Prescribing For Clinical Practice Unit Case Study- Non Medical Prescribing

 

Select a case scenario from your clinical practice area. The
scenario should be a typical patient/client situation that allows you to
demonstrate safe and effective decision-making in relation to assessment,
planning, care delivery, treatment and evaluation including integration of all
prescribing perspectives, legal and professional accountability. You are
required to write the case study in first person.
If you are a nurse, pharmacist, physiotherapist, podiatrist or therapeutic
radiographer you can chose to write the case study as either an Independent
Prescriber (IP) or Supplementary Prescriber (SP). If you are a diagnostic
radiographer or a dietician, you can only write the case study as a SP.
When writing as a SP, it is mandatory to attach the CMP that relates to
the case study.
The case study should comprise of the following three aspects:
Aspects: Weighting:
1 Clinical Assessment 30%
2 Prescribing Process 35%
3 Legal and Professional Issues 30%
1. Clinical Assessment:
A short introduction – your role and area of clinical practice and patient
anonymity.
This includes findings from history and clinical assessment with
consideration indicators used to make a diagnosis, socio-economic and
psychological issues. Clinical Assessment should include the following:
􀁸 You should be able to demonstrate how well you have used theory in
practice. You need to specify the consultation model used, why you chose
it, how it works for your clinical practice it and why you chose a particular
model over others.
􀁸 You should include important facts obtained in the history taking. You
should discuss pertinent data obtained through clinical examination and
investigation where appropriate. You may NOT use appendices – the only
permitted one is the clinical management plan (CMP) if you are writing as a
supplementary prescriber.
􀁸 You may use a box to list your differential diagnosis. This will not be
included in your word count. You may not discuss, refute or accept
diagnosis in this box – that should be contained succinctly in the body of
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the case study. If you do this in the box the contents will be included in
your word count.
􀁸 You should give the results of any investigations you did and comment on
their significance and support your interpretation with evidence/references.
You should also critically analyse differential diagnosis and how and why
you formed a particular diagnosis. Relevance of key issues should be
discussed in relation to diagnosis, assessment and patient management.
2. Prescribing Process:
The Prescribing Process should include the following:
􀁸 State whether you are writing the case study as an IP or SP. (You are
required to write the case study as though already qualified to demonstrate
your understanding of the role and how you will use it in practice.)
􀁸 You are required to prescribe DRUGS. This excludes devices (eg, spacer
devices for inhalers) and appliances (eg, compression stockings).
􀁸 Discuss the rationale for choosing the prescribed drug, this includes drug
factors and patient factors. You should be able to justify the use of your
drug option based on guidelines, the evidence that informs the guidelines
and any other factors that influenced your choice. You could discuss this
with reference to NPC pyramid. You must write the drug dose, frequency,
route of administration and duration of the course for the drug/s you
prescribe – that is the only time the BNF is a correct reference.
􀁸 You should demonstrate evidence based practice in support of treatment
options and management of patient care. Please note that a reference to
BNF/EMC is not acceptable as use of evidence based practice. Please
critically discuss best current evidence and guidelines. Local and national
issues should be discussed if applicable. Include evidence that
supports/informs the guidelines.
􀁸 If you are writing at Level 6, you are required to prescribe one drug. If you
are writing at Level 7, you are required to prescribe two drugs. Please
discuss the pharmacology of the drug prescribed; this includes mechanism
of action, side effects, contraindication, interactions that are relevant to
your patient. You should give references wherever applicable and make
links with the disease state or indication.
􀁸 Discuss patient management issues which include follow up, information
given, detailed safety netting of the condition and the drug/s.
3. Legal and Professional Issues:
This refers to the legal issues around your practice as a prescriber. Legal
and Professional Issues should demonstrate how the various legal issues
affect your practice with respect to the patient you are discussing in the
case study.
􀁸 Demonstrate awareness of 5 or 6 issues – for example – informed consent,
competence, duty of care, neglect, liability, confidentiality, accountability,
professional indemnity insurance, record keeping, CPD requirements,
clinical governance. Make sure they are directly related to your practice.
These are generic examples, you may choose different ones.
􀁸 Demonstrate your awareness of the legislation covering SP and IP
(whichever one is relevant to your case study/practice) and various legal
and professional implications of your role as a prescriber.
􀁸 Where appropriate, you may need to refer to recent changes in the law or
good practice guidance.
You MUST include all three sections in your case study in order to pass. The
length of each section should reflect the weighting of the marks, ie, each
section one third of the case study. You should obtain 40%/50% minimum
marks in each section.
Case Study Submission Requirement:
Failure to do so is subject to a deduction of 10% of the marks.
1. The case study should be electronically generated. The text should be
typed using “Arial” font size 12 with a line spacing of 1.5. All pages should
be numbered. If you don’t know how to do this, please ask someone for
assistance.
2. Please put your name, student number, your cohort, your level (level 6 or
level 7) and word count on the marking grid. You can find the marking grid
on page 31 of this Assessment Guide and as a separate Word document
on Moodle. Please type Turnitin Similarity percentage at the top of your
marking grid. Copy this sheet into the front your final case study for
electronic submission.
3. The word count must be clearly indicated on the marking grid and MUST
come within the given parameters of 3500-3850. We are required not to
mark anything beyond the maximum word limit as per University policy,
and it is essential you meet the minimum word count.