Speech pathology prescribing in the outpatient setting: A review of requirements, considerations and barriers.
ear nose and throate (ENT)
policy
practice
prescribing
Journal
International journal of language & communication disorders
ISSN: 1460-6984
Titre abrégé: Int J Lang Commun Disord
Pays: United States
ID NLM: 9803709
Informations de publication
Date de publication:
11 2022
11 2022
Historique:
received:
04
01
2022
accepted:
31
05
2022
pubmed:
7
7
2022
medline:
22
11
2022
entrez:
6
7
2022
Statut:
ppublish
Résumé
As health systems face increasing demands, non-medical prescribing is a workforce redesign strategy adopted within some services. Despite successful implementation in other professional groups, non-medical prescribing within speech pathology (SP) has not yet been described. To provide a descriptive account of the development and planned implementation of two SP prescribing models. The evolution of two SP-led prescribing models, including relevant training and credentialing, for use of (1) nystatin oral drops (100,000 units/mL); and (2) lidocaine (lignocaine) and phenylephrine nasal spray (5 mg/500 μg/spray), in the outpatient setting is detailed. Challenges to implementation are outlined. The development of relevant governance structures, a research evidenced-based project evaluation framework, and an overview of training pathways and credentialing was successfully completed. However, implementation of the models was unable to be achieved. A thorough review of the requirements and a discussion of contextual considerations that had a negative influence on the implementation of SP-led prescribing within this specific service context is provided. The successful implementation of SP-led prescribing is complex and highly context dependent. This work offers a discussion and review of the complexities of introducing a non-medical prescribing model in an outpatient hospital setting. What is already known on the subject Allied Health prescribing is an emerging practice area aiming to reduce current pressures on health services. SP-led prescribing has not been thoroughly investigated in the Australian context. What this study adds to existing knowledge This study describes the development of a SP-led prescribing process in the outpatient setting, and a thorough review and discussion of the drivers and barriers to the model's implementation. What are the potential or actual clinical implications of this work? The successful implementation of SP-led prescribing was identified to be complex from a legislative and operational perspective, as well as being highly context dependent. This study further highlights the importance of a thorough context evaluation and workflow mapping prior to full-scale implementation of SP prescribing trials.
Sections du résumé
BACKGROUND
As health systems face increasing demands, non-medical prescribing is a workforce redesign strategy adopted within some services. Despite successful implementation in other professional groups, non-medical prescribing within speech pathology (SP) has not yet been described.
AIMS
To provide a descriptive account of the development and planned implementation of two SP prescribing models.
METHODS & PROCEDURES
The evolution of two SP-led prescribing models, including relevant training and credentialing, for use of (1) nystatin oral drops (100,000 units/mL); and (2) lidocaine (lignocaine) and phenylephrine nasal spray (5 mg/500 μg/spray), in the outpatient setting is detailed. Challenges to implementation are outlined.
MAIN CONTRIBUTION
The development of relevant governance structures, a research evidenced-based project evaluation framework, and an overview of training pathways and credentialing was successfully completed. However, implementation of the models was unable to be achieved. A thorough review of the requirements and a discussion of contextual considerations that had a negative influence on the implementation of SP-led prescribing within this specific service context is provided.
CONCLUSIONS & IMPLICATIONS
The successful implementation of SP-led prescribing is complex and highly context dependent. This work offers a discussion and review of the complexities of introducing a non-medical prescribing model in an outpatient hospital setting.
WHAT THIS PAPER ADDS
What is already known on the subject Allied Health prescribing is an emerging practice area aiming to reduce current pressures on health services. SP-led prescribing has not been thoroughly investigated in the Australian context. What this study adds to existing knowledge This study describes the development of a SP-led prescribing process in the outpatient setting, and a thorough review and discussion of the drivers and barriers to the model's implementation. What are the potential or actual clinical implications of this work? The successful implementation of SP-led prescribing was identified to be complex from a legislative and operational perspective, as well as being highly context dependent. This study further highlights the importance of a thorough context evaluation and workflow mapping prior to full-scale implementation of SP prescribing trials.
Identifiants
pubmed: 35793383
doi: 10.1111/1460-6984.12756
doi:
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1194-1206Informations de copyright
© 2022 Commonwealth of Australia. International Journal of Language & Communication Disorders © 2022 Royal College of Speech and Language Therapists.
Références
Adigwe, O.P. (2012) Non-medical prescribing in chronic non-malignant pain. Doctoral dissertation, University of Leeds.
Allied Health Professions Office of Queensland. (2014) A framework for allied health professional prescribing trials within Queensland Health [Online]. Available: https://www.health.qld.gov.au/__data/assets/pdf_file/0020/158024/prescribing-fwork.pdf [Accessed 01/02/2017 2017].
Armstrong, A. (2015) Staff and patient views on nurse prescribing in the urgent-care setting. Nurse Prescribing, 13, 614-619.
Armstrong, A., Manfrin, A. & Gibson, J. (2021) Non-medical prescribing in primary care in the United Kingdom: an overview of the current literature. Journal of Prescribing Practice, 3, 352-361.
Australian Government. (2000) National Medicines Policy. https://www1.health.gov.au/internet/main/publishing.nsf/Content/B2FFBF72029EEAC8CA257BF0001BAF3F/$File/NMP2000.pdf.
Australian Government Department of Health. (2022) The Pharmaceutical Benefits Scheme [Online]. Available: https://www.pbs.gov.au/info/about-the-pbs [Accessed 17/02/2022 2022].
Bhanbhro, S., Drennan, V.M., Grant, R. & Harris, R. (2011) Assessing the contribution of prescribing in primary care by nurses and professionals allied to medicine: a systematic review of literature. BMC Health Services Research, 11, 1-10.
Borthwick, A.M., Short, A.J., Nancarrow, S.A. & Boyce, R. (2010) Non-medical prescribing in Australasia and the UK: the case of podiatry. Journal of Foot and Ankle Research, 3, 1-10.
Bowskill, D. (2009) The integration of nurse prescribing: Case studies in primary and secondary care. Doctorial dissertation: University of Nottingham. Available at https://eprints.nottingham.ac.uk/11036/1/The_Integration_of_Nurse_Prescribing.pdf
Carey, N., Stenner, K. & Courtenay, M. (2014) An exploration of how nurse prescribing is being used for patients with respiratory conditions across the east of England. BMC Health Services Research, 14, 1-13.
Cooper, R.A. (2006) Quality among a diversity of health care providers. Medical Journal of Australia, 185, 2.
Courtenay, M., Carey, N., Stenner, K., Lawton, S. & Peters, J. (2011) Patients’ views of nurse prescribing: effects on care, concordance and medicine taking. British Journal of Dermatology, 164, 396-401.
Cousins, R. & Donnell, C. (2012) Nurse prescribing in general practice: a qualitative study of job satisfaction and work-related stress. Family Practice, 29, 223-227.
Department of Health (2005) Supplementary prescribing by nurses, pharmacists, chiropodists/podiatrists, physiotherapists and radiographers within the NHS in England: A guide for implementation. https://bulger.co.uk/prison/NurseSuppprescribing.pdf [Accessed 17 February, 2022).
Department of Health (2006a) Guiding principles for medication management in the community. https://www1.health.gov.au/internet/main/publishing.nsf/650f3eec0dfb990fca25692100069854/3b48796d9e2ddd8aca257bf00021ddb8/$FILE/Guiding-principles-for-medication-management-in-the-community.pdf (Accessed 17 febuary, 2022).
Department of Health (2006b) Medicines Matters. A Guide to Mechanisms for the Prescribing, Supply and Administration of Medicines. Department of Health London. https://webarchive.nationalarchives.gov.uk/ukgwa/20130123191451/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_064325 (Accessed 17 febuary, 2022)
Downer, F. & Shepherd, C.K. (2010) District nurses prescribing as nurse independent prescribers. British Journal of Community Nursing, 15, 348-352.
Duckett, S. (2005a) Interventions to facilitate health workforce restructure. Australia and New Zealand Health Policy, 2, 2-14. https://doi.org/10.1186/1743-8462-2-14
Duckett, S.J. (2005b) Health workforce design for the 21st century. Australian Health Review, 29, 201-210.
Emmerton, L., Marriott, J., Bessell, T., Nissen, L. & Dean, L. (2005) Pharmacists and prescribing rights: review of international developments. Journal of Pharmacy and Pharmaceutical Sciences, 8, 217-225.
Gallagher, C.T. (2021a) Simplifying the legal management of controlled drugs as medicines in the UK. Oxford University Press: School of Life and Medical Sciences, University of Herfordshire, College Lane, Hatfield UK.
Gallagher, C.T. (2021b) UK non-medical CD prescribing law: permissive or restrictive? Prescriber, 32, 15-19.
Gielen, S.C., Dekker, J., Francke, A.L., Mistiaen, P. & Kroezen, M. (2014) The effects of nurse prescribing: a systematic review. International Journal of Nursing Studies, 51, 1048-1061.
Graham-Clarke, E., Rushton, A. & Marriott, J. (2021) A Delphi study to explore and gain consensus regarding the most important barriers and facilitators affecting physiotherapist and pharmacist non-medical prescribing. PLoS One, 16, e0246273.
Graham-Clarke, E., Rushton, A., Noblet, T. & Marriott, J. (2018) Facilitators and barriers to non-medical prescribing-A systematic review and thematic synthesis. PLoS One, 13, e0196471.
Graham-Clarke, E., Rushton, A., Noblet, T. & Marriott, J. (2019) Non-medical prescribing in the United Kingdom National Health Service: a systematic policy review. PLoS One, 14, e0214630.
Green, B. & Courtney, H. (2008) Evaluating the investment: a survey of non-medical prescribing. Mental Health Practice, 12, 28-32.
Gridley, K., Strudwick, K., Pink, E. & Nelson, M., (2019) Comparison of emergency physiotherapy practitioner prescribers versus existing emergency department prescribers for musculoskeletal injuries. Emergency Medicine Australasia, 31(6), 935-941.
Hill, D.R., Conroy, S., Brown, R.C., Burt, G.A. & Campbell, D. (2014) Stakeholder views on pharmacist prescribing in addiction services in NHS Lanarkshire. Journal of Substance Use, 19, 56-67.
Hindi, A.M., Seston, E.M., Bell, D., Steinke, D., Willis, S. & Schafheutle, E.I. (2019) Independent prescribing in primary care: a survey of patients', prescribers' and colleagues' perceptions and experiences. Health & Social Care in the Community, 27, e459-e470.
Hobson, R.J., Scott, J. & Sutton, J. (2010) Pharmacists and nurses as independent prescribers: exploring the patient's perspective. Family Practice, 27, 110-120.
Nissen, L. & Bettenay, K. (2016) A review of the prescribing capability of speech pathologists, dietitians and psychologists [Online]. https://www.health.qld.gov.au/__data/assets/pdf_file/0032/158936/prescribing-report.pdf. Available: https://www.health.qld.gov.au/__data/assets/pdf_file/0032/158936/prescribing-report.pdf [Accessed 03/03/2017 2017].
Noblet, T., Marriott, J., Graham-Clarke, E. & Rushton, A. (2017) Barriers to and facilitators of independent non-medical prescribing in clinical practice: a mixed-methods systematic review. Journal of Physiotherapy, 63, 221-234.
Noblet, T., Marriott, J., Hensman-Crook, A., O'Shea, S., Friel, S. & Rushton, A. (2020) Independent prescribing by advanced physiotherapists for patients with low back pain in primary care: a feasibility trial with an embedded qualitative component. PLoS One, 15, e0229792.
Noblet, T.D., Marriott, J.F. & Rushton, A.B. (2019) Independent prescribing by advanced physiotherapists for patients with low back pain in primary care: protocol for a feasibility trial with an embedded qualitative component. BMJ Open, 9, e027745.
Schwarz, M., Ward, E.C., Seabrook, M., Coccetti, A. & Whitfield, B. (2018) Administration of Co-Phenylcaine Forte Nasal spray during nasendoscopy: implementing and evaluating this extended scope role for speech language pathologists. Journal of Clinical Practice in Speech Language Pathology, 20, 70-76.
Stenner, K. & Courtenay, M. (2008) Benefits of nurse prescribing for patients in pain: nurses’ views. Journal of Advanced Nursing, 63, 27-35.
Stenner, K., Van Even, S. & Collen, A. (2021) Paramedic independent prescribing: a qualitative study of early adopters in the UK. British Paramedic Journal, 6, 30-37.
Taylor, G., Boland, C., Dooley, M., Fowler, P., Burridge, N., Mckenzie, D., O'Leary, K., Gordon-Croal, S. & Seaton, S. (2011) SHPA standards of practice for clinical pharmacy (supplement). Journal of Pharmacy Practice and Research, 41, 144-145.
Young, G., Hulcombe, J., Hurwood, A. & Nancarrow, S. (2015) The Queensland Health Ministerial Taskforce on health practitioners’ expanded scope of practice: consultation findings. Australian Health Review, 39, 249-254.