NMHS33140 Prescribing Practice Context

Academic Year 2023/2024

This module introduces the student to professional, ethical and legal regulations, policies and standards that inform safe and effective nurse/midwife prescribing practice. Quality patient safety issues are considered in the context of (1) prescribing governance (i.e. national and local), (2) the required knowledge, skill and competence of the individual prescriber, and (3) on going continuous professional development and life long learning.

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Curricular information is subject to change

Learning Outcomes:

Discuss primary medicines legislation, associated statutory instruments, regulations and rules that provide for the prescriptive authority of nurses and midwives.
Critically discuss professional regulations, policies, standards and frameworks that support the implementation, practice, governance and evaluation of nurse-midwife prescribing.
Critically analyse relevant moral theory, bioethical principles and national decision-making policies and frameworks that inform ethical and moral prescribing decision-making.
Utilise current evidence based medicines resources that support prescribing decision-making.
Discuss pharmaco-economic factors that influence the prescribers choice of medicine (i.e. generic substitution and the HSE ‘Preferred Drug Scheme’.
Explain how effective history taking, medication reconciliation, promoting concordance and shared decision making, analysing the benefit and/or harm of a medicine for the individual patient as part of the consultation process, reduces the incidence of non-compliance, prescribing errors and adverse drug reactions/ interactions.
Discuss factors that lead to prescribing errors and strategies used to prevent prescribing errors.
Critique governance structures, policies and individual prescriber responsibilities when managing an adverse event.
Discuss the importance of clinical governance and clinical audit as key strategies for quality safe prescribing practice.
Discuss the importance of maintaining professional responsibility and accountability in the context of medication safety and safe prescribing practice.
Discuss the benefits of collaboration with members of the MDT prescribing team for both patients and prescribers
Recognise the importance of continuous professional development in maintaining safe and effective prescribing practice.

Student Effort Hours: 
Student Effort Type Hours
Lectures

14

Specified Learning Activities

24

Autonomous Student Learning

80

Online Learning

7

Total

125

Approaches to Teaching and Learning:
This is a blended learning module. Some content is delivered face to face, and some is pre-recorded. All face to face lectures are delivered on Wednesdays, and are live streamed and recorded via Brightspace. Students are directed to compulsory readings specific to each lecture on a bi-weekly basis. Access to reading materials is available via links embedded within the weekly folders in Brightspace. Two formative MCQ quizzes are available for self-assessment of knowledge attainment as students progress through the module.

 
Requirements, Exclusions and Recommendations

Not applicable to this module.


Module Requisites and Incompatibles
:
-


 
Assessment Strategy  
Description Timing Open Book Exam Component Scale Must Pass Component % of Final Grade In Module Component Repeat Offered
Assignment: End of trimester essay (2000 words) Coursework (End of Trimester) n/a Alternative non-linear conversion grade scale 50% No

90

No
Assignment: HSeLand eLearning programme: Fundamentals of clinical audit Varies over the Trimester n/a Alternative non-linear conversion grade scale 50% No

10

No

Carry forward of passed components
No
 
Resit In Terminal Exam
Summer No
Please see Student Jargon Buster for more information about remediation types and timing. 
Feedback Strategy/Strategies

• Feedback individually to students, post-assessment
• Online automated feedback

How will my Feedback be Delivered?

Students receive individualized automated feedback following completion of the 'HSeLand Fundamentals of Clinical Audit' MCQs at the end of the programme of study. For the end of trimester essay, a rubric is used to provide feedback on a specific grade with individualized written feedback made available in Brightspace. Students can contact the module co-ordinator for additional feedback if required.

Core Textbooks

Beckwith, S. and Franklin, P. eds (2011) Oxford Handbook of prescribing for nurses and allied health
professionals. Oxford: Oxford University Press (e-book UCD Library)
Ross, S. (2014) Prescribing at a glance. West-Sussex: Wiley Blackwell. (e-book UCD Library)

Recommended Textbooks

Baker, E., Burrage, D., Lonsdale, D., Hitchings, A. (2014) Prescribing scenarios at a glance. West Sussex:
Wiley Blackwell. (e-book UCD Library)
Blaber, A., Ingram, H., Gorman, J. (eds) (2020) Independent prescribing for district nurses. Bristol: Class
Professional Publishing. (e-book UCD Library)
Boyd, C. (2013) Calculation skills for nurses. West-Sussex: Wiley Blackwell. (e-book UCD Library)
Courtenay, M. and Griffins, M. (eds) (2010) Independent and supplementary prescribing: An essential
guide, 2nd edn. Cambridge: Cambridge University Press.
Nuttall, D. and Rutt-Howard, J. (eds) (2020) The textbook of non-medical prescribing, 2nd edn. West
Sussex: Wiley-Blackwell. (e-book UCD Library)

Required Readings: Prescribing Standards, Policies and Guidance Documents

Government of Ireland (2015) Assisted Decision-Making (Capacity) Act. Located at:
https://www.irishstatutebook.ie/eli/2015/act/64/enacted/en/html. Accessed 9th November 2021.
Health Product Regulatory Authority (2018) Guide to interchangeable medicines. Located at:
https://www.hpra.ie/docs/default-source/publications-forms/guidance-documents/aut-g0115-guide-to-interchangeable-medicines-v5.pdf?sfvrsn=8. Accessed 9th November 2021.
Health Services Executive and State Claims Agency (2019) Open disclosure national policy. Quality and
Patient Safety Directorate. Dublin: Health Services Directorate.
Health Services Executive (2019) National consent policy. Dublin: Health Services Directorate.
Assisted Decision-making capacity Act
Health Services Executive ONMSD (2020) National Nurse and Midwife Medicinal Product Prescribing
Guideline. Dublin: Health Services Executive.
Health Services Executive ONMSD (2020) Guidance on Governance for the Registered Nurse and Midwife
Prescriber working in an Integrated Role. Dublin: Health Services Executive.
Health Services Executive ONMSD (2020) Authorised Medicinal Products, Off-label Prescription and
Exempt Medicinal Products Information Sheet. Dublin: Health Services Executive.
Health Services Executive ONMSD (2020) Guidance for clinical audit. Dublin: Health Services Executive
Health Services Executive ONMSD (2020) Sample audit tool. Dublin: Health Services Executive.
Health Services Executive ONMSD (2020) Sample audit tool: Appropriateness of medication index.
Dublin: Health Services Executive.
Health Services Executive ONMSD (2020) Audit of Nurse and Midwife Medicinal Product Prescribing
Practices Sample Template for Clinical Audit Report. Dublin: Health Services Executive.
Health Services Executive ONMSD (2020) Sample Template for Quality Improvement Plan. Dublin:
Health Services Executive.
HSE (2021) Preferred drugs: Medicine management programme. Located at: https://www.hse.ie/eng/about/who/cspd/ncps/medicines-management/preferred-drugs/. Accessed 9th
November 2021.
HSE (2021) Prescribing tips and tools: Medicine management programme. Located at:
https://www.hse.ie/eng/about/who/cspd/ncps/medicines-management/prescribing-tips-and-tools/. Accessed 9th November 2021
HSE (2021) Antibiotic Prescribing: Medicines management programme. Located at:
https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/. Accessed 9th November 2021.
HSE (2021) Prescribing and cost guidance: Medicines management programme. Located at: HSE (2021)
Antibiotic Prescribing: Medicines management programme. Located at: https://www.hse.ie/eng/services/list/2/gp/antibiotic-prescribing/. Accessed 9th November 2021. Accessed 9th November 2021.
HSE ONMSD (2021) User guide for Nurse and Midwife prescribing data collection system. Located:
https://healthservice.hse.ie/filelibrary/onmsd/nurse-and-midwife-prescribing-data-collection-system-user-guide.pdf. Accessed 12th November 2021.
Irish Nurses and Midwives Organization (2021) Benefits of membership of INMO. Located at:
https://www.inmo.ie/Membership_Benefits. Accessed 12th November 2021.
Medical Council and Pharmaceutical Society of Ireland (2017) Safe Prescribing and dispensing of
controlled drugs. Dublin: Medical Council.
Nursing and Midwifery Board of Ireland (2015) Scope of nursing and midwifery practice framework.
Dublin: Nursing and Midwifery Board of Ireland.
Nursing and Midwifery Board of Ireland (2019) Practice Standards and Guidelines for Nurses and
Midwives with Prescriptive Authority, 4th edn. Dublin: Nursing & Midwifery Board of Ireland.
Nursing and Midwifery Board of Ireland (2021) The code of professional conduct and ethics for registered
nurses and midwives. Dublin: Nursing and Midwifery Board of Ireland.
State Claims Agency (2018) Nurse & Midwife medicinal product prescribing. Located at:
https://stateclaims.ie/uploads/publications/Nurse-and-Midwife-Medicinal-Product-Prescribing-Jan-18.pdf. Accessed 9th November 2021
State Claims Agency (2018) Use of unauthorized (exempt) and authorized medicines prescribed for an
unauthorized indication off-label. Located at: https://stateclaims.ie/uploads/publications/Use-of-Unauthorised-Exempt-and-Authorised-Medicines-Jan-18.pdf. Accessed 9th November 2021

Recommended Readings

Amoroso, J., Otway, C. (2006) Ethics in prescribing practice: A review of topical issues. Nurse Prescriber,
4(1), p.38-42/
Aagaard L., Kristensen, K. (2018) Off-label and unlicensed prescribing in Europe: implications for
patients’s informed consent and liability. International Journal of Clinical Pharmacology, 40, P.509-512.
Ahern F, Salm L, Lynch D, McCarthy S. (2014) Determining the frequency and preventability of adverse
drug reaction-related admissions to an Irish University Hospital: a cross-sectional study. Emergency Medicine Journal, 31(1), p.24-9.
An Bord Altranais (2007) Guidance to nurses and midwives on medication management. Dublin: An
Bord Altranais
Anderson, B., Holford, N. (2013) Understanding dosing: children are small adults, neonates are
immature children. Archives of Disease in Children, 98, p.737-744.
Barry, M. (2009) Economies in drug usage in the Irish healthcare setting. https://health.gov.ie/wp-
content/uploads/2014/03/economies_drug_usage.pdf, Accessed on 19th February 2019
Beauchamp, T. and Childress, J. (2013) Principles of biomedical ethics, 7th edn. Oxford: Oxford
University Press.
Bellis, J., Kirkham, J., Thiesen, S. (2013) Adverse drug reactions and off-label and unlicensed medicines in
children: A nested case-control study of inpatients in a paediatric hospital. BMC Medicine, 11(1), p.238-246.
Brick, A., Gorecki, P., Nolan A. (2013) Ireland: Pharmaceutical prices, prescribing practice and usage of
generics in a comparative context. Dublin: ESRI, Research Series 32.
Bjeldbak-Olesen, M., Gadsbølle Danielsen, A., Vilstrup Tomsen, D. (2013) Medication reconciliation is a
prerequisite for obtaining a valid medication review, Danish Medical Journal 60 (4), A4605.
Chaplin S. (2012) PRACTICE - Prevalence and causes of prescribing errors. Prescriber, 5th June, p.35-41.
Clyne, W., Blenksopp, A., Seal, R. (2008) NHS National Prescribing Centre: A guide to medication review.
Located at: https://www.cff.org.br/userfiles/52%20-%20CLYNE%20W%20A%20guide%20to%20medication%20review%202008.pdf. Accessed 20th November 2021.
Cullinan, S., O’Mahony, D., Stephen, B. (2016) Application of the structured history taking of medication
use tool to optimize prescribing for older patients and reduce adverse events. International Journal of Clinical Pharmacology, 38, p.374-379.
Department of Health (2014) TILDA - The over 50’s in a changing Ireland: Economic circumstances,
health and well-being. Located at: https://www.ucd.ie/t4cms/0053-02_TILDA_Wave2_v2.3_Key_Findings_Report.pdf. Accessed 9th November 2021.
Department of Health (2016) Values for nurses: Caring, compassion, commitment. Position paper one.
Department of Health; Dublin.
Drennan, J., Naughton, C., Hyde, A., Felle, P., O’Boyle, K., Treacy, P. (2009) National independent
evaluation of the nurse-midwife prescribing initiative. Located at: https://www.lenus.ie/bitstream/handle/10147/89103/NatIndependentEvaluation.pdf;jsessionid=D75BE3824D3D8830C2F2A15D449EBEF5?sequence=1. Accessed 9th November 2021.
Eggleton, A. (2012) Calculation skills for nurses: Calculating paracetamol dosages. Nurse Prescribing,
10(11), Mag online library.
Eggleton, A. (2013) Calculation skills for nurses: Dosage calculation for children. Nurse Prescribing,
11(11), Mag online library.
Eggleton, A. (2010) Calculation skills. In Courtenay, M. and Griffiths, M. (eds) Independent and
supplementary prescribing: An essential guide, 2nd edn. Cambridge: Cambridge University Press, P.147-179.
Eggleton, A. (2014) Finding errors in dose calculations. Nurse Prescribing, 12(12), Mag online library.
Eggleton, A. (2014) Antibiotic dosage calculation for children. Nurse Prescribing, 12(10) Mag online
library.
Fitzgerald, R. (2009) Medication errors: the importance of an accurate drug history. British Journal of
Pharmacology, 67(6), p.671-675.
Frank C., Weir, E. (2014) Deprescribing for older people. Canadian Medical Association Journal, 186(18),
p.1369-1376.
Gampaolo, P & Pietro, M. (2009) Medication errors: Prescribing faults and prescribing errors. British
Journal of Clinical Pharmacology, 67(6), p.624-628.
Government of Ireland (2003) Medicinal Products (Prescription and Control of Supply) Regulations 2003,
Statutory Instrument No. 540 of 2003 (as amended 2005, 2007 and 2008). Dublin: Stationary Office.
Government of Ireland (2006) The Irish Medicines Board (Miscellaneous Provisions) Act 2006 (Statutory
Instrument No. 3 of 2006). Dublin: Stationary Office.
Government of Ireland (2007) The Medicinal Products (Prescription and Control of Supply)
(Amendment) Regulations, 2007 (Statutory Instruments, (SI) No. 201 of 2007. Dublin: Stationary Office.
Government of Ireland (2009) Irish Medicine Board (Miscellaneous Provision) Act 2006
(Commencement) order (Statutory Instrument No. 67 of 2009). Dublin: Stationary Office.
Government of Ireland (2012) Nurses and Midwives Act 2011. Dublin: Stationary Office.
Government of Ireland (2013) Nurses and Midwives Rules 2013 Statutory Instruments 435 of 213.
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Government of Ireland (2017) The Misuse of Drugs 2017 (statutory Instrument No. 173 of 2017). Dublin:
Stationary Office.
Government of Ireland (2018) Medicinal Products Control of Placing on the Market (Statutory Instrument
No. 529). Dublin: Stationary Office.
Government of Ireland (2020) Nurses and Midwives Rules 2007 (amended). Dublin: Stationary Office.
Griffith, R., (2016) Controlled drugs and the principle of double effect: The role of the district nurse.
British Journal of Community Nursing, 21(12), p.
Grimes T., Deasy E., Allen A., O'Byrne J., Delaney T., Barragry J. (2014) Collaborative pharmaceutical care
in an Irish hospital: uncontrolled before-after study. British Medical Journal Quality & Safety, 23, p.574-83.
Granby, T., Chapman, S. (2010) Evidence-based prescribing Cited in Courtnay, M. & Griffiths, M. (eds)
Independent and supplementary prescribing: An essential guide. Cambridge: Cambridge University Press, pp.119-129.
Hart, t., Bird, D., Holloway J. (2016) Addressing concordance issues: How motivational interviewing
strategies can complement the nurse prescribing consultation, Nursing Prescribing, 14(10), p.510-515.
Health Information Quality Authority (2014) Principles of good practice in medication reconciliation.
Located at: https://www.hiqa.ie/sites/default/files/2017-01/Guidance-Medication-Reconciliation.pdf. Accessed 12th November 2021.
Health Information Quality Authority (2019) Guide to HIQA’s Medication Safety Monitoring Programme
against the National Standards for Safer, Better Healthcare in acute healthcare services in 2019. Located at: https://www.hiqa.ie/sites/default/files/2019-01/Medication_Safety_Monitoring_Programme_Guide_2019.pdf. Accessed 12th November 2021.
Health Product Regulatory Authority (2018) Guide to Interchangeable Medicines. Located at:
http://www.hpra.ie/docs/default-source/publications-forms/guidance-documents/aut-g0115-guide-to-interchangeable-medicines-v6.pdf?Status=Master&sfvrsn=17. Accessed 8th December 2022.
Health Product Regulatory Authority (2020) Guide to Biosimilars for healthcare Professionals. Located
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Health Product Regulatory Authority (2020) Generic Medicines: Patient Information Leaflet. Located at:
http://www.hpra.ie/docs/default-source/publications-forms/information-leaflets/generic-medicines_web.pdf?sfvrsn=4. Accessed 12th November 2021.
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HSE ONMSD (2020) National Nurse and Midwife Medicinal Product Prescribing Guideline. Dublin:
Stationary Office.
HSE ONMSD (2020) Authorised Medicinal Products, Off-Label Prescription and Exempt Medicinal
Products Information Sheet. Dublin: Stationary Office.
HSE ONMSD (2020) Guidance on Governance for the Registered Nurse and Midwife Prescriber Working
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HSE ONMSD (2020) Guidance for clinical audit. Dublin: Stationary Office
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https://apps.who.int/iris/bitstream/handle/10665/325131/WHO-UHC-SDS-2019.10-eng.pdf. Accessed 9th November 2021.
World Health Organisation (2019) Medication safety in polypharmacy. Located at:
https://www.who.int/publications/i/item/medication-safety-in-polypharmacy-technical-report. Accessed 9th November 2021.
World Health Organisation (2019) Medication safety in transitions of care. Located at:
https://www.who.int/patientsafety/medication-safety/TransitionOfCare.pdf?ua=1#:~:text=The%20goal%20of%20WHO's%20third,five%20years%20globally%20(5).&text=At%20each%20point%20in%20transitions,transition%20needs%20to%20be%20identified. Accessed 9th November 2021.



Other Textbooks Available via UCD Library

• Carroll, W., Gilchrist, F.J., Mitchell, M., Sammons, H., Srinivas, J. (2020) Practical Paediatric Prescribing: How to Prescribe the most common drugs. Elsiver. New York.
• Taylor, D. (2015) The Maudsley Prescribing Guidelines in Psychiatry, 12th edn. West Sussex: Wiley Blackwell. (e-book UCD Library)
• Doran, C. (2013) Prescribing mental health medication: The practitioners guide, 2nd edn. Oxon: Routledge (e-book UCD Library)
• Qureshi, Z., Maxwell, R.J. (2014) The unofficial guide to prescribing. Elsevier: London. (e-book UCD Library)
• Greer, D. (2014) Prescribing for specialist groups in Bradbury, H., Strickland-Hodge, B., McKimm, J., Forres, K. Practical prescribing for medical students. London: Learning Matters. (e-book UCD Library)
• Bhaumik, S., Kumar, S., Branford, D. (2014) The Firth prescribing guideline for people with intellectual disabilities. West Sussex: Wiley & Sons (e-book UCD Library)
• Brown, M.A., Kaplan, L. (2012) The advance practice registered nurse as a prescriber. West Sussex: Wiley Blackwell. (e-book UCD Library)
• Mari, J. (2019) The APRN’s Complete guide to prescribing drug therapy. New York: Springer Publishing Company. (e-book UCD Library)

eJournals Available via UCD Library
• Nurse Prescribing
• Prescriber