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Extending Independent Nurse Prescribing within NHSScotland
EDUCATION AND TRAINING
The programme of preparation for extended nurse prescribing
Nurses, midwives and health visitors preparing for extended nurse prescribing
will undertake a specific programme of preparation at degree level (Level 3). The programme will include the equivalent of 25 days' theory plus 12 days' 'learning in practice', when a designated prescribing practitioner (currently a medical practitioner) will provide the student with supervision, support and opportunities to develop competence in prescribing practice. The 12 days refers to the nurse's time rather than the doctor's. More details are at Annex C. An additional element of self-directed learning will also be needed, but this does not increase the length of the programme.
The programme will be part-time over a minimum period of 3 months: NES recommends the maximum duration should be no longer than 6 months. Whilst the formal programme time is 37 days, it is important that employers of nurses undertaking the programme recognise the demands of private study, providing support where necessary.
The programme will include an assessment of theory and practice that must be passed before the student's entry on the NMC register can be annotated to indicate that they hold the prescribing qualification for extended nurse prescribing.
The standards for the preparation for extended nurse prescribing have been set out by the NMC.
2 They are in addition to, and do not replace, the standards for the preparation of District Nurse/Health Visitor prescribers, who will continue to qualify to prescribe through their specialist practitioner programmes.
An outline curriculum for the preparation for extended nurse prescribing was published by NES in November 2001.
3 The training includes pharmacology, therapeutics, public health issues, practical aspects of prescribing and the safe and secure handling of medicines. It also includes the legal and financial aspects of nurse prescribing.
NES will approve the specific programmes of preparation proposed by Higher Education Institutions, which meet the requirements of the NMC. Nurses can only qualify to prescribe by attending an NES-approved nurse prescribers' programme of preparation.
Other training and education
Although many universities, and some pharmaceutical companies, offer training and education in aspects of pharmacology and medicines management, only NES-approved programmes of preparation for nurse prescribing will be recorded by the NMC. However, the Higher Education Institutions offering the specific programme of preparation for prescribing from the Extended Formulary may accredit the nurse prescriber's prior learning.
Continuing Professional Development (CPD)
All nurses and midwives have a professional responsibility to keep themselves abreast of clinical and professional developments. This is no less true for nurse prescribing. Prescribers will be expected to keep up to date with best practice in the management of conditions for which they may prescribe, and in the use of the drugs, dressings and appliances from the Nurse Prescriber's Extended Formulary. They may use the learning from this activity as part of their Post Registration Education and Practice (PREP-CPD) activity. The employer should ensure that the practitioner has access to relevant education and training provision. Details of additional training and updating will need to be incorporated by the individual into their personal professional profile, in order to renew their registration with the NMC. The Scottish Executive Health Department is in contact with the National Prescribing Centre in England about its programme of CPD support for nurse prescribers.
Nurse prescribing should be introduced and take place within a framework of clinical governance. Clinical supervision sessions provide an excellent opportunity for reflection on prescribing, as well as other aspects of practice. The model of clinical supervision should be agreed at local level, taking account of other staff support mechanisms and resources, and should be monitored and evaluated regularly. During the pilot phase of nurse prescribing by DNs and HVs, pharmacists were extremely helpful in providing expert input into clinical supervision as well as CPD sessions for nurse prescribers.
The National Prescribing Centre has led the production of a document setting out a framework for assessing nurse prescribing competencies, using an iterative process, which involved the input of both professional organisations and experienced nurse prescribers. SEHD is looking at how this can be used by students of nurse prescribing, newly qualified and more experienced nurse prescribers, their employers and managers, as a tool to assist in reflecting on practice and identifying CPD needs. This document is available on the NPC's website www.npc.co.uk
Notification of qualification to prescribe to NMC
Once the nurse or midwife has successfully completed the prescriber preparation, the NMC will be notified by the NES. The individual's entry on the NMC professional register will be annotated to indicate that she/he has qualified as a nurse prescriber for extended nurse prescribing. A nurse or midwife cannot legally prescribe until this annotation has been made. (This will be a different annotation to that used for district nurses and health visitors who completed preparation to prescribe from the current NPF.) The NMC Voice Bank telephone line will confirm to any enquirer whether or not a nurse is eligible to prescribe, and from which formulary: district nurses and health visitors or from the Extended Formulary.
NMC Voice Bank Enquiries
Callers will need to state the nurse prescribers PIN and date of birth otherwise they will have to speak to a manual operator when they access the system.
The telephone number is 020 7631 3200
The caller code for pharmacists is: 990159
The pass number is: 6390
The code number is 20
V100 is DN/HV prescriber
V200 is Nurse Prescriber Extended Formulary
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