Evaluate the non medical influences on prescribing practice.
Evaluate the non medical influences on prescribing practice.
In the UK, nurse prescribing was born out of the need to increase efficiency in the NHS by making best use of its resources. Nurse-led services are one means of improving healthcare provision and a string of legislative change has gradually broadened the scope of nurse prescribing in the UK. (Courtenay et al 2007).
The role expansion of nurses to meet efficiency targets has meant that nurse-led services in the healthcare setting are expanding as one means of coping with a growing, increasingly ageing population. For those nurses running nurse-led services the focus for that reason, needs to be on treatment that improves the quality of someone’s life and represents an effective use of NHS resources. Prescribing is therefore one stage in making a rational treatment decision.
If prescribing is to be effective, the practitioner must be able to:
• Identify the problem in terms of the patient’s needs and the ultimate goal of any treatment
• Break the problem down into more explicit questions, such as ‘what are the treatment options?’; ‘how well do they work?’; ‘what are the resource implications?’
• Check the evidence In order to do this, the efficacy of treatment options must be considered. This involves considering efficacy and clinical effectiveness, which are quite different. Efficacy is when a drug is proven to have a pharmacological effect greater than a placebo which does not necessarily translate into improved clinical outcome. Clinical effectiveness is when that efficacy results in a proven clinical outcome. Knowing that a drug represents value for money is as much a part of evidence-based prescribing as clinical effectiveness. If two drugs have the same clinical effect then it makes sense to prescribe the cheapest alternative – known as cost minimisation – without any other coercement being involved.
The pharmaceutical industry has traditionally denied attempts to influence prescribing
In the UK, nurse prescribing was born out of the need to increase efficiency in the NHS by making best use of its resources. Nurse-led services are one means of improving healthcare provision and a string of legislative change has gradually broadened the scope of nurse prescribing in the UK. (Courtenay et al 2007).
The role expansion of nurses to meet efficiency targets has meant that nurse-led services in the healthcare setting are expanding as one means of coping with a growing, increasingly ageing population. For those nurses running nurse-led services the focus for that reason, needs to be on treatment that improves the quality of someone’s life and represents an effective use of NHS resources. Prescribing is therefore one stage in making a rational treatment decision.
If prescribing is to be effective, the practitioner must be able to:
• Identify the problem in terms of the patient’s needs and the ultimate goal of any treatment
• Break the problem down into more explicit questions, such as ‘what are the treatment options?’; ‘how well do they work?’; ‘what are the resource implications?’
• Check the evidence In order to do this, the efficacy of treatment options must be considered. This involves considering efficacy and clinical effectiveness, which are quite different. Efficacy is when a drug is proven to have a pharmacological effect greater than a placebo which does not necessarily translate into improved clinical outcome. Clinical effectiveness is when that efficacy results in a proven clinical outcome. Knowing that a drug represents value for money is as much a part of evidence-based prescribing as clinical effectiveness. If two drugs have the same clinical effect then it makes sense to prescribe the cheapest alternative – known as cost minimisation – without any other coercement being involved.
The pharmaceutical industry has traditionally denied attempts to influence prescribing