Non-medical prescribing in critical care: A mixed methods study.

BACKGROUND: Little is known about non-medical prescribers in critical care in the United Kingdom. In 2007, a small survey identified few non-medical prescribers; however, in the intervening years, there have been many changes to the Medicine Act 1968. It is likely that prescribing within the non-medical workforce in critical care has changed significantly. AIM/S: This survey aimed to explore the breadth and diversity of prescribing practices of non-medical prescribers working within the wider critical care environment in the United Kingdom. METHOD: Data were collected via an online questionnaire adapted from the 2007 version and distributed by the BACCN to their members between 26th October 2021 and 19th November 2021. Freedom of Information requests were made to the Nursing and Midwifery Council, The Health and Care Professions Council and the General Pharmaceutical Council to understand the number of non-medical prescribers. RESULTS: The survey elicited 259 responses; 105 respondents identified themselves as non-medical prescribers, and 57 used Patient Group Directions only. In the ICU/HDU, 75 respondents identified as non-medical prescribers, with an additional 45 using Patient Group Directions. CONCLUSION: Since the last survey, there has been a large increase in the number and representation across all professional groups identifying as a non-medical prescriber and/or utilising patient group directions across critical care. Many staff responded to this survey who were neither NMPs nor utilising PGDs; of these, a large proportion were interested in taking on this additional responsibility. IMPLICATIONS FOR PRACTICE: Many people working within critical care are interested in becoming non-medical prescribers. Assists with understanding characteristics of those working as non-medical prescribers within critical care. Shows variations in practice in respect to PGDs, authorising of blood products and prescribing.

Pain assessment tools for use with children in acute pain in the emergency department.

There is a lack of timely administration of an appropriate analgesic for children in acute pain in emergency departments in the UK and elsewhere. Unrelieved acute pain may result in deterioration in a child's physical and psychological condition therefore assessment is essential to enable triage nurses to offer an appropriate analgesic. This should be achieved by using a validated pain assessment tool which, where appropriate, enables the child to self-report their pain. This article describes various validated pain assessment tools for use with children with acute pain and considers how triage nurses can determine which is the most appropriate to use. Regardless of which tool is selected, it is important to offer the child an analgesic and to reassess their pain at appropriate intervals.