Introduction
An essential worldwide health resource management concern is the dearth of healthcare professionals in many settings. Natural attrition, the absence of the necessary expertise, insufficient recruitment processes, and weak deployment tactics are just a few of the elements that play into this and reduce the number of potentially excellent specialists. These issues limit the utilization of medical resources. I am an experienced clinical site coordinator (CSC) and a nurse team leader of the intensive care unit working in a consultant-led island hospital. We have no junior doctors, and consultant doctors are not readily available when you need them; treatment and patient access to medicine is often delayed. Patients may be forced to wait for significant periods before receiving the care they require in some situations. Delays in patient access to health care services have been attributed to a lack of available consultants and their inability to access health facilities.
Medical officials are expected to prescribe proper medications as part of their duties. When a doctor prescribes medication for the treatment or prevention of disease or other physical or mental disorders, they are engaging in the practice of prescribing medicine. Medical orders are often written down and include what medication has been prescribed, why, and how much a patient is to take. Ideally, patients’ medical histories should be thoroughly examined before doctors write prescriptions. The lack of junior doctors or consultants in the health facilities delays this process.
There is much discussion about the number of medical prescribers and the length of time they take to prescribe therapeutic drugs. Practitioners of health care who are not physicians can provide patients with medication recommendations in the absence or absence of medical professionals. Physiotherapists, diabetic specialists, and pain specialists, among others, should be permitted to prescribe certain medications to patients to reduce drug access delays and increase the efficiency of health care services. They should be authorized to do so (Nuttall, 2019). Nurses spend most of their time with patients. They can identify when particular prescriptions need to be adjusted, or new medications must be added to the patient’s prescription list. Nurses can improve their prescribing abilities by attending prescription seminars and expanding their scope of practice.
The Roles of Non-Medical Prescribers
Medical officers are not always present when non-medical prescribers are needed, although they can be found in various places. This will make it easier for prescribers, family members, and patients to communicate with one another (Graham-Clarke, 2019). Anxiety in the family and the patient was caused by the deletion of vital information when prescribing a drug, according to user feedback 1. One user input notes a lack of information on the possible clinical consequences of a drug’s adverse effects. Providing care requires effective communication on the part of the nurse. The royal pharmaceutical society recommends that patients access adequate medication information to effectively adhere to and comply with treatment protocols (Myers, 2020). This, in turn, will help to reduce the number of antibiotics and other recommended regimens that are being overprescribed. Patients are more likely to use the recommended medication if adverse effects and mechanisms of action are explained to them rather than if they are just given the prescription and sent home.
Patients and clientele rely on non-medical prescribers since they spend time with them. Patients should be able to get their medications from non-medical prescribers in emergencies where doctors are unavailable or cannot be reached (Noblet, 2018). This should be carried out professionally to guarantee high-quality patient outcomes and customer satisfaction. It shows professionalism in dispensing prescriptions, a good standing, and the patient’s company in user feedback 4 (Kanan and Hartshorn, 2017). Clients and patients in England benefit from the NICE clinical guidelines. As per the NICE clinical guidelines, several research-based techniques should be used for individuals with distinct needs and in diverse contexts.
Limitations and Competencies
As a non-medical prescriber, I should be aware of the limitations and consequences my actions could invoke. In that regard, non-medical workers should only prescribe the drug classes they were appropriately educated about: for instance, through seminars or additional courses. Even then, they should understand that their scope of practice is limited by the lack of professional medical education and should not issue any prescriptions they feel unsure about or unqualified for. Ultimately, I must always practise within my competencies, base the prescriptions on research, evidence, and ymedical history of the patient, and remember to only act in situations where a medical worker is not available to help.
How the Roles of Non-Medical Prescribers Make a Difference to the Patient
This process has three parts: understanding the activities of various drugs and how well they work to treat symptoms. Non-medical prescribers are involved in the holistic care of patients as well as the treatment of their medical conditions. According to NICE recommendations, customers and patients should receive the best possible treatment and care (Davies, 2018). This takes into account their entire personhood. To benefit their patients’ other requirements, non-medical prescribers can provide this information to them. It can reduce hospitalizations and extended stays by providing non-medical prescriptions that suit the client’s specific needs.
According to the fourth and final perspective, patients who have been given enough knowledge about their treatment alternatives do not complain about them and have better health. The NICE recommendations describe how healthcare providers and patients can improve their communication skills (Davies, 2018). Effective communication may be impossible when junior doctors and experts are out of reach. Non-medical prescribers who are usually on hand can aid in the smooth flow of information between the many parties involved. The influence of non-medical prescribers on patient care is, thus, beneficial.
Improvement of Patient Care
Individuals who misuse antibiotics are more likely to develop resistance to them. Antibiotics should not be given without first confirming what is causing the illness, according to input from user number five. Antibiotic resistance, according to the pharmaceutical industry, is a risk of improper or excessive use of antibiotics (Ho, 2020). Resistance can be reduced with the use of appropriate research and clinical discretion. Empirical treatment should always be contrasted to treatment based on cultural organisms. Following up on the investigations before starting medicine is possible because of the availability of health practitioners. Many times non-medical prescribers can help guarantee that evidence-based regimens are available to patients, thereby facilitating the prescription of suitable drugs.
A complete physical exam and a thorough review of family medical history are required to prescribe drugs in Reflections 1, 2, and 5. Correct information on a patient’s condition is critical to their care. There are non-medical prescribers who can acquire sufficient information about the patient, including environmental elements that may have contributed to the condition (Nuttall, 2019). The optimal treatment regimens are implemented when the many interdisciplinary team members work together. As a result, patients will receive better care based on solid research.
How the Roles of Non-Medical Prescribers Improve Patient Care
Reflection 5 discusses professionalism’s role in ensuring patients and clients receive high-quality medical care across various health care institutions. Following the standards set forth by the Royal College of Nursing Practice, facilities must ensure that their clients and patients understand the current state of their conditions and the range of treatment options available to them (Marangozov, 2017). According to the General Medical Council, providing health care services should begin with putting the needs of patients first (Alberti, 2017). Nursing and midwifery principles also stress the importance of maximizing available resources to ensure patients receive the best possible care (Baltruks, 2018). Remedies are more likely to be prescribed and administered on time when non-medical prescribers are involved. The NICE recommendations stress the importance of effective communication in promoting evidence-based practice. It is possible to discuss treatment choices and consult with experts in various fields if communication skills are developed (Nuttall, 2019). To provide better care to patients, non-medical prescribers should seek the advice of specialists on problematic issues rather than making assumptions about treatment alternatives. As a result, consultants will not have to travel long distances to prescribe necessary prescriptions.
Easy Access to Treatment Secondary to Non-Medical Prescribers Roles
One of the most important aspects of prescribing procedures is accountability, addressed in reflection 4. One of the essential responsibilities that nurses and midwives have for the people they serve is to be accountable (Carragher, 2017). In the prescription and administration of medications, accountability necessitates efficient knowledge that is evidence-based to support one’s arguments (Nuttall, 2019). Confidence and effective communication in patient care make therapy more accessible than when it must be postponed because the consultant is out of town or otherwise unable to provide it. Long wait times and a lack of faith in the hospital can make it difficult for patients to get the care they need. It restricts people’s ability to seek medical help when they need it. If patients cannot wait for the arrival of consultants, non-medical prescribers can speed up the process of getting them into the hospital. In addition, patients benefit from continuity of care, and non-medical prescribers benefit from increased knowledge.
Reduction of Hospital Admissions
One of the concerns that should be avoided, as discussed in reflections 1-7, is a return to the hospital due to inadequate information and unsuitable guidance. Antibiotics for viral infections, for example, can lead to hospitalization if prescribed by a doctor. According to the NICE guidelines for health and care, this raises the cost of treatment for patients (Ho, 2020). This may be secondary to their limited time with their clients and hence make inaccurate health assessments. In a work with a patient, it is important to maintain the high level of offered services as it directly contributes to their level of satisfaction (Rudall et al., 2017). When non-medical prescribers conduct the history and physical examinations, it is easier to arrive at a correct diagnosis. Additionally, the non-medical prescribers take care of a client’s overall health, ensuring that these patients and clients receive high-quality treatment. In addition to reducing the number of hospitalizations, proper management of the patient’s symptoms also minimizes the length of time spent in the hospital (Ho, 2020).
Benefits to the Hospital and Colleagues
Patients, clients, coworkers, and the healthcare institution all gain from the employment of non-medical prescribers. The use of non-medical prescribers benefits patients and customers by increasing access to health care and ensuring the continuity of treatment. To provide the most effective intervention based on current scientific knowledge, collaborating with non-medical prescribers is a smart move for everyone involved (Noblet, 2018). It also helps widen the expertise of various healthcare professionals and take charge in the absence of other healthcare practitioners, such as in emergencies. Prescribers who are not doctors can help reduce the number of off-duty calls and disturbances. Patients in the hospital are better served when non-medical prescribers are used to guarantee continuity of care (Graham-Clarke, 2019). The non-medical prescribers’ positions in a hospital’s leadership and management also help the facility achieve its desired outcomes. Having good lines of communication throughout the medical facility makes it easier to research there. Adopting more efficient interventions in the hospital improves the quality of treatment delivered, increasing patient confidence in the facility (Ho, 2020).
Safe prescribing
Safe prescribing requires proper patient examination, evaluation, and diagnosis to ensure the effective, safe, and cost-effective administration of medication. The prescriber ensures compliance with national requirements and, where appropriate, local formulations. Following the administration of the prescribed medication, they must monitor the treatment’s favorable and bad outcomes. To minimize bad outcomes, safe prescribing should ensure that the patient’s condition is treated safely (Linton and Murdoch-Eaton, 2020). Therefore, the prescriber should consider acquiring sufficient information about the patient’s condition, ensuring that the proposed medication matches the patient’s needs, and doing a thorough examination and assessment of the patient. This is done to ensure that sufficient information, permission, and medicine capability are obtained from the patient.
In reflections 1-3, miscommunication makes it unsafe to prescribe medication if the prescriber does not have sufficient knowledge about the patient’s health or if the consultation style is not suited to their requirements. If the patient refuses to consent to the prescriber sharing information with their GP, or if the patient does not have a GP, the prescriber should tell the patient of the risks associated with not revealing this information. Their medical records must reflect this information (Kennedy, Haq, et al., 2019). In addition, if failure to share facts could compromise patient safety, the prescriber must inform the patient that the prescriber cannot prescribe. The prescriber should tell them of their options and direct them to alternative providers that meet their needs. All of their decisions should be supported by extensive documentation.
In reflections 1-7, if prescribers are uncertain whether a patient can decide, they should analyze their capacity based on the applicable legal standard (Bebbington et al., 2021). Their decision-making and consent guidance give comprehensive information on assessing a patient’s capacity and making decisions when it is known that the patient lacks capacity.
Deprescribing
Reflection 4 urges that deprescribing be performed cautiously and closely to avoid aggravating illness or causing withdrawal symptoms. Achieve patient understanding and acceptance, and this takes thorough individualized dialogue. Patients may benefit from the usage of unique terminology. Individual needs and preferences should be considered when providing therapy and care (Bebbington et al., 2021). Individuals utilizing health and social care services should be able to be cared for and treated in conjunction with their healthcare and social care professionals. It is understood that this is a complex process, not a single act with multiple steps.
In reflection 5, professionals are needed in handling adults since they are more susceptible to severe drug responses, drug-drug combinations, and rapid deterioration if the recommended medication is not optimized. User reflection seven insights that consideration must be given to frailty assessment in multimorbid patients. Identifying patient groups who are likely to take many drugs and are more susceptible to harmful drug interactions is crucial (Kennedy, Williams, et al., 2019). Polypharmacy, elderly patients over the age of 75 who are weak, housebound and nursing home patients, patients with signs of decreasing life expectancy, vulnerable patients, and decline in liver function are examples.
Care discussions necessitate an excellent quantity of time. This may demand longer or alternative consultations, and periodic, planned reviews may be advantageous. User feedback 5 demonstrates that individual permission is required, and if necessary, a mental capacity evaluation must be conducted (Reeve, 2020). To be valid, permission must be free, complete, and informed, which implies that the patient must be able to make the decision voluntarily and fully know all pertinent information. When deprescribing, clinical documentation must be of high quality. Especially when the care decision does not appear to be supported by the best available data, there should be a record of the logical justifications for the adjustments made. In reflection, five patient decision tools benefit collaborative decision-making (Okeowo et al., 2018). These are appropriate when numerous available courses of action exist, and the patient’s reaction to the outcome probability determines the optimal choice. PDAs developed as part of a clinical guideline to aid a person in weighing the possible benefits and drawbacks of various treatment options are examples of condensed versions that can be used in a consultation.
Social prescribing
In reflections 1 and 2, a link in workers is referred to clients encompassing approach to their health and well-being (Le Bosquet, Barnett, and Minshull, 2019). Those needing practical or emotional support are referred to community organizations and government initiatives. Numerous local organizations, such as pharmacists, admission and discharge services, allied health professionals, social care services, and self-referrals, might refer clients to link workers when social prescribing is beneficial.
Chronic illnesses account for approximately 70% of total health expenditures. However, since there is no solution for them, we must look beyond the typical NHS clinical concept. This is the opportunity to improve the overall wellness and well-being of large numbers of people through social prescribing (Scott et al., 2020). Psychosocial prescribing aspects of employment, who work in GP practices and accept recommendations from all local groups, have emerged; as a result, they connect clients with practical and emotional community assistance. Link workers are afforded sufficient time to establish trustworthy relationships, begin with the individual’s priorities, form a shared objective, and expose them to community resources.
In reflection, six social prescribing connects individuals to various activities; for example, the voluntary organization’s sector usually provides volunteer opportunities in the arts and education as well as other forms of participation in the community, such as farming, befriending, cooking, eating healthy, and sports (Payne, 2020). The NHS, general practices, pharmacists, multidisciplinary teams, and admission and discharge teams can refer patients to social pharmacology link workers.
Local policies and legislation
The FDA monitors drugs utilizing numerous data sources, such as clinical trials, epidemiologic studies, and post-marketing reports. This article aims to provide clinicians who prescribe FDA-approved drugs with a foundational grasp of drug regulation (Courtenay et al., 2018). The Medicines Act of 1968 gives the prescriber the legal authority to provide medication to a person the prescriber assist. According to the Act, anyone may administer prescription medication to another person as long as they adhere to the prescriber’s directions (Lorencatto et al., 2018). The Human Medicines Regulations 2012, which entered into effect in 2012, consolidated the law governing pharmaceutical goods for human use in the United Kingdom (Statutory Instruments, 2012). The federal government regulates prescription drug manufacturers by implementing laws and standards to prevent hazardous prescriptions and safeguard public health.
The prescriber considers it essential to manage patient expectations, and the practice team must comprehend and communicate the role to patients (Graham-Clarke et al., 2019). Receptionists at the office of the prescriber use care navigation, which entails obtaining a brief medical history from the patient to find the most appropriate individual to speak with. Receptionists advise patients that the prescriber collaborates with other physicians at the office and will seek their advice as needed (Pescheny, Pappas, and Randhawa, 2018). The consultation room door of the prescriber is labeled with their name and job description, so patients who attend in-person appointments know whom they are seeing. According to the prescriber, time and consistency have also helped patients adjust to their duties (Ho, van Hove, and Leng, 2020). However, the prescriber should emphasize that it may take patients and other healthcare professionals some time to become familiar with her new responsibilities in general practice.
Antibodies Stewardship
Stewardship of antimicrobials is related to the organizational or medical framework of antimicrobials use to ensure their long-term efficacy and safety (Fixsen et al., 2020). The antibiotic stewardship program, as per commissioners, should be implemented in all healthcare facilities. Antimicrobial stewardship programs that consider the resources needed to support antibacterial management in all healthcare settings should be developed. Consider including the following components in a program for antimicrobial stewardship: Monitoring and evaluating antibiotic prescriptions in light of local resistance trends sending regular feedback on antimicrobial prescribing to individual prescribers across all care settings, such as by utilizing professional regulatory numbers and prescriber codes. In user feedback, five hospitalizations for potentially unnecessary life-threatening infections and patient safety risks associated with antibiotic use include Clostridium difficile infections and anaphylaxis (Chiva Giurca, 2018). Educating and training healthcare practitioners on pharmaceutical care and antimicrobial resistance
Infection prevention program roles, obligations, and accountability are clarified when audits are integrated into current improvement initiatives (Tierney et al., 2020). Think about establishing systems and practices to provide prescribers and prescription managers monthly updates on prescribing patterns and trends compared to regional and national averages for antimicrobials. Consider developing methods and procedures for identifying and analyzing whether hospital admissions of patients with possibly preventable infections are related to earlier prescribing decisions.
Reflections, 1-7 consider providing prescribers with IT or decision support systems when deciding whether or not to prescribe an antimicrobial, primarily when a condition is treated with a high frequency of antimicrobials (Drinkwater, Wildman, and Moffatt, 2019). If quick antimicrobial prescribing is not an option, other options may be necessary. Whenever a patient’s care is transferred to a different facility, consider developing processes and procedures to ensure that the essential information is available: information on current or recent antimicrobial use and when a current antibiotic course should be assessed (Wildman, J. and Wildman, J.M., 2021). Designed to perform specific antimicrobial resistance monitoring to enhance antibacterial stewardship in all care settings should be considered, considering the necessary resources and programs—pack antimicrobials in quantities corresponding to regional and national guidelines for course lengths. Check prescription rates and trends to see how antimicrobial stewardship programs work.
Moreover, establishing peer-review processes and mechanisms for prescriptions at the local level. Allow health professionals to examine their colleagues’ antibiotic prescribing practices if they are discordant with domestic or international recommendations, and no rationale is supplied (Balinskaite et al., 2019). Prescribers should be encouraged and assisted in using antimicrobials only when medically necessary. To promote antimicrobial stewardship, health and social care professionals in all settings should work together to communicate and exchange information about antimicrobial resistance and stewardship and share their own experiences and knowledge in this area.
Conclusion
Finally, I intend to improve my education and prepare for my new prescriber work by attending obligatory training sessions and elective courses. I will also seek mentorship from physicians of diverse disciplines to improve my prescribing skill as it is a necessary part of working with the patients efficiently and to provide excellent service opportunities. To stay current on new regulations and legislation, subscribe to MHRA alerts, NICE clinical advice and support, the electronic medicine comprehensive list, and the British formulary online. Additionally, I must reflect on and follow up on the patients I prescribe for, look for new difficulties, and provide reliable and practical patient care. Online access to MHRA warnings, NICE clinical recommendations, an electronic medication compendium, and the British formulary. I intend to strengthen my evaluation and diagnostic talents to be more effective in my new job. All of my future prescribing will be displayed and maintained for self-audit and safe prescription records. By doing this regularly, I may quickly increase my field of practice.
Reference List
Balinskaite, V. et al. (2019) ‘The impact of a national antimicrobial stewardship program on antibiotic prescribing in primary care: an interrupted time series analysis, Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America, 69(2), pp. 227–232.
Baltruks, D. and Callaghan, P.P. (2018) Nursing, midwifery and allied health clinical academic research careers in the UK. Council of Deans for Health (CoDH), p. 21.
Bebbington, E. et al. (2021) ‘Evaluation of a framework for safe and appropriate prescribing of psychoactive medications in a UK prison’, Criminal behaviour and mental health: CBMH, 31(2), pp. 131–142.
Carragher, J. and Gormley, K. (2017) ‘Leadership and emotional intelligence in nursing and midwifery education and practice: a discussion paper’, Journal of Advanced Nursing, 73(1), pp. 85–96.
Chiva Giurca, B. (2018) ‘Social prescribing student champion scheme: a novel peer-assisted-learning approach to teaching social prescribing and social determinants of health’, Education for primary care: an official publication of the Association of Course Organisers, National Association of GP Tutors, World Organisation of Family Doctors, 29(5), pp. 307–309.
Courtenay, M. et al. (2018) ‘Development of consensus-based national antimicrobial stewardship competencies for UK undergraduate healthcare professional education, The Journal of Hospital Infection, 100(3), pp. 245–256.
Davies, H.O. et al. (2018) ‘Impact of UK NICE clinical guidelines 168 on referrals to a specialist academic leg ulcer service’, Phlebology, 33(2), pp. 84–88.
Drinkwater, C., Wildman, J. and Moffatt, S. (2019) ‘Social prescribing’, BMJ, 364, p. 364.
Fixsen, A. et al. (2020) ‘Applying critical systems thinking to social prescribing: a relational model of stakeholder “buy-in”,’ BMC Health Services Research, 20(1), pp. 1–13.
Graham-Clarke, E. et al. (2019) ‘Non-medical prescribing in the United Kingdom national health service: a systematic policy review’, PLoS ONE, 14(7), pp. 1–29.
Ho, K.H., van Hove, M. and Leng, G. (2020) ‘Trends in anticoagulant prescribing: a review of local policies in English primary care’, BMC health services research, 20(1), pp. 1–8.
Kennedy, M.B., Haq, I., et al. (2019) ‘The role of undergraduate teaching, learning and a national prescribing safety assessment in preparation for practical prescribing: UK medical students’ perspective’, British Journal of Clinical Pharmacology, 85(10), pp. 2390–2398.
Kennedy, M.B., Williams, S.E., et al. (2019) ‘UK medical students’ perspectives on practical prescribing teaching and learning provisions: a cross-sectional survey’, European Journal of Clinical Pharmacology, 75(10), pp. 1451–1458.
Le Bosquet, K., Barnett, N. and Minshull, J. (2019) ‘Deprescribing: practical ways to support person-centred, evidence-based deprescribing’, Pharmacy (Basel, Switzerland), 7(3), p. 129.
Linton, K.D. and Murdoch-Eaton, D. (2020) ‘Twelve tips for facilitating medical students prescribing learning on clinical placement’, Medical Teacher, 42(10), pp. 1134–1139.
Lorencatto, F. et al. (2018) ‘Driving sustainable change in antimicrobial prescribing practice: how can social and behavioural sciences help?’, The Journal of Antimicrobial Chemotherapy, 73(10), pp. 2613–2624.
Marangozov, R. et al. (2017) Royal College of Nursing Employment Survey 2017. Institute for Employment Studies (IES). Web.
Myers, L.B. and Midence, K. (2020) ‘Concepts and issues in adherence’, in Adherence to treatment in medical conditions. CRC Press, pp. 1–24.
Noblet, T. et al. (2018) ‘Clinical and cost-effectiveness of non-medical prescribing: A systematic review of randomised controlled trials’, PloS One, 13(3), p. e0193286.
Nuttall, D. and Rutt-Howard, J. (eds) (2020) The textbook of non-medical prescribing. 3rd edn. Hoboken, NJ: Wiley.
Okeowo, D. et al. (2018) ‘Clinical practice guidelines for older people with multimorbidity and life-limiting illness: what are the implications for deprescribing?’, Therapeutic Advances in Drug Safety, 9(11), pp. 619–630.
Payne, R.A. (2020) ‘Polypharmacy and deprescribing’, Medicine, 48(7), pp. 468–471.
Pescheny, J.V., Pappas, Y. and Randhawa, G. (2018) ‘Facilitators and barriers of implementing and delivering social prescribing services: a systematic review’, BMC Health Services Research, 18(1), pp. 1–14.
Reeve, E. (2020) ‘Deprescribing tools: a review of the types of tools available to aid deprescribing in clinical practice’, Journal of Pharmacy Practice and Research, 50(1), pp. 98–107.
Rudall, N. et al. (2017) ‘PROTECTED-UK – Clinical pharmacist interventions in the UK critical care unit: exploration of relationship between intervention, service characteristics and experience level’, The International Journal of Pharmacy Practice, 25(4), pp. 311–319.
Scott, S. et al. (2020) ‘Development of a hospital deprescribing implementation framework: A focus group study with geriatricians and pharmacists’, Age and Ageing, 49(1), pp. 102–110.
The human medicines regulations 2012 (2012). Queen’s Printer of Acts of Parliament. Web.
Tierney, S. et al. (2020) ‘Supporting social prescribing in primary care by linking people to local assets: a realist review’, BMC Medicine, 18(1), pp. 1–15.
Wildman, J. and Wildman, J.M. (2021) ‘Evaluation of a community health worker social prescribing program among UK patients with type 2 diabetes’, JAMA Network Open, 4(9), pp. 1–12.