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Extending Independent Nurse Prescribing within NHSScotland
GOOD PRACTICE, ETHICS AND ISSUES COMMON TO ALL NURSE AND MIDWIFE PRESCRIBERS
Responsibility for prescribing decisions
Nurses qualified to prescribe should not do so on behalf of a nurse who is not a qualified nurse prescriber. A nurse prescriber can only order a drug for a patient whom he/she has assessed for care and in primary care, should only write prescriptions on a prescription pad bearing his/her own unique identifier number.
In the absence of the patient's original nurse prescriber, another nurse prescriber may issue a repeat prescription or order repeat doses following an assessment of need, and taking into consideration continuity of care. Accountability for the prescription rests with the nurse who has issued the prescription or ordered the drugs.
Stock items
In primary care settings, nurse prescriptions should not be written when an item has been administered to a patient using GP surgery or clinic stock order items.
Informing patients
Nurse and midwife prescribers must ensure that patients are aware of the scope and limits of nurse prescribing and how the patient or client can obtain other items necessary to their care.
Who to write prescriptions for
Practice nurse prescribers may only issue prescriptions for the patients of their own practice. PMS pilot nurses may only issue prescriptions for patients registered to the pilot. Nurses employed by a PCT may only issue prescriptions for the patients of the GP practices within the PCT. Nurses should only prescribe for the visiting relatives of patients if they are temporarily registered with the doctor concerned. Nurses can prescribe for travelling families, provided that the appropriate residency forms have been completed.
Nurses and midwives in secondary care settings can only prescribe for patients in the ward or clinic in which they are working (or in their area of clinical responsibility).
Prescribing for self, family and friends
Registered nurses and midwives are accountable for their practice at all times, and if a situation arises where they find themselves in a position to prescribe for themselves or their family, then they must accept accountability for that decision. It is recommended that (as for doctors and dentists) nurses should avoid prescribing for themselves or close family members wherever possible as judgement may be impaired and important clinical examination may be impossible.
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