Prescribing in practice

Topics: Medical prescription, Seborrhoeic dermatitis, Nursing Pages: 8 (2261 words) Published: April 24, 2014
Critical analysis of prescribing episode


The following assignment will discuss and analyse a prescribing episode, within practice, furthermore will outline safe prescribing from the Nurse Prescribing Formulary (NPF, 2013-2015).To be able to analyse and reflect on my new role as Community Practitioner Nurse Prescriber (CPNP) I will use Gibbs (1988) reflective model and a structure that will allow the use of a consultation model (Appendix1,Fig1). The focus on prescribing within nursing profession was first brought into discussion by Royal College of Nursing (RCN) in 1980 but has proven to be cornerstone after was part of the government agenda as a result of Cumberlege report in 1996.This report outlined the need for nurse to become a prescriber especially in community settings to provide clients with better care, safe and practical access to medication (Nuttal, 2008). Furthermore “The Medicinal Product Prescribing Act “1992 outlined changes in circumstances including nurses as prescribers, followed by recommendations made by Crown Reports1999 that suggest that health visitors (HV)) should be authorised to prescribe from a limited list, identified as the nurse prescriber’s formulary (NPF). (DH,2004). Scenario

For the purpose of this assignment all names has been changed to maintain confidentiality according to NMC (2008).The following scenario it is in relation to a situation experienced while on the morning baby clinic working alongside my mentor .A mother Lisa come for a regular weight check for her 4 month old infant called James .While discussing with Lisa her son weight progress ,she mentioned about her son having very dry scaly skin on scalp since birth moreover Lisa explained that sometimes skin on the scalp become like a patchy crusty rash and James feel uncomfortable , at times not settling. Edwards (2010) suggest that using a holistic assessment it is very important when coming in contact with the client as the problem presented can have a drastic impact on the quality of life for child and the family. As a student under the supervision of my mentor we started a holistic assessment of James and finalise with a prescription decision. I start by using open questions related to James general health and I asked Lisa if she had any concerns but she confirmed back to me that there was no issues with his health since birth .To make sure that information provided by Lisa was correct and I have accuracy in details exposed I repeated back and she confirmed. As a student practitioner prescriber it is very important to maintain good practice and use assessment frameworks and consultation models as possibility to improve and gain better skills(Nuttall,2008).

The Consultation

The purpose of the consultation model in prescribing practice is to assist nurses in identifying strategies to deliver a diagnoses and ultimately the appropriate prescription .There are various consultation models used in practice with normative or descriptive character , however for the purpose of this case scenario I will concentrate on Roger Neighbour 1987 consultation model. Moreover Neighbour (2005) outline through his model consultation as a journey divided by check points , connecting which is the first point where client establish the relation with the practitioner is essential followed by summarising, handing over, safety netting and housekeeping. To progress further it is relevant to mention influence of communication skills in consultation process furthermore considering that nurse practitioners don’t need different communication skills in comparison with other professionals prescribers (While,2002).However(While,2002)found that the need for appropriate environment that can maintain privacy and confidentiality could be a potential barrier during consultation rather than communication especial for those working in client homes. I choose Neighbour 1987 model for consistency and easy to apply in any...
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