DILYSE NUTTALL was Principal Lecturer and Divisional Lead, Family, Community & Public Health Division, School of Health, The University of Central Lancashire, UK.

JANE RUTT-HOWARD is Principal Lecturer, School of Medicine, The University of Central Lancashire, UK. She is course leader for Master of Physician Associate Studies (Hons).

Acknowledgements xiii Notes on Contributors xiv About the Companion Website xvi Introduction xvii
Dilyse Nuttall and Jane Rutt-Howard 1 Prescribing in Context 1Dilyse Nuttall The prescribing journey 1 Defining non¿medical prescribing 2 The non¿medical prescribing vision 3 Attitude shifts 3 Non¿medical prescribing, medical prescribing or prescribing 5 Changes in clinical practice 6 The role of non¿medical prescribing 6 Compassion in practice, the 6 Cs and leading change 7 The economic context 7 The private sector 8 The public health context 9 UK public health policy 9 Need and expectations 10 Differentiating between prescribers 11 Independent prescribing 11 Assessment 12 Supplementary prescribing 14 Nurse non¿medical prescribers 19 Pharmacist non¿medical prescribers 22 Allied health professional non¿medical prescribers 23 PGDs 26 Access to education programmes 28 Summary of the context of prescribing 28 References 30 2 Professional, Legal, and Ethical Issues in Prescribing Practice 35Ruth Broadhead Part 1: Professional issues 36 Part 2: Legal issues 48 Part 3: Ethical issues 80 Conclusion 86 Table of cases 87 References 87 Acts and statutory instruments 91 3 Factors Influencing Prescribing 93Georgina Louise Ritchie and Val Lawrenson The prescriber 93 The patient 101 The product 107 References 114 4 The Consultation Umbrella Supporting Effective Consultations 117Jane Rutt¿Howard Presenting the consultation umbrella 118 The value of therapeutic communication 119 Consultation models in context 126 The consultation umbrella - a consultation model 130 Clinical decision¿making 141 Conclusion 147 References 148 5 Essential Pharmacology for Non¿medical Prescribers 152Janice Davies Pharmacology as part of prescribing practice 153 Example of potential pharmacokinetic impact on patient care 153 Example of potential pharmacodynamic impact on patient care 154 Brief introduction to pharmacological terms 154 Guide through processes to build and develop one's own formulary, with examples 167 BNF: practise using this essential resource 169 Prescribing in cömorbidity 170 Management and avoidance of drug interactions 172 Management and avoidance of ADRs 174 Drugs with a narrow therapeutic index or range 178 Other resources to support your learning 180 References 181 6 The Multidisciplinary Prescribing Team 183Dawn Eccleston Defining 'the multidisciplinary prescribing team' 183 Confusion in terminology 184 The drivers in multidisciplinary team working 184 The benefits to prescribing within a team 185 Models for the multidisciplinary approach 185 Putting the 'P' in MDT 188 Understanding roles 188 Pharmacists 188 Nurse and midwife prescribers 189 Allied health professionals 190 Physiotherapists 191 Radiographers 191 Optometrists 192 Podiatrists 193 Dietitians (Nutritionists) 194 Paramedics 194 Non¿medical prescribing lead 195 The multidisciplinary non¿medical prescribing team 195 Benefits to patients and clients 196 Commissioning and the MDPT 198 Problems with multidisciplinary team working! 199 Education and learning 201 Conclusion 201 References 204 7 Clinical Skills 207Jane Rutt¿Howard and Kathryn Smyth Holistic assessment and initial impressions 208 The national early warning score 209 Vital signs 211 Clinical examination 222 Examination of body systems 228 Conclusion 231 References 235 8 Prescribing for Specific Groups 238Janice Davies and Dilyse Nuttall Introduction 238 Prescribing in liver disease 238 Renal 244 Prescribing in pregnancy 248 Prescribing in breastfeeding 253 Prescribing for older people 255 Prescribing for children and young people 260 Other groups 266 References 270 9 Enhancing Non¿medical Prescribing Through Reflective Practice, Evidence¿based Prescribing and Continuing Professional Development 274Janice Davies and Charlotte Smith Introduction: non¿medical prescribing - a success story 274 What is reflective practice? 276 Evidence¿based prescribing practice 280 Medicines management and medicines optimisation 282 Medication review 286 Polypharmacy 288 Medicines at the interface 291 Medicines reconciliation 292 Building concordance 293 Continuing professional development 296 Numeracy and NMP 299 NMP: into the future 299 References 303 Patient Case Studies 309 Case study 1: Harold 309 Case study 2: Barbara 310 Case study 3: Meihui 310 Case study 4: Julie 311 Case study 5: Annette 311 Case study 6: Yasmin 311 Case study 7: Amy 312 Case study 8: Louis 312 Case study 9: Viktor (with clinical management plan) 312 Case study 10: Joanne 314 Case study 11: Mrs Elliott 314 Case study 12: Miss Richards 314 Health Professional Case Studies 315 Case study A: Debbie 315 Case study B: Mark 316 Case study C: Sabina 316 Case study D: Farhad 317 Case study E: David 317 Case study F: Andrew 318 Case study G: Andrea 318 Case study H: Lisa 318 Case study I: Christine 319 Case study J: Simon and Janice 319 Case study K: Lucja 319 Case study L: Katy 320 Case study M: Emyr 320 Index 321