Non-medical Prescribing in the Acute Setting: A Case Report

Within NHS Lothian an advanced nurse practitioner is required to have completed Masters level education in patient history taking, clinical examination and non-medical prescribing (NMP) before they can prescribe independently. A definition for advanced nursing practice is followed by an overview of the roles and responsibilities of the Hospital at Night Team (HAN) at the Royal Infirmary of Edinburgh. A case study based on a commonly encountered request for patient review illustrates the application of NMP in advanced nursing practice and provides the clinical context for the discussion that follows. The focus of the discussion is the complexities of prescribing for an elderly patient including immunosenescence, polypharmacy and adverse drug reactions. Standards for education and continuing professional development (CPD) are required to support the safe practice of NMP. This is especially relevant to HAN non-medical prescribers due to the wide range of medications they prescribe. For the purposes of confidentiality all identifying patient details have been removed.