Nurses and pharmacists as independent prescribers: what is effective clinical supervision?

Bullingham, Rebecca 2021. Nurses and pharmacists as independent prescribers: what is effective clinical supervision? PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

In the United Kingdom, pharmacists and nurses who have completed a university accredited course can independently prescribe medicines within their scope of practice. Independent Prescribers (IPs) have th e same prescribing access to medicines as a doctor. However, after qualification, insufficient clinical supervision (CS) for IPs has been reported. CS has broadly been criticised in healthcare for not being adequately defined, resulting in ‘pot luck’ CS ex periences, usually driven by the supervisor. In Phase 1, semi structured interviews with nurse (n=6) and pharmacist (n=10) IPs working in primary care in Wales were conducted to explore IPs’ perceptions of effective CS. Interview findings were used to deve lop a modified Delphi survey for a sample of IPs in Phase 2 to identify whether there was consensus amongst nurse and pharmacist IPs on what is required for effective clinical supervision. In P hase 2, 22 IPs (n=7 nurses, n=15 pharmacists) responded to roun d one of the Delphi survey exploring the purpose, characteristics and structure of CS. In round two, 16/22 (72.7%) responded to the Delphi survey exploring the structure and characteristics of CS. Nine statements met consensus in round one and four statem ents in round two. The consensus statements were used to create an Informed Model of Supportive Supervision (TIMSS) which was shown to key independent prescribing stakeholders in Wales in P hase 3 of the research. For P hase 3, semi structured individual (n= 7) and group (n=2) interviews with independent prescribing key stakeholders in Wales were conducted to explore perceptions of TIMSS and the governance of IPs in primary care. Findings were used to amend the TIMSS model. The three phases of research suggest that regulatory and professional bodies, policy makers and IPs need to reflect on the governance arrangements for IPs and further develop the role of CS and the TIMSS model in supporting confident and competent clinical practice.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Pharmacy
Subjects:	Q Science > Q Science (General)
Date of First Compliant Deposit:	6 September 2021
Last Modified:	03 Aug 2022 01:39
URI:	https://orca.cardiff.ac.uk/id/eprint/143897

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