Get Full Essay Get access to this section to get all help you need with your essay and educational issues. Get Access Prescribing Case Study Essay Sample As my learning needs and areas of development have been identified within my portfolio, the following case study will focus on the assessment and prescribing process for a 64 year old lady with a history of venous leg ulcers.
Providing the correct amount and type of information Aiding accurate recall and understanding Achieving a shared understanding: Closing the session The consultation was initiated by developing initial rapport with Betty who was asked to describe the current problems she was experiencing.
It transpired in the course of the consultation that she had experienced pain on micturition, frequency and urgency of urination and nocturnal polyuria for the past 2 days. There were no complaints of back pain or fever, she denied any signs of haematuria and there were no other systemic symptoms.
She had tried drinking cranberry juice, and increased her fluid intake to try and relieve the symptoms, but with no effect. The discussion revealed she was currently taking no prescribed medication and had no known allergies.
Social history revealed she lived with her husband, worked part time and was usually fit and active. Patient urinalysis was performed using Combur-7 test Strips and revealed: The results of the urinalysis combined with the history indicated the diagnosis of an uncomplicated UTI.
Those most at risk include the young and sexually active, however, the elderly population, both male and female, whose advancing age, co-existing illness, institutional care and bladder catheterisation are also at risk and may present with asymptomatic bacteriuria DOHBardsley Courtney et al reminds us that nurse prescribing has introduced us to a new sphere of accountability and the NMC clearly states that nurses are personally accountable for their practice.
As stated earlier I would be acting illegally if I allowed a GP to prescribe based on my assessment and diagnosis. I therefore explained the situation to Betty and discussed my findings with her, explaining that the GP would consult with her and provide the appropriate prescription.
For the purpose of this portfolio I will continues as if I were an independent prescriber. Consider Choice of Products Barber identifies four areas that prescribers should aim to achieve when considering treatment.
Using this model enables the independent practitioner to bring together the traditional balance of risks and benefits, the need to reduce costs and the right of the patient to make the right treatment choices. Pharmokenetics, pharmacodynamics and polyphramacy must all be considered when selecting the appropriate product.
Pharmacokinetics can be defined as how the body handles a drug MeReC, It is known that as we age we are more susceptible to drug effects. The biggest change is a reduction in renal clearance, this affects drug metabolism and drugs may be excreted at a reduced rate, leading to accumulation and adverse drug events.
It is essential that we are aware of these changes and prescribe accordingly. Both pharmacokinetics and pharmacodynamics are very complex. It is essential that as a nurse prescriber to have an understanding of these to be able to predict and individualise drug therapy. Reddy states that before prescribing for the older patient, we should be sure that the prescription is required and the drug is appropriate.
Inappropriate prescribing in this group of people can lead to both over and underuse of drugs. Maximise effectiveness All professionals who are prescribers have a legal responsibility to ensure the item that they select is the most appropriate to meet the needs of the individual patient and that it is safe and effective Anderson To achieve maximum effect for Betty, it is important to ensure that the correct antibiotic is prescribed, at the optimal dose and duration.
Hummers-Pradier and Kochen also point out that if both nitrates and leucocytes are negative the probability of a UTI is low and antibiotics should not be given. The HPA also provide guidelines to aid the practitioner as to when a urine sample ought to be collected and sent to the pathology laboratory for culture and sensitivity.
Many authors DOHHummers-Praider and Kochen suggest the first line treatment of choice for a diagnosed, uncomplicated UTI is short term therapy with an antibiotic. As a primary health care team we follow the antimicrobial prescribing guidelines for uncomplicated UTI.
Within these guidelines there are three first line choices: Trimethoprim, Nitrofurantion and Cephalexin. These can all be used for a short term course of three days for women. As a PCT the guidelines recommend the use of Trimethoprim as first line treatment as it is currently the most clinically effective as well as being the most cost effective.
Prodigy Guidelines DOH also suggest an NHS prescription age from 14 to 75 years for Trimethoprim tablets for three days and provides evidence that a course of three days is as likely to be as effective as a course of five to seven days and much more cost effective.
Trimethoprim is also known to be tolerated more by the elderly and can be used in those patients with renal impairment, unlike Nitrofurantion, which is contraindicated in patients with renal impairment.
Trimethoprim also has a lower level of drug allergy compared to other options. The treatment regime is simple Prodigy guidelines recommend a dose of mgs twice a day for a period of three days.
Even when antibiotics are clinically indicated they are sometimes prescribed and used inappropriately. Consideration should be given to the dose, duration of use, interval and likely patient adherence to the regime.
The multi-disciplinary approach to care within the specialist team, allows for discussion between a numbers of health care professionals, this helps to facilitate discussion and provides all practitioners with invaluable up to date information relating to practice. Minimise risk All drugs are known to have a measure of risk and can cause adverse reactions.
The pharmacodynamics and pharmacokinetics of a given drug may be affected by many factors these include, renal function, body weight, co-existent pathology and other prescribed drugs.Independent prescribing is defined as "prescribing by a practitioner (e.g. doctor, dentist, nurse, pharmacist) responsible and accountable for the assessment of patients with undiagnosed and diagnosed conditions and for decisions about the clinical management required, including prescribing" (DH, p2).
Here you will find general guidelines on how to prepare excellent nursing reflective essays. It seems that nursing students are the luckiest of all other students. Why? essay format; nursing essay; It seems that nursing students are the luckiest of all other students.
Student nurse essays have a standard structure. Thus, make sure you. Nov 15, - Extension of Nurse Prescribing. I had to write 8 prescribing episodes with a reflective account.
Independent Prescribing Supplementary Prescribing - UK Essays 10 Jan The author also feels confident sample essays about yourself for college that non-medical prescribing in mental ) in the future. A REFLECTIVE ESSAY This is a reflective essay based on a event which took place in a hospital setting.
The aim of this essay is to explore how members of the Multidisciplinary Team (MDT) worked together and communicate with each other to achieve the best patients outcome. Department of Health. () Report of the Advisory Group on Nurse Prescribing.
The Crown Report). London: HMSO. Department of Health. () Review Of Prescribing, Supply And Administration Of Medicines. (The Crown Report Two) London: HMSO.
Department of Health. () Medicines Matters. London: HMSO. Department of Health. I will use a reflective model to discuss how I have achieved the necessary level of competence in my nurse training programme. The reflective model I have chosen to use is Gibbs model (Gibbs ).
Gibbs model of reflection incorporates the following: description, Reflective Essays for Hca.