4 Symptom Select therapy Supply and Initiate therapy Monitor and Stat therapy Continue therapy Discontinue Supervision recognition / administer modify therapy therapy diagnose therapy Independent Full Full No Full Full Full Full Full Independent Collaborative Medical Yes No Yes Yes Yes Yes Yes Collaborative prescribing practitioner nominated diagnosis, initial individual treatment decision independent prescriber Supplementary Medical Agreed patient No Agreed patient Agreed patient Agreed patient Agreed patient Agreed patient Nominated prescribing practitioner specific specific specific specific specific specific individual diagnosis, initial management plan management plan management plan management plan management plan management plan independent treatment decision prescriber Patient referral Medical Medical No Medical Management of Management of Management of Management of Delegated by practitioner practitioner practitioner specific therapy or specific therapy or specific therapy or specific therapy or nominated diagnosis, initial diagnosis, initial diagnosis, initial specific specific specific specific individual treatment decision treatment decision treatment decision therapeutic therapeutic therapeutic therapeutic independent outcome outcome outcome outcome prescriber Formulary List of approved Pre-approved No Indirect Criteria for referral Length as per Length as per Length as per Indirect according – treatable formulary to preapproved symptoms according to formulary formulary formulary formulary therapy symptoms Protocol List of approved Pre-approved Yes Protocol driven According to According to According to According to Prescribing treatable formulary symptoms protocol protocol protocol protocol delegated by symptoms according to independent symptoms prescriber Patient List of approved Written direction Supply and No No Yes No No Nil delegated – direction treatable under administration under symptoms written under approved protocols approved conditions and protocols protocols Medical Medical Supply (only) No No No Yes previously No Nil delegated Repeat prescribing – – (continuance) practitioner practitioner sufficient next prescribed pre-approved diagnosis, initial diagnosis, initial appointment medication only conditions – treatment decision treatment decision no modification Administration List of Pre-approved Administer for No No According to No No Nil- delegated treatable formulary immediate approved protocol under symptoms according to treatment only approved symptoms conditions and protocols
4 Symptom recognition / diagnose Select therapy Supply and administer therapy Initiate therapy Monitor and modify therapy Stat therapy Continue therapy Discontinue therapy Supervision Independent Full Full No Full Full Full Full Full Independent Collaborative prescribing Medical practitioner diagnosis, initial treatment decision Yes No Yes Yes Yes Yes Yes Collaborative nominated individual independent prescriber Supplementary prescribing Medical practitioner diagnosis, initial treatment decision Agreed patient specific management plan No Agreed patient specific management plan Agreed patient specific management plan Agreed patient specific management plan Agreed patient specific management plan Agreed patient specific management plan Nominated individual independent prescriber Patient referral Medical practitioner diagnosis, initial treatment decision Medical practitioner diagnosis, initial treatment decision No Medical practitioner diagnosis, initial treatment decision Management of specific therapy or specific therapeutic outcome Management of specific therapy or specific therapeutic outcome Management of specific therapy or specific therapeutic outcome Management of specific therapy or specific therapeutic outcome Delegated by nominated individual independent prescriber Formulary List of approved treatable symptoms Pre-approved formulary according to symptoms No Indirect – formulary Criteria for referral Length as per formulary Length as per formulary Length as per formulary Indirect according to preapproved therapy Protocol List of approved treatable symptoms Pre-approved formulary according to symptoms Yes Protocol driven symptoms According to protocol According to protocol According to protocol According to protocol Prescribing delegated by independent prescriber Patient direction List of approved treatable symptoms Written direction under protocols Supply and administration written under protocols No No Yes No No Nil – delegated under conditions and protocols Repeat prescribing (continuance) Medical practitioner diagnosis, initial treatment decision Medical practitioner diagnosis, initial treatment decision Supply (only) sufficient next appointment No No No Yes – previously prescribed medication only – no modification No Nil – delegated pre-approved conditions Administration List of approved treatable symptoms Pre-approved formulary according to symptoms Administer for immediate treatment only No No According to protocol No No Nil- delegated under conditions and protocols approved approved approved
Background%20Paper%20-%20Registered%20Nurse%20Midwife%20Prescribing%20Symposium%20March.docx