Transcript Prescribing in Practice

Prescribing in Practice
Part 1 (h)
Summary
Summary
• Before you prescribe it is important to
consider the prescribing triangle and
principles of good prescribing
• Refer to BNF and NMC standards for legal
requirements
• Be aware of potential for fraud
Security of prescriptions
• Is the responsibility of the employing
organisation and the prescriber
• Hold only minimal stocks of pads in order
to minimise the impact in case of loss or
theft
• This also helps when forms are reviewed
annually to avoid waste
Serial numbers and loss of pads
• Should be recorded by the employer before issue to the
nurse
• Recorded by the nurse to aid identification in case of theft
• Astron should be contacted if there is loss, or ordered pads
do not arrive
• NHBSA notified if they are not found
• Inform prescribing lead who will contact counter fraud
specialist at the PCT
• They will alert pharmacists and the prescriber will use a
different coloured pad until the matter is resolved
Getting your prescriptions
• After completing the course and qualifying as a IP/SP
Prescriber the NMC/HPC/RPSGB will be informed by
the university and will then annotate the register to
indicate that the NMP can prescribe as either an IP/SP
or SP using the BNF.
( This is different from the HV/DN annotation V100)
• The University will also inform the prescribing leads
of successful course completion.
• Employers can check professional register to
confirm prescribing status
Getting started
• PRESCRIPTION PADS ARE NOT SENT
OUT AUTOMATICALLY.
• FP10 s need to be ordered from the
supplier (currently ASTRON) Orders
cannot be placed with ASTRON until the
NHSBSA have been notified of the new
nurse prescribers details.
• ASTRON will not issue prescriptions
unless the NHSBSA details match those
given by the organisation requesting
Action for employers
• The employer (PCT Prescribing Lead) will
then inform the NHS Business Services
Authority (NHSBSA) of the Nurse/AHP
Prescribers details using the proforma
available on the NHSBSA website:
http://www.nhsbsa.nhs.uk/
(Note hospital based nurses/AHPs do not
need to inform the NHSBSA)
Stock items
 Items should be prescribed for individual
patient use
 Over prescribing to stock up the nurses
own supplies is illegal.
Security of Prescriptions
• The security of Prescription forms is the
responsibility of the Employing
Organisation and the Nurse Prescriber.
• It is advisable to only hold minimal stocks
of prescription forms in order to minimise
loss in the case of theft or break in, and
also helps keep prescription forms up to
date. (normally reviewed annually)
Serial Numbers
• Should be recorded by the employer
before issue to the nurse.
• Recorded by the nurse to aid identification
in the case of theft.
• Blank prescriptions should NEVER be presigned.
Loss of prescription pads
• ASTRON should be contacted about
prescriptions ordered but not received.
• NHSBSA should be notified if they are not
found.
• Community prescribers should inform the
local counter fraud specialist at the PCT,
their manager and the Prescribing Nurse
Lead, if they loose or have prescription
pads stolen.
References cont.
Latter, S, Blenkinsopp, A, Smith, A, Chapman, S, Tinelli, M, Gerard, K,
Little, P, Celino, N, Granby T, Nicolls, P and Dorer G (2010)
Evaluation of Nurse and Pharmcist Independent Prescribing
University of Southampton and Keele University available at
http://eprints.soton.ac.uk/184777/3/ENPIPfullreport.pdf
Medicines and Health care products regulatory agency ww.mhra.gov.uk
Misuse of Drugs Act 1971 www.legislation.gov.uk
Midwifery Council (NMC) (2010) Record Keeping guidelines
www.nmc.org.uk
NHS Business Services Authority www.nhsbsa.nhs.uk
The Medicines Act 1968 www.legislation.gov.uk
References
British National Formulary (BNF) www.bnf.org.uk
Cavell GE, and Hughes DK (1997) Does computerised prescribing improve
the accuracy of drug administration? Pharmaceutical Journal vol 259,
pp782-84
Dean, BS, Schachter M, Vincent, C and Barber ND (2002) Prescribing errors
hospital inpatients: their incidence and clinical significance, Quality and Safety
in Healthcare December vol 11(4) pp 340-44
Department of Health (DH) (2006) Nurse Independent Prescribing
www.dh.org.uk
Department of Health (DH) (2011) Nurse Prescribing Frequently Asked
Questions www.dh.org.uk (accessed 3/8/11
Further reading
Medicinal products: prescription by nurse
and others Act 1992 www.legislation.go.uk
Useful websites
Royal Pharmaceutical Society of Great
Britain (RPSGB) wwwrpharms.com
Health Professions Council (HPC) www.
hpc-uk.org
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