Additional Information
Book Details
Abstract
Independent prescribing is intended to support and enhance the overall delivery of care to patients within a wide range of circumstances and the devolution of prescribing from medical practitioners has been in place for several years. In 2018, legislation was passed in the UK allowing for paramedics to also undertake training to become independent prescribers. Independent prescribing is now carried out by those paramedics who are practising at an advanced level and have a role in clinical practice for which prescribing is a benefit to patient care.
This book is the first guide on independent prescribing for paramedics reflecting the 2018 legislation. Bringing together a range of specialist authors, the book supports the College of Paramedics’ practice guidance and also covers the theoretical knowledge and context associated with independent prescribing. It will appeal to any paramedic working at an advanced level with an interest in independent prescribing as well as senior student paramedics who are interested in further development post-registration.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Cover | i | ||
| Contents | iv | ||
| About the Authors | viii | ||
| Acknowledgements | xii | ||
| Abbreviations and Acronyms | xiv | ||
| Introduction | 1 | ||
| 1 Background to Independent Prescribing for Paramedics | 3 | ||
| Introduction | 3 | ||
| Background to Non-medical Prescribing | 3 | ||
| Overview of the Prescribing Mechanisms (Independent and Supplementary Prescribing) | 5 | ||
| The History of Independent Prescribing by Paramedics | 6 | ||
| Prescribing Roles | 9 | ||
| Rationale and Case of Need | 12 | ||
| Aims of Paramedic Prescribing | 13 | ||
| Conclusion | 15 | ||
| 2 Law and Ethics | 21 | ||
| Introduction | 21 | ||
| Prescribing | 21 | ||
| Scope of Prescribing Practice | 23 | ||
| Indemnity Insurance | 27 | ||
| Legislation and Prescribing | 27 | ||
| Licensing of Medicines | 28 | ||
| Legal Considerations | 30 | ||
| Ethical Considerations | 32 | ||
| Good Practice Considerations | 33 | ||
| Controlled Drugs | 35 | ||
| Evidence-Based Prescribing | 36 | ||
| Conclusion | 37 | ||
| 3 Assessing Health: History Taking and Consultation | 39 | ||
| Introduction | 39 | ||
| Health Assessment | 40 | ||
| Assessment and Consultation | 41 | ||
| Consultation Models | 42 | ||
| Wider Determinants of Health | 47 | ||
| Age, Sex and Constitutional Factors | 48 | ||
| Individual Lifestyle Factors | 51 | ||
| Social and Community Networks | 58 | ||
| General Socio-economic, Cultural and Environmental Conditions | 59 | ||
| Conclusion | 61 | ||
| 4 Basics of Pharmacology | 63 | ||
| Introduction | 63 | ||
| Key Terminology | 65 | ||
| Drug Design and Delivery | 65 | ||
| Pharmacodynamics | 68 | ||
| Pharmacokinetics | 78 | ||
| Dose Response and Steady State | 91 | ||
| Conclusion | 96 | ||
| 5 Decision Making for Prescribing | 99 | ||
| Introduction | 99 | ||
| An Overview of Decision Making | 100 | ||
| Theoretical Models | 101 | ||
| Human Factors | 107 | ||
| The Practical Application of Decision Making inPrescribing Pract ice | 111 | ||
| Principles of Good Prescribing | 114 | ||
| Conclusion | 117 | ||
| 6 Prescribing as Part of a Team | 123 | ||
| Introduction | 123 | ||
| Integrated Care and Healthcare Policy | 123 | ||
| Integrated Care and Prescribing Practice | 123 | ||
| Integrated Team Working | 124 | ||
| Clinical Governance | 127 | ||
| Supplementary Prescribing and ClinicalManagement Plans | 128 | ||
| Sharing of Information | 128 | ||
| Conclusion | 129 | ||
| 7 Public Health and Prescribing | 131 | ||
| Public Health | 131 | ||
| The Public Health Outcomes Framework | 133 | ||
| Deprivation and Health Outcomes | 134 | ||
| Public Health and the Prescribing Role | 135 | ||
| Antimicrobial Resistance | 139 | ||
| Antimicrobial Stewardship and Awareness | 139 | ||
| Infection Control | 141 | ||
| Conclusion | 142 | ||
| 8 Medicines Optimisation | 145 | ||
| Introduction | 145 | ||
| Long-Term Conditions | 145 | ||
| Medicines Use | 146 | ||
| Polypharmacy | 146 | ||
| Medicines Optimisation | 148 | ||
| Medicines Reconciliation | 152 | ||
| Medication Review | 152 | ||
| Medicines Adherence | 153 | ||
| Motivational Interviewing | 154 | ||
| Conclusion | 155 | ||
| 9 Patient Factors and Prescribing | 159 | ||
| Introduction | 159 | ||
| Renal Impairment | 160 | ||
| Liver Impairment | 163 | ||
| Pregnancy and Lactation | 165 | ||
| Paediatrics | 168 | ||
| The Elderly | 174 | ||
| Drug Interactions | 176 | ||
| Adverse Drug Reactions (ADRs) | 178 | ||
| Individual Patient Variation: Pharmacogenetics | 181 | ||
| Conclusion | 182 | ||
| 10 Continuing Professional Development and Reflective Practice | 185 | ||
| Introduction | 185 | ||
| Defining ‘Professional Practice’ | 186 | ||
| Sources of Expectation as a Professional | 187 | ||
| What Constitutes ‘Advanced Practice’ for the Paramedic Profession? | 188 | ||
| What is the Purpose of Reflection on Your Prescribing Practice? | 189 | ||
| Why Write up Reflections on Prescribing? | 190 | ||
| Commonly Cited Barriers to Written Reflection | 190 | ||
| Ideas on How to Start Reflecting in a Meaningful Way | 191 | ||
| Reflective Models | 194 | ||
| Reflexivity versus Reflection | 198 | ||
| Clinical Supervision or Person-centred Development? | 199 | ||
| Continuing Professional Development (CPD) | 203 | ||
| Conclusion | 207 | ||
| Index | 211 |