# data[].attributes.headline
External influences that may affect Prescribing decisions

# data[].attributes.subject
External influences that may affect Prescribing decisions

# data[].attributes.body
Formularies

Personal values/beliefs/experiences (consider possible bias)

Cost

Patient/colleagues expectations

Evidence based practice

Legal and ethical issues

Media/marketing

Code of conduct/professional competence

Unlicensed/off label

Time pressures

Knowledge/ education

McIntosh et al (2016) ‘Influences on prescribing decision making among non medical prescribers in the UK: systematic review’.

And Carter, et al (see blackboard slides 18.3.24).

# data[].attributes.body
1. Introduction

2. Prescribe safely (eg consent, history taking, EASE)

3. Prescribe professionally ( consent, communication)

4. Improve prescribing practice ( evidence based practice)

5. Prescribe as part of a team (shared decision making)

6. Conclusion

# data[].attributes.body
Prescribing of something in practice ( use EASE)

E - effective

A - appropriate

S - safe

E - Cost effective

(NPC, 1999)

See EMC website - pharmacological properties, patient info leaflets.

NICE CKS - health topics.

BNF

Local formularies

# data[].attributes.body
Good for you, good for us, good for everyone (Department of health and social care, 2021).

Shared decision making - NICE guidance (2021),

RPS competency framework,

Best practice statements (wounds UK)

Clinical knowledge summaries,

Trust formulary

NMC code of conduct.

NHS long term plan

# data[].attributes.body
Easier to organise into headings -

Prescribing safely - red flags, allergies, drug interactions, benefits vs risks, consent, history & examination, work to CPNP formulary and scope of practice, evidence based practice, policies, guidelines and legislation

Prescribe professionally - shared decision making, concordant agreement with patient, empowerment, CPNP formulary and scope of practice, consent and communication. NMC code of conduct.

Improve prescribing practice - Evidence based practice and sharing knowledge and learning, safety huddles (raising issues), reflecting on practice, reporting incidents or adverse effects, liaising with NMP lead, prescribing supervision, training and annual updates, personal formulary, continued professional development

Prescribe as part of a team - sharing knowledge, learning and clinical info, multidisciplinary working and communication (who are the members of MDpT) (Eccleston, 2021)

# data[].attributes.body
consent

Communication (building therapeutic relationships)

Evidence based practice

History taking (SOAP, red flags).

Shared decision making and person centred approach

# data[].attributes.body
Prescribe safely appropriately and cost effectively from the Nurse Prescribers’ Formulary for Community Practitioners

# data[].attributes.body
Reflect on and evaluate prescribing practice in their area of clinical practice, as defined within the “Prescribing Governance Domain” of “A Competency Framework for all Prescribers” (RPS, 2021)

# data[].attributes.body
Meet the competencies set out in the “Consultation Domain” of “A Competency Framework for all Prescribers” (RPS, 2021)

# data[].attributes.headline
Present options and reach a shared decision

# data[].attributes.subject
Present options and reach a shared decision

# data[].attributes.headline
Identify evidence-based treatment options available for clinical decision-making

# data[].attributes.subject
Identify evidence-based treatment options available for clinical decision-making