message for instructions28 | Community Practitioner April 2013 Volume 86 Number 4


Christina Brooks RN (Adult) RM SCPHN (HV)
BSc(Hons) Community Practitioner Nurse Prescriber
Clinical Team Leader for Health Visiting and
School Nursing
Leicestershire Partnership Trust

[email protected]

Key words
Non-medical prescribing, health visitors, clinical
updates, support, V100, Call to Action

Prescribing is an essential element of the health
visitor’s role. However, in one inner-city locality
prescribing in practice was evaluated to be at
a low level. A number of barriers to prescribing
were identified through a focus group. A project
to support health visitors was planned and
delivered. The project involved clinical updates
and improvement to the registration process,
thereby reducing delays for practitioners in
getting prescribing pads. The result was that
prescribing confidence improved and prescribing
activity increased.

Community Practitioner, 2013; 86(4): 28–30.

Conflict of interest: none

Developing health visitor prescribing
Non-medical prescribing (NMP), specifically

the V100 qualification, has been an inherent

part of health visitor and district nurse

training since 1999 (While and Biggs, 2004). It

is also an important element of the specialist

community public health nursing (SCPHN)

course for health visitors and school nurses.

However, evidence, both anecdotal and

through a data activity report taken from the

online prescription services database ePact,

demonstrated that prescribing activity in

the health visiting service was at a low level.

Therefore, a project to develop non-medical

prescribing in the health visiting and school

nursing services in an inner city locality

was planned.

Background and context
NMP was first proposed in the Crown Report

(Department of Health (DH), 1989). The

benefits to clients identified in the report

included better use of time for clients and

nurses, and improved patient care.

NMP has evolved to allow allied health

professionals and nurses to prescribe from

the whole British National Formulary (BNF)

within their specialty. This has been evaluated

as beneficial for clients, nurses and their

organisations (Courtenay, 2010). This form

of prescribing is known as independent

prescribing and the qualification is called

V300; however, this project focused on

community practitioner nurse prescribers

who have the V100 qualification; specifically,

health visitors. This qualification allows

health visitors, school nurses and district

nurses to prescribe for their clients from the

Nurse Prescribers’ Formulary for Community

Practitioners (NPF).

There are now more than 50,000 nurse

prescribers registered with the Nursing and

Midwifery Council (NMC) (Culley, 2010).

However, although health visitors were

among the first professionals to adopt the

role, enthusiasm remaiSAMPLE SHEET

Impacting Factors Tool Resource

Instructions: Use this tool to document your assessment of the factors impacting the capstone project. Be sure to cite and reference necessary sources according to APA format, using the last page for your reference list.

Name: ______________________________________________________________________

Stakeholder Identification and Engagement Strategies to Secure Support

SWOT based on
Statement from WS One. Each SWOT
will be

Stakeholder- anyone person or organization affected by or through the changed process.

· Patients
· Patients family members
· Organizational departments
· Co-workers
· Physicians

Engagement Strategies to secure support-

· Communicate plan clearly and consistently
· Acquire management buy in
· Background research to support proposal

SWOT Analysis-is used to complete an objective analysis of the capstone project.

Strengths and
Weaknesses are internal organizational factors that may be controlled within the organization.

Opportunities and Threats are external factors to the organization that cannot be controlled by the organization.

Opportunities not acted upon can become threats.

present within the organization that support the planned change process.

· Co-workers knowledgeable of the ACA
· Strong unit manage supportive of project
· Robust organization reputation

present within the organization that could be barriers or challenges to the planned change process.

· Chief medical officer unreceptive to change
· Weak internal communication process
· Cash flow problems
· Poor organizational morale


· The ACA requires the Hospital Readmissions Reductions Program
· Loyal customers
· Protect hospital income


· Failure to meet discharge readmission rates mandated will result in loss of income.
· Other organizations have decreased discharge readmission rates.
· Loss of income could result in employee lay offs

Financial Implications of the Capstone Project

· What is the cost of the project to the organization and the patient?
· Is there any potential income that may result from the planned change?
· Will the potential income from the planned change be more than the cost of the project?
· What is the cost-savings to the patient?

External Influencing Factors-any factors external to the organization that influence the project. External factors will vary from project to project.

External stakeholder engagement and support

· Patients, community members, collaborative partners, businesses, fellow healthcare agencies, and others
· Collaboration with stakeholders should occur early in the process, and be maintained throughout the planned change process

Evidence-based, best practice s

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