form: ………………………………………………………………….

http://www.tees.ac.uk/


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Please rate how effective you felt the student was in relation to the following areas by ticking one box for each statement:

Poor

OK

Good

Excellent

N/A

1. The student introduced themselves appropriately and professionally.

2. They conducted themselves appropriately and professionally.

3. The student used language appropriate for the setting and made the service user/carer/parent feel valued.

4. The student’s non-verbal communication was effective in establishing a therapeutic relationship

5. Explored the service user’s/carer’s/parent’s understanding of the consultation and aims for a satisfactory outcome for the individual and prescriber.

6. Worked with the service user/carer/parent in partnership to empower them to make informed choices, agreeing a plan that respects individual preferences including the right to refuse or limit treatment.

7. The student identified and respected the service user’s/carer’s/parent’s thoughts in relation to diversity, values, beliefs and expectations about their health and treatment with medicines.

8. Explained the rationale behind and the potential risks and benefits of management options in a way the service user/carer/parent understood. This may include referral to another prescriber.

9. If appropriate assessed adherence in a non-judgemental way and demonstrated understanding of the different reasons non-adherence can occur (intentional or non-intentional) and how best to support individuals.

10. The student appropriately guided the service user/carer/parent on how to identify reliable sources of information about their medicines and treatments and demonstrated knowledge of these sources.

11. The student sought feedback on the prescribing decision that was agreed and provided.

12. The student demonstrated sound working in partnership with the service user/carer/parent.

13. The student demonstrated compassion in all aspects of the consultation and treatment advice given.

14. The core values of dignity and respect were upheld at all times.


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Please give a summary of areas on which the student needs to focus in order to develop their practice and also of the areas in which they are demonstrating good practice: …………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Name of Community Prescribing Mentor

Signature of Community Prescribing Mentor


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To be completed by Student

This tool should facilitate assessment of your ability to communicate with the service users/carers/parents in your prescribing treatment. Underpinning evidence to support the areas assessed include:

NMC (2015) The Code



NMC (2006) Standards of Proficiency for Nurse and Midwife Prescribers

RPS (2016) A Competency Framework for all Prescribers Please use the table below to provide a self-assessment of your abilities in the areas identified. You can reflect on either one individual interaction or a combination of interactions you have had with service users/carers and parents. Please undertake this self-assessment towards the time of your intermediate meeting so that discussion of this form within that meeting reflects your performance at that time. Name of Student: …………………………………………………………… Module being studied: ………………………………………………………………….. Date of completion of form: …………………………………………………………………


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Please rate how effective you felt you were in relation to the following areas by ticking one box for each statement:

Poor

OK

Good

Excellent

N/A

You introduced yourself appropriately and professionally.

You conducted yourself appropriately and professionally.

You used language appropriate for the setting and made the service user/carer/parent feel valued

Your non-verbal communication was effective in establishing a therapeutic relationship

You explored the service user’s/carer’s/parent’s understanding of the consultation and aims for a satisfactory outcome for the individual and for you as the prescriber.

You worked with the service user/carer/parent in partnership to empower them to make informed choices, agreeing a plan that respected individual preferences including the right to refuse or limit treatment.

You identified and respected the service user’s/carer’s/parent’s thoughts in relation to diversity, values, beliefs and expectations about their health and treatment with medicines.

If appropriate you assessed adherence in a non-judgemental way and demonstrated understanding of the different reasons non-adherence can occur (intentional or non-intentional) and how best to support individuals.

You took a partnership approach to the prescribing decisions made, this may have included referral to another prescriber.

The service user’s or carer’s decisions were respected and valued.

You sought feedback on the prescribing decision that was agreed and provided.

You appropriately guided the service user/carer/parent on how to identify reliable sources of information about their medicines and treatments and demonstrated knowledge of these sources.

Your approach was inclusive of all those significant in the service user’s care and the carer’s/parent’s support.

The core values of dignity and respect were upheld at all times.

You demonstrated compassion in all care given.


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Please give a summary of areas on which you feel you need to focus in order to develop your practice and also of the areas in which you feel you are demonstrating good practice: …………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

…………………………………………………………………………………………………

Signature of Student: ………………….......................................................................


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SUMMARY REFLECTION

To be completed by Student

Please use this form to reflect on your communication skills and demonstration of professional attitudes and values in clinical practice. You will need the following in order to do this: Practice-based assessment of communication skills by:

Service user/and/or Carer/Parent

Community Prescribing Mentor

Self-assessment

You may also want to draw upon the standards upon which this assessment has been developed. These are:

NMC (2015) The Code



NMC (2006) Standards of Proficiency for Nurse & Midwife Prescribers

RPS (2016) A Competency Framework for all Prescribers This form must be completed in advance of the tripartite meeting and brought to that meeting for discussion. Name of student: ……………………………………………………………. Module studied: …………………………………………………………………………. Date form completed: ………………………………………………………………………..


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1. Discuss the common themes which are evident across the assessment form, including any discrepancies in the way you have been perceived by others and by yourself.

2. What factors may have affected your assessment by the different people?

3. Why are the issues which have been identified in this tool important in prescribing practice?

Signature of student: ……………………………………………………


39 ©TU-SOHSC (2016)

This assessment tool has been developed with service users/carers at Teesside University and with the following resources: Department of Health (2015) The NHS Constitution – the NHS belongs to us all. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf The Health and Care Professions Council (2013) Standards for Prescribing. http://www.hpc-uk.org/aboutregistration/standards/standardsforprescribing/ The Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife Prescribers. https://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/ The Nursing and Midwifery Council (2015) The Code. https://www.nmc.org.uk/standards/code/ The Royal Pharmaceutical Society (2016) Prescribing Competency Framework. http://www.rpharms.com/unsecure-support-resources/prescribing-competency-framework.asp

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/480482/NHS_Constitution_WEB.pdf

http://www.hpc-uk.org/aboutregistration/standards/standardsforprescribing/

https://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

https://www.nmc.org.uk/standards/additional-standards/standards-of-proficiency-for-nurse-and-midwife-prescribers/

https://www.nmc.org.uk/standards/code/

http://www.rpharms.com/unsecure-support-resources/prescribing-competency-framework.asp

http://www.rpharms.com/unsecure-support-resources/prescribing-competency-framework.asp


40 ©TU-SOHSC (2016)

UNIVERSITY MARKING CRITERIA – LEVEL 6

Level 6

90%-100% Exceptional work. Presentation is logical, error-free and, where appropriate, creative. There is an in-depth understanding of issues/problems and excellent critical/deep engagement with the material and concepts involved. Very skilful interpretation of data. Arguments, ideas and, where appropriate, solutions are presented coherently and fully underpinned by thorough research and reading.

80%-89% Outstanding work with presentation of a very high standard. There is comprehensive understanding of key concepts and knowledge and clear evidence of critical analysis and insight. Accurate interpretation of data with arguments, ideas, and solutions presented effectively and based on strong research and reading.

70%-79% Extremely good work with presentation of a high standard. Demonstrates an excellent knowledge base with a clear understanding of the issues and application to practice where appropriate. There is some effective critical and analytical application of relevant research and reading.

60%-69% The work is very good, logically structured and presented to a high standard. Demonstrates a strong knowledge base with a clear understanding of the issues and application to practice where appropriate. There is some critical and analytical application of relevant research.

50%-59% The work is clearly presented and logically structured. It shows evidence of a sound understanding of the topic and addresses major issues. The work contains some discussion and interpretation of relevant perspectives although further development of the arguments presented would be beneficial. There are examples of critical reflection and evidence of application of theory to practice.

40%-49% Adequate presentation. The work displays basic knowledge and understanding of the topic but is largely descriptive. There is an attempt to bring together different ideas and concepts although this would have been strengthened by the inclusion of further key issues. The structure of the work requires attention to its coherence and logical development of content. The link between theory and practice, where appropriate, is somewhat tenuous and its development would enhance the work considerably.

30%-39% – Fail The work is poorly presented and contains numerous errors, inconsistencies, and omissions with limited use of source material. The work displays a weak knowledge base and a lack of sufficient understanding of the topic. There is little or no evidence of the application of theory to practice where appropriate. It contains many unsupported statements with little attempt to bring issues together and lacks critical analysis and reflection.

29% and below – Fail The work is very poorly presented and contains numerous serious errors, inconsistencies, and omissions with little use of source material. The work displays a very weak knowledge base and a lack of sufficient understanding of the topic. There is little or no evidence of the application of theory to practice where appropriate. It contains many unsupported statements with little attempt to bring issues together and there is a complete lack of critical analysis and reflection.


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Obtaining Informed Consent

Rationale As part of the assessment and/or portfolio-keeping process students are sometimes required to illustrate the relationship between theory and practice by using information relating to specific clients, e.g. care studies, care plans, assessments, projects and reflective pieces. In these circumstances obtaining informed consent is essential. In order to demonstrate compliance with statutory/professional codes of conduct the attached Obtaining Informed Consent Declaration Form must be completed and submitted with the work. Failure to obtain consent and/or submit the completed declaration form will result in automatic referral/failure and could lead to disciplinary action. A slideshow relating to Confidentiality and Informed Consent can be accessed via e-learning@tees. It is the student’s responsibility to review this at least annually. Responsibilities The Lecturer supervising a piece of work for which consent is required is responsible for:

Directing the student to the e-learning@tees site where they can access a copy of the Obtaining Informed Consent Declaration Form and Guidance Notes prior to the assessment.

Drawing the student’s attention to the Access to Health Records Act (1990), in particular:

Section 5.3, which states that third parties may only access patients’ records provided that information given by the patient and/or the results of examinations/investigations will not be disclosed.

Section 5.1 which states that the information obtained from the patients’ health records must not be used in a way as to cause the patient serious physical or mental harm, or that the patient may be identified.

Drawing the student’s attention to the Data Protection Act (1998) in particular:

Reviewing the rationale and each point set out in the Obtaining Informed Consent Declaration Form.

Reminding the student that the completed Declaration Form must accompany the assignment when submitted.


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The Student The student is responsible for:

Informing the Practice Mentor/Supervisor of the nature of the assignment/ Portfolio and the requirement to complete an Obtaining Informed Consent Declaration Form.

Seeking informed consent from the patient/client and/or patient/client representative and/or carers, and/or colleagues/staff in accordance with points 1–4, as set in the Declaration Form.

Completing and signing the Declaration Form with the Practice Mentor/ Supervisor.

Ensuring the completed Declaration Form is submitted with the assignment by the required date.

Ensuring that a pseudonym is used for client/patients, relatives, carers and staff. The use of the pseudonym should be documented within the assignment and clearly identified on the Informed Consent and Declaration Form.

Ensuring that any documentation submitted as part of the assessment will be rewritten and not photocopied e.g. care plans, assessment forms.

Practice Mentor/Supervisor The Practice Mentor/Supervisor is responsible for: 1. Providing the student with appropriate support and guidance whilst obtaining

informed consent from the patient/client and/or patient/client representative and/or colleagues/staff.

2. Signing the Obtained Informed Consent Declaration Form, if s/he is confident that the criteria have been met.


43 ©TU-SOHSC (2016)

Obtaining Informed Consent Declaration Form

Student Name

Cohort/Year of Entry

Personal Tutor

Declaration by Student

In order to comply with the requirements of the Access to Health Records Act (1990) and the Data Protection Act (1998), I confirm I have discussed the following with the patient/client* and/or the patient’s/client’s* representative, e.g. parent/guardian, next of kin, carers, colleagues/staff and have obtained permission to use personal relevant data:

* Delete as appropriate

The nature of the assessment.

The reason I wish to use data relating to the patient/client.

That client/patient, carers, colleagues/staff anonymity and confidentiality in relation to any material gathered or produced in the course of this work will be maintained e.g.:

For all persons mentioned pseudonyms and/or general titles will be used, not individual names

The patient/client address and any information which could identify their address will be omitted

General terms will be used to describe occupation/workplace/school/ hobbies etc

Time, date and location of admission will be omitted

Information which may identify the patient/client/relatives/carer and colleagues/staff will be omitted from documentation e.g. care plans, pathways of care, risk assessments etc

Those who will have access to the work in addition to myself e.g. typist, teaching staff, other students, Board of Examiners


INFORMED CONSENT DECLARATION FORM

N.B. Patient/Client/Carer/Colleagues/Staff column should be completed by using a Code e.g. Client/Patient A, Client/Patient B in order to provide anonymity and confidentiality. If names are used in the first column a pseudonym must be used and it must be clearly stated that this is a pseudonym. The pseudonyms used must be the same as those referred to in the assignment.

Patient/ Client/ Carer/

Colleague/ Staff Module Title Academic

Support Teacher

Informed Consent Gained

Practice/ Mentor

Supervisor Name

Practice/ Mentor

Supervisor Signature

Student Signature

Date

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Yes/No

Agreed at SASC 26 September 2012


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Disclosure and Barring (DBS) Status Verification I confirm that there have been no changes to my DBS Status for the duration of the Prescribing from the Community Practitioners Formulary Programme. Name Signature Date DBS Certificate Number DBS Date of Certificate

prescribing from the community practitioner … · \\soh-leto\myfiles\u0022163\prescribing...

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