Non Medical Prescribing

Case Study 1: Trimethoprim for lower Urinary Tract Infection.

Background.
For the purpose of this case study and to protect anonymity, the patient will be referred to as Sarah. The patient is a 29 year old woman, whom presented herself to Accident and Emergency with lower abdominal ache, frequency of micturition and dysuria for 24 hours.

The author works as an Advanced Nurse Practitioner (ANP) and was asked to perform an assessment of Sarah as well as diagnose and discuss treatment options with her. Working under the supervision of her designated medical practitioner, the author diagnosed Sarah with a lower urinary tract infection and prescribed 200 mg of trimethoprim, to be taken orally, at 12 hour intervals for 3 days, until the course of treatment was completed. The decision to prescribe this drug will be examined throughout this case study.

2.3: Makes an accurate assessment and diagnosis and can generate treatment options
Non- Medical Prescribers (NMP) are responsible and accountable for the assessment of patients with undiagnosed or diagnosed conditions and for decisions about clinical management required, including prescribing (Scottish Executive Health Department, 2006).

Effective communication is the basis for good prescribing practice. According to Lewis and Allen (2002), this means building a relationship built on trust and mutual respect. This can be achieved by listening to and understanding patients’ expectations, needs and beliefs. Working in partnership with patients’ will help them to make informed choices, understand their treatment and encourage them to take responsibility for their health.

To build rapport, the author began the consultation with a greeting, introduction and explaining the role of an ANP. A consultation provides the opportunity for patients to tell their story with an unfolding of symptoms, feelings and problems. However, stories are usually told in unstructured ways and the use of an assessment model helps the...