Neuropharmacology and mental health nurse prescribers

Faculty of Health Sciences, Staffordshire University, Stoke-upon-Trent, England, United Kingdom
Journal of Clinical Nursing (Impact Factor: 1.23). 09/2006; 15(8):989-97. DOI: 10.1111/j.1365-2702.2006.01378.x
Source: PubMed

ABSTRACT To outline the development and content of a 'top-up' neuropharmacology module for mental health nurse prescribers and consider how much pharmacology training is required to ensure effective mental health prescribing practice.
Debate about the content of prescribing training courses has persisted within the United Kingdom since the mid-1980s. In early 2003 supplementary prescribing was introduced and gave mental health nurses the opportunity to become prescribers. The challenge of the nurse prescribing curriculum for universities is that they have only a short time to provide nurses from a range of backgrounds with enough knowledge to ensure that they meet agreed levels of competency for safe prescribing. There is growing concern within mental health care that the prescribing of medication in mental health services falls short of what would be deemed good practice. Over the past two decades, nurse training has increasingly adopted a psychosocial approach to nursing care raising concerns that, although nurses attending prescribing training may be able to communicate effectively with service users, they may lack the basic knowledge of biology and pharmacology to make effective decisions about medication.
Following the completion of a general nurse prescribing course, mental health nurses who attended were asked to identify their specific needs during the evaluation phase. Although they had covered basic pharmacological principles in their training, they stated that they needed more specific information about drugs used in mental health; particularly how to select appropriate drug treatments for mental health conditions. This paper describes how the nurses were involved in the design of a specific module which would enable them to transfer their theoretical leaning to practice and in so doing increase their confidence in their new roles.
The findings of this study suggest that the understanding and confidence of mental health nurse prescribers about the drugs they prescribe coupled with the information they provide to service users can be improved as a result of specific educational support. It would appear that adopting a prescribing dimension to one's role requires nurses to revisit a number of skills that are integral to the work of the mental health nurse, e.g. good communication, establishing empathy, listening to what clients say, responding to what is required and involving clients in their own care.
Mental health nurses from one particular Trust in the West Midlands were provided with a 'top-up' course in neuropharmacology and, although they found this challenging, ultimately they found this to be helpful. As nurse prescribing is 'rolled out' to other nursing specialities it is important that local Trusts and Workforce Development Directorates maintain a dialogue about nurse prescriber training to ensure that nurse prescribers receive the appropriate time and support for their ongoing Continued Professional Development. As increasing numbers of nurses from different specialities qualify as nurse prescribers it is vital that they are supported by their employing organizations and given the opportunity to maintain their competency and confidence in their prescribing practice.

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    Journal of Advanced Nursing 09/2013; 69(7):1478-1488. DOI:10.1111/jan.12004 · 1.69 Impact Factor
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    04/2008; 5(1). DOI:10.5920/mhldrp.2008.51119
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    ABSTRACT: What is already known about the topic? To date there are in excess of 400 qualified mental health nurse prescribers in the UK but uptake has been slower than was initially anticipated. Some have suggested that one of the main barriers for implementation is the unsupportive behaviours of psychiatrists. A proportion of the medical profession has expressed grave concerns about the safety of nurse prescribing whereas others appear supportive. What this paper adds Overall both professional groups were in favour of mental health nurse prescribing, although significantly more psychiatrists expressed concerns. General beliefs, impact and uses were inter-related constructs as evidenced by high correlation co-efficients. Psychiatrists in particular were concerned with aspects of clinical and legal responsibility and the appropriate Background: In the United Kingdom, mental health nurses (MHNs) can independently prescribe medication once they have completed a training course. This study investigated attitudes to mental health nurse prescribing held by psychiatrists and nurses. Method: 119 MHNs and 82 psychiatrists working in South-East England were randomly sampled. Participants completed a newly created questionnaire. This included individual item statements with 6-point likert scales to test levels of agreement which were summated into 7 subscales. Results: Psychiatrists had significantly less favourable, albeit generally positive attitudes than MHNs regarding general beliefs (63% vs. 70%, p < 0.001), impact (62% vs. 70%, p < 0.001), uses (60% vs. 71%, p < 0.001), clinical responsibility (69% vs. 62%, p < 0.001) and legal responsibility (71% vs. 64%, p < 0.001). More MHNs than psychiatrists believed that nurse prescribing would be useful in emergency situations for rapid tranquilisation (82% vs. 37%, p < 0.001), and that the consultant psychiatrist should have ultimate clinical responsibility for prescribing by an MHN (42% vs. 28%, p < 0.001). Approximately half of all participants agreed nurse prescribing would create conflict in clinical teams. Conclusions: The majority of both groups were in favour of mental health nurse prescribing, although significantly more psychiatrists expressed concerns. This may be explained by a perceived change in power balance.
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May 20, 2014