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The Textbook of Non-Medical Prescribing, 2nd Edition



The Textbook of Non-Medical Prescribing, 2nd Edition

Dilyse Nuttall (Editor), Jane Rutt-Howard (Editor)

ISBN: 978-1-118-86186-8 June 2015 Wiley-Blackwell 352 Pages

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The Textbook of Non-Medical Prescribing is an easy-to-read, comprehensive overview of the essential knowledge, key issues and skills relevant to non-medical prescribing.  Now fully updated and linked to the National Prescribing Centre Single Competency Framework for non-medical prescribers, with activities to help you link your continuing professional development within the competences required as a prescriber.  This practical title remains an ideal resource for all qualified health professionals to practice safe and effective non-medical prescribing.

The section edition is structured around four core themes – public health, social and cultural issues, prescribing principles, and continuing professional development – which are threaded throughout the text. It also includes additional material on the importance on continuing professional development in prescribing, as well as the history and context of non-medical prescribing; ethical, legal and professional issues; effective consultations; essential pharmacology; clinical skills; prescribing for specific groups; and the role of the multidisciplinary team.

Key Features:

  • Accessible and study-friendly
  • Each chapter has learning objectives and activities to support a deeper understanding of the theoretical knowledge base and its application to practice
  • Case studies linking the topics to real-life scenarios
  • Companion website at with a range of self-assessment questions, quizzes, numeracy exercises, case studies and weblinks.

The Textbook of Non-Medical Prescribing provides support to anyone studying for a prescribing qualification or looking for a refresher on the subject.

Notes on Contributors ix

Acknowledgements xi

About the companion website xii

Introduction xiii
Dilyse Nuttall and Jane Rutt-Howard

1 Prescribing in Context 1
Dilyse Nuttall

The prescribing journey 1

Defining non‐medical prescribing 2

The non‐medical prescribing vision 3

Changes in clinical practice 6

The economic context 7

The private sector 8

The public health context 9

Need and expectations 10

Differentiating between prescribers 11

Nurse non‐medical prescribers 19

Pharmacist non‐medical prescribers 23

Allied health professional non‐medical prescribers 24

Access to education programmes 27

Summary of the context of prescribing 29

References 31

2 Professional, Legal and Ethical Issues in Prescribing Practice 35
Ruth Broadhead

Part 1: Professional issues 36

The regulatory framework for prescribing 36

Part 2: Legal issues 47

The UK legal system 47

Part 3: Ethical issues 77

Conclusion 82

Table of cases 84

References 84

Acts and statutory instruments 88

3 Factors Influencing Prescribing 89
Val Lawrenson

The prescriber 89

The patient 96

The product 102

References 110

4 Effective Consultations and ‘the Consultation Umbrella’ 113
Jane Rutt‐Howard

Presenting the consultation umbrella 114

The value of therapeutic communication 115

Consultation models in context 124

The consultation umbrella – a consultation model 126

CDM 138

Conclusion 144

References 145

5 Essential Pharmacology: Therapeutics and Medicines Management for Non‐medical Prescribers 148
Jane Alder, Alison Astles, Anne Bentley, Janice Davies, David Kelly and Samir Vohra

Pharmacology as part of prescribing practice 149

Brief introduction to pharmacological terms 150

Guide through processes to build and develop one’s own formulary, with examples 160

BNF: Practise using this essential resource 165

Prescribing in co‐morbidity 165

Management and avoidance of drug interactions 167

Management and avoidance of adverse medicine reactions 169

Drugs with a narrow therapeutic index or range 174

Medicines management 177

Medicines optimisation 178

Other resources to support your learning 179

References 180

6 The Multidisciplinary Prescribing Team 183
Dawn Eccleston

Defining ‘the multidisciplinary prescribing team’ 183

The benefits to prescribing 185

Understanding roles 188

Non‐medical prescribing lead 194

The multidisciplinary non‐medical prescribing team 194

Commissioning and the MDPT 197

Education and learning 200

Conclusion 200

References 203

7 Clinical Skills 205
Jane Rutt‐Howard

Vital signs 206

Conscious level 206

Respiratory rate 207

Temperature 210

Pulse rate 211

Blood pressure 213

Additional vital signs 214

Clinical examination 216

Examination of body systems 218

Numeracy skills 232

Medication review 235

Conclusion 237

References 239

8 Prescribing for Specific Groups 241
Janice Davies and Dilyse Nuttall

Prescribing in liver disease 241

Prescribing in renal disease 247

Prescribing in pregnancy 251

Prescribing for older people 257

Prescribing for children and young people 262

Other groups 268

References 272

9 Enhancing Non‐medical Prescribing 277
Jean Taylor and Anne Lewis

Current practice in prescribing 277

UK history of prescribing 278

Non‐medical prescribing in other countries 280

The impact of prescribing 281

Issues emerging from the introduction of non‐medical prescribing 284

Medicines management 298

Conclusion 298

References 300

Patient Case Studies 305

Case study 1: Harold 305

Case study 2: Barbara 306

Case study 3: Meihui 306

Case study 4: Julie 307

Case study 5: Annette 307

Case study 6: Yasmin 307

Case study 7: Amy 308

Case study 8: Louis 308

Case study 9: Viktor (with clinical management plan) 308

Health Professional Case Studies 310

Case study A: Debbie 310

Case study B: Mark 311

Case study C: Sabina 311

Case study D: Farhad 312

Case study E: David 312

Case study F: Andrew 313

Case study G: Andrea 313

Case study H: Lisa 313

Case study I: Christine 314

Case study J: Simon and Janice 314

Index 315