Role of the Advanced Practice NP as Prescriber Flashcards
NP as a Prescriber
Advanced knowledge
Clinical judgement
Prescription writing
Board of Nursing
Regulates practice
Scope of Practice
Determined by NP license
Nurse Practitioners…
Blend medical and nursing knowledge.
Understanding of disease process, pharmacology, and nursing.
Knowledge required to be a safe prescriber
- Pathophysiology and disease process
- Pharmacology
- Rational drug selection
Nursing is foundational to NP practice. Includes:
Communication
Education
Lifestyle Management
Nutrition
Clinical Judgement in Prescribing
Clear indication?
What drugs are effective for the disease?
What are the goals of therapy?
Monitoring to see if drug is meeting goals
Duplications in medications patient is taking
OTC vs prescription drugs
Cost
Sources of information
Collaborating with Other Providers
Collaboration is critical for quality patient care
Physician
- Historical issues in NP-doctor relationships
- Different perspectives on prescribing
Pharmacist
- PharmD: a clinical practice doctorate
- Expert in pharmacokinetics and pharmacotherapeutics
Other NPs or PAs
Role of the NP in Canada
Scope of Practice varies from province to province.
Educational preparation varies.
Most provinces have independent practice and prescribing.
NP title is protected.
2012 federal restrictions on NP authority to prescribe controlled substances lifted.
Specialties
-Pediatric NP, Family NP, APN, Anesthesia NP, mental health NPs working of prescriptive authority, but must be a prescribing NP in family, pediatric, or primary care
Facilitating Postive Outcomes
Adherence
Intentional vs. non-intentional non-adherence
Adverse drug reactions
Asymptomatic conditions
Chronic conditions
Knowledge deficit
Cognitive impairment and psychiatric illness
Barriers to Adherence
Complex drug regimens and polypharmacy
Sensory or mobility challenges
The pediatric patient
Fiscal issues
Improving Adherence
Longer-acting drugs
Use of reinforcements
Caregiver roles
Simplifying regimen
Cues as reminders
Follow-up visits
Measuring Adherence
Patient reports
Medication adherence scales
Predictors of adherence
Issues and Trends in Health Care
Autonomy and prescriptive authority
Interdisciplinary teams
- The IOM goals
- Medical Home model of care
Level of education
Reimbursement
