Non Medical Prescribing Making a Difference

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Non Medical Prescribing Making a
Difference Karen Selwood Advanced Nurse
Practitioner
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ANPs in paediatric oncology

• 2 ANPs in the late 1990s
• Role development over the last 10 years
• Moved to a new unit
• 2 more ANPs wider service

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Prescribing before the V300

• Group protocols
• Written instruction for the supply and/ or
  administration of medicines in an identified
  clinical situation.

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PATIENT GROUP DIRECTION FOR NURSE PRESCRIBING OF
ANTIBIOTICS IN ONCOLOGY 11.2.1 AIMS OF
TREATMENT To treat neutropenic pyrexia following
chemotherapy 11.2.2 POLICY PROCEDURE
STATEMENT The policy and procedures on the nurse
or HCP administration of drugs according to
prescribing exemptions are followed. 11.2.3
ADDITIONAL CRITERIA FOR ROLE EXPANSION Oncology
ANP or clinician 11.2.4 DRUGS Piperacillin,
Netilmicin, Ceftazidime, Amikacin,
Teicoplanin. 11.2.5 EXCEPTIONS See guidelines
relating to infection control in oncology.
Patients allergic to one of the drugs or who have
shown a previous ADR. 11.2.6 CONTRAINDICATIONS,
PRECAUTIONS OR SPECIAL CONSIDERATIONS Consider
previous anti-infective therapy, renal function
adverse reactions, and aminoglycoside
levels. 11.2.7 ASSESSMENT ADMINISTRATION
PROCEDURES Refer to guidelines on the use of
anti-infectives in oncology. Document
administration on the patient's nursing and
medical notes. 11.2.8 FOLLOW UP All children will
be assessed within 24 hours by a doctor. 11.2.9
DRUG DETAILS Administration and side effects -
see guidelines. 11.2.10 REFERENCES Guidelines on
the use of anti-infectives in oncology
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Prescribing before the V300

• Group protocols
• Written instruction for the supply and/ or
  administration of medicines in an identified
  clinical situation.
• Transcription on admission/ discharge

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V300

• Issues
• Adult orientated
• Practical aspects from paediatric perspective
• A means to an end!

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Prescribing in paediatrics

• Within scope of practice
• Licensed medicines
• Off label use
• Limitations of an Independent prescriber
• The use of unlicensed medicines
• Controlled drugs

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Now in practice

• Independent Prescriber
• Clinical management plans
• Partnership between independent/ supplementary
  prescriber
• Can prescribe all medicines
• Written care plan
• Needs a diagnosis
• Shared records

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Now in practice

• Cover all areas of oncology unit
• Nurse led day care
• Leukaemia clinics
• Advantages for families
• Holistic approach to care
• Seen in more timely manner
• See small team who know the child and their
  history

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Issues for the future

• Controlled drugs
• Awaiting changes in legislation
• Unlicensed medicines

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• Thank you for listening
• Any Questions?
• Karen.selwood_at_alderhey.nhs.uk