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2021/22 Taught Postgraduate Module Catalogue

HECS5322M Independent and Supplementary Prescribing for Nurses and Midwives

30 creditsClass Size: 25

If you are applying for a stand-alone Masters level module please note you must meet either the general University entry criteria or the specific module pre-requisite for this level of study.

Module manager: Rebecca Dickinson
Email: r.dickinson@leeds.ac.uk

Taught: 1 Jan to 30 Sep, 1 Sep to 30 Jun (adv year), Semesters 1 & 2 (Sep to Jun) View Timetable

Year running 2021/22

Pre-requisite qualifications

Current NMC registration as a Registered Nurse/Midwife (RN/M). The module outcomes can be applied to all parts of the NMC register: the four fields of nursing practice (adult, mental health, learning disabilities and children's nursing); midwifery; and specialist community public health nursing.
Certified evidence of ability to study at Level M
Normally two years' WTE experience* as a practising nurse, midwife or specialist community public health nurse. For part time applicants the following formula will be applied: WT = 47 weeks x 37.5 = 1762.5. Students must have worked the part time equivalent of 1762.5 since registration.
Support of and evidence from the employer/manager/educational lead that the applicant:
- is competent to take a history, make a clinical assessment and make a diagnosis in their own field of practice OR
- is undertaking an appropriate programme of study to enable them to do so
- has demonstrated appropriate numeracy skills
- is in a role where there is a clinical need to justify prescribing
- is in a role that enables them to prescribe, and that the necessary infrastructure will be in place to allow them to do so
- has a valid Disclosure and Barring Service (DBS) certificate
- has completed level 1 safeguarding adults training
- has completed level 3 safeguarding children training if their role involves contact with children
Has a named Practice Assessor (either a Designated Medical Practitioner (DMP) or a Designated Prescribing Practitioner (DPPs, post 2020 following RPS competency framework publication)
Has an Practice Supervisor (PS) allocated to supervise the applicant for the 12 days (90 hours) of supervised learning in the practice area who:

Satisfactory application and interview

* Normally 2 years' experience for standard entry, for applicants with relevant professional experience exceptions may be appropriate and considered through the School of Healthcare' Individualised Programme Panel (IPP) IPP. The minimum post registration experience allowed is one year as per NMC stipulation Standard 1.7

This module is mutually exclusive with

HECS3103Independent and Supplementary Prescribing for Nurses and Mid
HECS5321MIndependent and Supplementary Prescribing for Allied Health
HECS5323MIndependent Prescribing for Pharmacists

Module replaces

HECS5120M

This module is not approved as an Elective

Module summary

This module prepares nurse and midwives for the advanced role of Independent and Supplementary prescribing. It is taught interprofessionally with pharmacists and this is the most frequently mentioned 'positive' element mentioned in the module evaluations. The module is 38 days in length over a period of up to 26 weeks including 12 days of clinical practice. The University taught element is completed within the first 13 weeks for all students. A multidisciplinary approach has been used in the development of this module with lecturers drawn from a range of academic, research and clinical backgrounds

Objectives

This module is designed for level 1 RNs and RMs to obtain the necessary knowledge and skills to become independent and supplementary prescriber. The module includes taught compulsory days along with blended learning and supervised clinical practice learning with an PS and a PA(DMP). This module leads to a recordable qualification and on successful completion of the module, RN/Ms are able to apply to the NMC to have their registration annotated with the qualification of independent and supplementary prescriber (NMC code V300). The module centres on the development of competence as an independent prescriber by focusing on the core domains of person centred care, professionalism, professional knowledge and skills and collaboration linked to the Royal Pharmaceutical Society (RPS) Competency Framework for all Prescribers.

Learning outcomes
The learning outcomes (LO) for this module reflect core domains of person-centred care, professionalism, professional knowledge and skills, and collaboration. Following completion of this module, the individual will be able to:
1. synthesise knowledge and skills from a wide range of appropriate sources (eg bio-psycho- social theories of human biology and development, pharmacology and applied therapeutics, pharmacy calculations, social influences, academic reviews, national and local policies and guidelines), to enable an in depth consultation with a patient in a structured, systematic manner. The consultation includes evidence based history-taking techniques, effective communication with patients/carers as well as implementing a plan for assessment and review of the patient where appropriate (LO1)
2. demonstrate a critical appraisal of the roles and responsibilities of an independent and supplementary prescriber with knowledge of the legal, ethical and professional framework for accountability and responsibility in relation to prescribing (LO2)
3. demonstrate the ability to question and interpret evidence to enable appropriate, safe and cost-effective prescribing decisions taking into account evidence-based practice and national/local guidelines where they exist (LO3)
4. evaluate and synthesise different communication strategies to support effective collaboration with other healthcare professionals to ensure the safe and effective management of the patient (LO4)

Skills outcomes
On successful completion of this module, the individual will be able to:
1. Critically evaluate and deliberate patients' needs for medicines, taking account of their wishes and values in prescribing decisions;
2. Utilise a critical reflective approach to information gathering, interpretation and application to diagnosis;
3. Critically discuss the pathophysiology of the condition being treated and recognise the signs and symptoms of illness;
4. Recognise the unique implications involved in the assessment of children in all of the above domains and if appropriate, undertake an assessment based on consideration and comprehension of the legal, cognitive, emotional and physical differences between children and adults understand and critically apply knowledge of drug action in prescribing practice;
5. Understand and critically apply knowledge of drug actions in prescribing practice;
6. Demonstrate a reflective approach to continuing professional
development of prescribing practice;
7. Develop a supplementary prescribing clinical management plan within legislative requirements;
8. Monitor response to therapy, review the working/differential diagnosis and modify treatment or refer / consult / seek guidance as appropriate;
9. analyse, apply and evaluate the relevant legislation to the practice of non-medical prescribing;
10. Identify sources of information, advice and decision support and explain how they will use them in prescribing practice taking into account evidence based practice and national / local guidelines;
11. Critically analyse, evaluate and respond to influences on prescribing practice at individual, local and national levels;
12. Critically analyse the roles and relationships of others involved in prescribing, supplying and administering medicines, particularly that of Medical Independent Prescribers;
13. Critically evaluate the legal, ethical and professional framework for accountability and responsibility and practices, understands own limitations and work within the limits of professional competence.


Syllabus

To satisfy the LO defined by each of the 4 domains, the following indicative content will focus on consultation, decision-making, assessment and review, prescribing in a team context, applied therapeutics, evidence-based Practice and Clinical Governance, legal, Policy, Professional and ethical aspects and prescribing in the public health context. The LO have been mapped to these core subject matters.

Consultation
- History-taking techniques through effective consultation skills (Domain 1 Person Centred Care)

Decision-Making
- Psychological and physical impact of prescribing decisions on people and patient centred care (Domain 1 Person Centred Care)
- Support individuals to make informed choices that respect people's preferences (Domain 1 Person Centred Care)
- Role of the prescriber in working in partnership with people who may not be able to make fully informed decisions about their health needs or who lack the capacity to do so. (Domain 1 Person Centred Care)
- Factors that influence prescribing decisions (Domain 2: Professionalism)
- Health economics when making prescribing decisions (Domain 2: Professionalism)
- Risks and benefits associated with prescribing decisions (Domain 3: Professional knowledge and skills)

Assessment and Review
- Investigations and interpretation of their results and data (Domain 3: Professional knowledge and skills)
- Effective monitoring and management to improve patient outcomes (Domain 3: Professional knowledge and skills)

Prescribing in a Team Context
- The role of the independent prescriber and the role of others in multi-professional teams (Domain 2: Professionalism)
- Work collaboratively with others to optimise individuals' care, understanding their roles in the prescribing process (Domain 4: Collaboration)

Applied Therapeutics
- Application of pharmacology as it applies prescribing practice (Domain 3: Professional knowledge and skills)

Evidence-based Practice and Clinical Governance
- Clinical governance of the prescriber, who may also supply medicines to patients (Domain 2: Professionalism)
- How to raise concerns related to inappropriate or unsafe prescribing by other prescribers (Domain 2: Professionalism)
- Evidence-based decision-making for prescribing (Domain 3: Professional knowledge and skills)
- Managing prescribing and medication errors (Domain 3: Professional knowledge and skills)

Legal, Policy, Professional and Ethical Aspects
- Legal responsibilities under equality and human rights legislation and respect diversity and cultural differences (Domain 1 Person Centred Care)
- Legal and ethical implications of prescribing, remote prescribing and the handling and sharing of confidential information (Domain 2: Professionalism)
- Local, regional and national guidelines, policies and legislation related to healthcare (Domain 2: Professionalism)
- Record keeping to ensure safe and effective care and align with relevant legislation (Domain 3: Professional knowledge and skills)
- Current and emerging systems and technologies in safe prescribing (Domain 3: Professional knowledge and skills)
- People’s need when prescribing remotely (Domain 3: Professional knowledge and skills)
- Role and responsibilities, and those of others, in safeguarding children and vulnerable adults (Domain 4: Collaboration)
- When and where to refer people appropriately and when to seek guidance from another member of the healthcare team or an appropriate authority (Domain 4: Collaboration)

Prescribing in the Public Health Context
- Public health issues in promoting health in prescribing (Domain 3: Professional knowledge and skills)

Teaching methods

Due to COVID-19, teaching and assessment activities are being kept under review - see module enrolment pages for information

Delivery typeNumberLength hoursStudent hours
On-line Learning193.0057.00
Clinical Practice127.5090.00
Class tests, exams and assessment23.006.00
Lecture163.0048.00
Practical83.0024.00
Tutorial23.006.00
Independent online learning hours3.00
Private study hours66.00
Total Contact hours231.00
Total hours (100hr per 10 credits)300.00

Private study

There is a minimum of 66 hours at Level M included for private study. Students are expected to spend private study time in preparation for lectures, tutorials, practicals, the portfolio and assessment. Students are also required to spend 90 hours with the designated prescribing practitioner practice assessor

Opportunities for Formative Feedback

Formative assessment is provided throughout the module. Formative OSCEs are provided during a 3 hour session two weeks prior to summative assessment providing students. In addition, case-based scenarios and questions are used within the lectures and seminars for students to work on. There are also workbooks and online learning for students to complete which have formative assessments within them. Feedback is also provided by the DMP (PA) and PS via observation of practice, discussions about patient cases and achievement of competencies throughout the portfolio.
In preparation of the portfolio, students are encouraged to send in examples of their work in the portfolio; these are reviewed by a member of the module team and returned to the student. There is a timetabled session on preparing the portfolio and students can bring samples of their work to this session and receive feedback from the tutor. There are also three additional tutorials offered to students in the months following completion of the OSCE, when the students are undertaking their placement hours. Students are encouraged to attend one of these three tutorial sessions to receive feedback from one of the module team on drafts of their work. We are also happy to see any student for discussions outside lecture times as appropriate.
A detailed academic supervision document has been developed for the module which draws on the School's Academic Supervision Policy. This is shared with the students during the induction session so that they have a clear idea of the nature and extent of academic supervision and opportunities for feedback throughout completion of the module.

Methods of assessment

Due to COVID-19, teaching and assessment activities are being kept under review - see module enrolment pages for information


Coursework
Assessment typeNotes% of formal assessment
PortfolioPass/Fail. The portfolio forms the main framework for recording supervised hours and independent study. It includes a prescribing log, supervised practice time log, a numeracy test (100% pass mark) and evidence of prescribing competency in various forms such as: reflective accounts, witness testimonies, case studies, records of meetings, visits, discussion, protocol or guideline development and use (EBP)0.00
In-course AssessmentFORMATIVE: Exam (1.5 hours)0.00
PracticalFORMATIVE: OSCE (1.5 hours)0.00
Total percentage (Assessment Coursework)0.00

The format of this assessment in 2020/21 may be subject to change as a result of restrictions imposed as a result of the Covid-19 epidemic but the learning outcomes will remain unchanged and approval of the appropriate PSRB (Professional, Statutory and Regulatory Bodies) will be obtained The portfolio forms the main framework for recording supervised hours and independent study. It includes a prescribing log, supervised practice time log, a numeracy test (100% pass mark) and evidence of prescribing competency in various forms such as: - reflective accounts - witness testimonies - case studies - records of meetings, visits, discussion - protocol or guideline development and use (EBP) The portfolio is marked as a Pass or Fail by the PA(DMP) who signs to verify the students' achievement of each competency indicator. Students must demonstrate all specified competencies based on the RPS single competency framework for all prescribers. Academically the portfolio is assessed as a pass or fail. Additionally the Portfolio must include a numerical assessment. This will take the form of a drug calculation constructed by the student's PA(DMP) related to the context of the student's practice. A prescription linked to this calculation is necessary to demonstrate competence in this area. Students must achieve a 100% pass assessed and verified by the PA(DMP) and by the academic marker. All elements (demonstration of competencies, supervised practice time, numerical assessment, prescription assessment, 'sign-off' from PA(DMP) and PS) of the portfolio have to be satisfactory, otherwise the portfolio will be deemed a fail. If the student fails, the student is permitted a 2nd attempt and if successful at the second attempt they will be awarded a pass but the overall course mark will be reduced to the minimum allowed for a pass (50). There is no compensation allowed between assessment elements. The summative elements of the assessment I.e. the OSCE, portfolio and graded element of portfolio all need to be a pass for the student to pass the module.


Exams
Exam typeExam duration% of formal assessment
Standard exam (closed essays, MCQs etc) (S1)2 hr 30 mins50.00
OSCE (Objective Structured Clinical Exam)0 hr 40 mins50.00
Total percentage (Assessment Exams)100.00

The pharmacology examination is a MCQs examination of 2.5 hour duration consisting of 40 questions with automated marking which ensures the impartiality of the prescribing team. Half the examination will consist of Single Best Answer (SBAs) questions; each question will consist of a lead-in statement with a list of five options to choose the single best answer from. The second half of the examination will be Extended Matching Questions (EMQs); this operates similarly to the first, each question will consist of a clinical scenario followed by a lead-in question, and then a list of 5 options from which 1 or several can be chosen. In the marking scheme incorrect answers will not be penalised. OSCE stations will assess a range of skills, knowledge and behaviours covered within the teaching sessions of the module. Stations will examine several topics including clinical assessment skills, knowledge of legislation related to prescribing, pharmacology and therapeutics, and communication skills. The OSCE will last for 40 minutes with a minimum of 3 stations. Compensation is permitted between OSCE stations. Each OSCE station will be standard set individually and then the total score or the equivalent total percentage based on the modified Angoff method will be calculated. All scores of the standard set stations are added together to get a final pass mark. We will then model the addition of a standard error of measurement (SEM) which is approximately 2-3% addition to the pass mark. This is to ensure that false positive decisions are not made and that we are confident that all who ‘pass’ should have done. However, a failure to identify a serious problem or an answer which would cause the patient harm will result in overall failure of the OSCE. The student is the required to complete a second attempt at the OSCE. Currently the summative OSCEs are recorded for internal moderation and are uploaded to Grademark for external examining purposes and deleted after the appeals process deadline has expired

Reading list

The reading list is available from the Library website

Last updated: 30/06/2021 16:22:17

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