The School Of Nursing And Midwifery. SNM3223/624 NURSE / MIDWIFE INDEPENDENT / SUPPLEMENTARY PRESCRIBING PROGRAMME STUDENT HANDBOOK 1 MARCH 2012 2 CONTENTS Page No. Introduction and welcome 3 Programme Administration 4 Pre-course preparation 4 Programme teaching team 5 The programme 6 Aims 6 Structure 6 Learning outcomes 6 Indicative course content 7 Teaching and learning strategies 9 Assessment 10 Seen structured examination 10 Unseen examination 11 Case studies and assignments 12 Clinical Competence 12 Portfolio 13 Assessment calendar 14 Student Support 15 3 Student Representation 15 Key Texts, Journal and Websites 16 Appendix A Portfolio feedback sheet 17 Appendix B Sample portfolio title page 18 Introduction and welcome I would like to extend a very warm welcome to you from the University of Sheffield and the nurse prescribing teaching team. This handbook introduces the course and provides important information that is intended to be useful to you as you pursue your study. This education programme aims to prepare nurses and midwives to prescribe safely, appropriately and cost-effectively as an independent/supplementary nurse prescriber in a rapidly changing practice environment. In addition it aims to enable you to meet the Nursing and Midwifery Councils standards, in order to be recorded as an independent/supplementary prescriber on the professional register. Information contained in this handbook is up to date at the time of publication 4 but national, professional and university standards, processes and policies regarding non-medical prescribing are constantly changing. It is your responsibility to keep abreast of the changes by reviewing the Department of Health website and ensuring that you always have access to and use the up to date British National Formulary. The course and the Programme Co-ordinator Debbie Turner (0114 2222065, d.a.turner@shef.ac.uk) are based at Samuel Fox House, Northern General Hospital, Herries Road, Sheffield S5 7AU. The teaching team look forward to getting to know you and hope that you find the course informative, stimulating and enjoyable. Derek Darling Nurse Prescribing Programme Leader Programme Administration 5 This 26 week integrated theoretical and practical course is validated by the University of Sheffield and approved by the Nursing and Midwifery Council (NMC) and meets the standards outlined in the Standards of proficiency for nurse and midwife prescribers. (NMC 2006) and The University of Sheffield Calendar. In addition, it takes account of the Department of Health guidance, Supplementary prescribing by nurse/pharmacist/ chiropodist/ physiotherapist and radiographers within the NHS in England (2005) and the National Prescribing Centre (NPC) “Maintaining Competency in the Prescribing Framework (2003).. Pre- course preparation The course application criteria are set down by the University of Sheffield, the Department of Health (2005) and the NMC (2006) The NMC requires employers to undertake an appraisal of a registrant’s suitability to prescribe before they apply for a training place. Employers must also have the necessary clinical governance infrastructure in place (including a Criminal Records Bureau check) to enable the registrant to prescribe once they are qualified to do so. Where the registrant is not undertaking a module to prepare them in diagnosis and physical assessment alongside the nurse/midwife independent/supplementary prescribing programme, then the employer is responsible for confirming that: • The applicant has been assessed as competent to take a history, undertake a clinical assessment and diagnose, before being put forward. • There is clinical need within the registrant’s role to justify prescribing. • The applicant has sufficient knowledge to apply prescribing principles taught on the programme of preparation to their own area and field of practice. • The applicant must be able to demonstrate appropriate numeracy skills (these will be further developed within the context of prescribing and assessed on the course). 6 It is also advisable that the prospective student refresh basic numeracy skills and knowledge of anatomy and physiology before starting the programme. 7 The Programme Team The multi-professional course teaching team is made up of nursing lecturers, specialist practising nurses, a medical doctor and a pharmacist, chosen because of their particular expertise. They cover both primary and secondary care elements within the course. As members of the course steering group they advise on ongoing course development and planning. In addition, each student cohort is encouraged to select a student to represent them on the course steering group. Tracey Moore Head of Taught tracey.moore@sheffield.ac.uk Studies University 0114 of 2222056 Sheffield Derek Darling Programme Leader d.darling@sheffield.ac.uk University 0114 of 2222041 Sheffield Angela Walker Programme Facilitator a.j.walker1@sheffield.ac.uk University 0114 of 2222070 Sheffield Debbie Turner Programme Co- University 0114 d.a.turner@sheffield.ac.uk ordinator of 2222065 Sheffield Dr. Pankaj Chaturvedi Consultant Physician / Doncaster Associate Lecturer & Bassetlaw NHS Trust Jacqui Holcombe Course Tutor BTEC Sheffield Pharmacy Services / College Associate Lecturer Melanie Stevens Nurse Practitioner / Sheffield Associate Lecturer Teaching 8 Hospitals NHS Trust Vacancy Student representative The Programme Aims The education programme aims to prepare nurses and midwives to prescribe safely, appropriately and cost-effectively as an independent/supplementary nurse prescriber in a rapidly changing practice environment. In addition, it aims to enable participants to fulfil the Nursing and Midwifery Council’s criteria in order to be recorded on the Professional Register as an independent/supplementary prescriber. In addition, on successful completion of the programme, the University of Sheffield will award 40 academic credits at degree level 6, (formally level three) or 30 credits at master’s level, depending on the level of study determined when registering with the University. 9 Structure The attendance pattern is part time over a period of six months and comprises a total of 38 days study. These days are made up as follows 14 days attendance at the University 12 days independent study 12 days (90 hours) supervised assessed practice The 12 days (90 hours) in supervised clinical practice are completed in between the study days to fit in with the student’s normal working practice. The School of Nursing and Midwifery is obliged to provide information about attendance to the course purchasing Strategic Health Authority. Maximum attendance is the expected norm and absences in excess of 20% of the taught course are not permitted. If this is the case your manager will be notified. You are required to attend a minimum of 80% of the overall attendance (i.e. not having more than 5 days absence). If you do not attend 80% you will be informed in writing and be deemed withdrawn from the course. In this case, if you wish to complete the course re-application through the usual nomination procedure is required. Learning Outcomes The learning outcomes, set out below, reflect the nationally prescribed learning outcomes as defined by The Department of Health in ‘Supplementary Prescribing by Nurses and Pharmacists within the NHS in England’ (DH 2005) and The Nursing and Midwifery Council ‘Standards of Proficiency for Nurse and Midwife Prescribers’ (2006) The learning outcomes of the programme at degree level enable the practitioner to: 1. Assess and consult with patient, clients, parents and carers 10 2. Undertake a thorough history, including medication history and current medication (including over-the-counter, alternative and complementary health therapies) to inform diagnosis 3. Understand and apply the relevant legislation to the practice of nurse/midwife prescribing 4. Critically appraise, use sources of information / advice and decision support systems in prescribing practice 5. Understand the influences that can affect prescribing practice, and demonstrate your understanding by managing your prescribing practice in an ethical way 6. Understand and apply knowledge of drug actions in prescribing practice 7. Demonstrate an understanding of the roles and relationships of others involved in prescribing, supplying and administering medicines 8. Prescribe safely, appropriately and cost effectively 9. Practise within a framework of professional accountability and responsibility 10. Develop a clinical management plan within legislative requirements (supplementary prescribing only) 11. If prescribing for children, demonstrate appropriate history taking, undertake a clinical assessment and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults. The learning outcomes of the programme at masters level enable the practitioner to: 1. Critically evaluate the impact of pharmacokinetics and pharmacodynamics on the individual and the implications for prescribing practice. 2. Critically evaluate the relevant legislation and it’s application to the practice of nurse/midwife prescribing 3. Critically appraise sources of information/advice and decision support systems in prescribing practice 4. Critically evaluate the influences that can affect prescribing practice, and demonstrate understanding by managing prescribing practice in an ethical way 5. Critically evaluate the roles and relationships of others involved in prescribing, 11 supplying and administering medicines 6. Undertake a thorough history including medication history and current medication (including over-the-counter, alternative and complementary health therapies) to inform diagnosis 7. Assess and consult with patient/clients, parents and carers 8. Prescribe safely, appropriately and cost effectively. 9. Practise within a framework of professional accountability and responsibility 10. Develop a clinical management plan within legislative requirements. 11. If prescribing for children, demonstrate appropriate history taking, undertake a clinical assessment and make an appropriate diagnosis, having considered the legal, cognitive, emotional and physical differences between children and adults. Indicative Content Consultation, decision-making and therapy, including referral • Models of consultation • Accurate assessment, history taking, communication and consultation with Patients / clients and their parents / carers • Concepts of working diagnosis or best formulation • Development of a management plan and/or clinical management plan • Confirmation of diagnosis/differential diagnosis - further examination, investigation, and referral for diagnosis • Prescribe, not to prescribe, non-drug treatment or referral for treatment • Numeracy and drug calculations • Stopping medication prescribed by others • Medicines review Influences on, and psychology of, prescribing • Patient / client demand, and preference versus patient / client need – knowing when to say ‘no’ • External influences, eg. Pharmaceutical companies or colleagues • Patient/client partnership in medicine-taking, including awareness of cultural and ethnic needs • Concordance, as opposed to compliance • Achieving shared understanding and negotiating a plan of action 12 Prescribing in a team context • Rationale, adherence to, and deviation from national and local guidelines, local formularies, protocols, policies, decision support systems and formulae • Understanding the role and functions of other team members • Documentation, with particular reference to communication between team members, including electronic prescribing • Auditing, monitoring and evaluating prescribing practice • Interface between multiple prescribers and management of potential conflict • Budgets and cost effectiveness • Dispensing practice issues Clinical pharmacology, including the effects of co-morbidity Pharmacology, including pharmacodynamics, pharmacokinetics, pharmaco therapeutics Anatomy and physiology as applied to prescribing practice and community practitioner formulary Basic principles of drugs to be prescribed, eg. absorption, distribution, metabolism and excretion, including adverse drug reactions (ADR) Interactions and reactions Patient / client compliance, concordance and drug response Impact of physiological state on drug responses and safety, for example, in elderly people, newborn babies, children and young people, pregnant or breast feeding women Pharmaco-therapeutics related to controlled drugs Evidence-based practice and clinical governance in relation to nurse prescribing • Rationale, adherence to and deviation from national and local guidelines, protocols, policies, decision support systems and formulae • Continuing professional development - role of self and role of the organisation • Management of change in prescribing practice • Risk assessment and management, including safe storage, handling and disposal • Clinical supervision • Reflective practice / peer review • Critical appraisal skills 13 • Auditing practice and scrutinising data, systems monitoring • Identify and report adverse drug reactions and near misses • Prescribing controlled drugs • Prescribing and administering • Prescribing and dispensing Legal, policy and ethical aspects • Sound understanding of legislation that impacts on prescribing practice • Legal basis for practice, liability and indemnity • Legal implications of advice to self-medicate including the use of alternative therapies, complementary therapy and over-the-counter (OTC) medicines • Safe-keeping of prescription pads, action if lost, writing prescriptions and record keeping • Awareness and reporting of fraud (recommendations from the Shipman Inquiry, (Fourth Report) • Drug licensing • Yellow Card reporting to the Committee of Safety on Medicines (CSM) and reporting patient/client safety incidents to the National Patient Safety Agency • Prescribing in the policy context • Manufacturer’s guidance relating to literature, licensing and off-label • Ethical basis of intervention • Informed consent, with particular reference to client groups in learning disability, mental health, children, critically ill people and emergency situations • Legal implications and their application to supplementary prescribing Professional accountability and responsibility • The NMC Code of Professional Conduct; Standards for Conduct, Performance, and Ethics (2008) • NMC Standards for Prescribing Practice (2006) • Ethical recommendations from the Shipman Inquiry, Fourth Report • Accountability and responsibility for assessment, diagnosis and prescribing • Maintaining professional knowledge and competence in relation to prescribing • Accountability and responsibility to the employer 14 Prescribing in the public health context • Duty to patient / clients and society • Policies regarding the use of antibiotics and vaccines • Inappropriate use of medication, including misuse, under-use and over-use • Inappropriate prescribing, including over-prescribing and under-prescribing • Access to health care provisions and medicines • Prescribing in its broadest sense, e.g. exercise Teaching and learning strategies The teaching and learning methods used reflect the programme philosophy, which recognises previous learning, expertise and experience of the individual student and group as a whole, and values independent learning based on critical reflection. The teacher is seen as a facilitator of learning and partner in the learning experience. Peer group learning is actively exploited in order to promote the presentation of differing and challenging viewpoints of the diverse aspects of prescribing and develop professional support networks. In order to accommodate the various learning styles of the participants, a wide variety of teaching and learning methods are used to help students gain knowledge and develop independent critical thinking skills and competence. The teaching and learning methods used include the following: Problem solving approaches using case studies, group work and project work will enable the student to demonstrate an ability to assess and manage prescribing scenarios in conjunction with peers. This will foster a notion of individual and collective thought, enquiry and the ability to demonstrate innovative ideas, thus encouraging and enhancing a team approach; Guided study will provide a structured opportunity for learning in specific prescribing areas. Lectures will provide a medium through which you access the main knowledge base areas. 15 Experiential learning, such as role play situations, will be utilised as appropriate to develop and explore interpersonal skills, as well as a safe environment within which to develop therapeutic skills and to express and reflect upon personal feelings; Seminars will facilitate the broadening of theoretical knowledge and the ability to locate, correlate and reflect upon the relationship of theory to practice. In addition it will allow you to develop presentation skills. Random case analysis taken from your own practice will allow in-depth analysis and reflection of treatment scenarios, patient care and prescribing behaviour. The case analysis will be documented in your portfolio. A portfolio of learning will be used as a means of facilitating and recording critical thinking and reflection and be used as evidence to support your claim for competence and thus the professional and academic awards. You will be encouraged to explore and develop their particular clinical interests. The portfolio approach recognises your autonomy and personal experience and provides opportunities for the development of independent, student centred lifelong learning skills. Supervised assessed clinical practice facilitates the integration of prescribing theory and practice and enables you to gain clinical competencies in a safe, supported environment. Progress and achievement will be recorded in the “The Assessment of Practice Record” MOLE2 The University of Sheffield operates an internal communication system called MOLE2. Once you are registered with the University and have a university computer username and password you can access this system. The course leaders will use it extensively to communicate with group members and will post notices, announcements, useful resources, information updates and lecture handouts on there, so it is important that you access it regularly for information. You can also access the university wide groups and forums that you may be interested in. Assessments 16 The standards for assessment of the programme are prescribed by the Nursing and Midwifery Council and The University of Sheffield. A range of assessment strategies will be employed to test knowledge, decision-making, competence, and the application of theory to practice. You must undertake and successfully complete all assessments. Two attempts at each assessment are allowed. Should you not be successful at these two attempts, you will be required to repeat the whole programme, including the theory and practice, before undertaking the assessments again. The assessments include the following: Seen structured examination Unseen examination Four case studies using the Seven Principles of Prescribing Four assignments of 2,000 words each. Assessment of clinical competencies Portfolio SEEN STRUCTURED EXAMINATION This examination takes the form of an adapted Objective Structured Clinical Examination (OSCE), which is a systematic and detailed examination of practice within a simulated learning event relevant to the registrant’s area / field of practice. This examination takes place in a classroom under strict examination conditions. A clean copy of the British National Formulary may be taken into the examination room The examination comprises the following elements: Part one You will identify a drug which is used within your own practice. Knowledge will be demonstrated by discussing the indications, cautions, contra-indications, side 17 effects, and dose for the identified drug. Ten minutes is allocated to complete the task. Part two You will be required to write a legally correct prescription for the drug discussed in part one. Ten minutes is allocated to complete the task. A copy of a FP 10 prescription will be issued within the examination pack. If, however, you use a different prescription format in personal clinical practice (e.g. inpatient drug sheet) it is your responsibility to bring the relevant prescription sheet to complete for the exam. Failure to bring this will result in a fail, as you will not be in a position to complete the examination. Part three You will be required to critically analyse the drug that has been prescribed and demonstrate a wider knowledge of the stated drug, including the research and evidence base for its use. Thirty minutes is allocated to complete the task. Marking Criteria Part one and two of the seen examination will be assessed against the standards and information outlined in the British National Formulary and is on a pass / fail basis. Part three is also pass / fail, using the pass mark criteria set at 40% in the University of Sheffield 100 point scale for diploma/degree students. The marking criteria can be found in the additional “General Student Handbook”. UNSEEN EXAMINATION This examination aims to test your numerical skills and knowledge of 18 pharmacology and its application to prescribing practice. A mock examination is provided for you to practice this examination prior to the event, which takes place in a classroom under strict examination conditions. A clean copy of the Nurse Prescribing Formulary, British National Formulary may be taken into the examination. An electronic calculator may also be used during the examination, as long as the calculator is a simple standard model, which has been approved by the University of Sheffield’s Computer and Information Services (CICS). The examination is in two parts. Part one – Pharmacology Consists of twenty short answer or multiple choice style pharmacology or pharmacology related questions. You must achieve a minimum 80% pass in order to be successful. These are generic questions in order to ensure that all candidates, whatever their field of practice, will have an equal opportunity to be successful. One hour is allocated to complete this task. Part two - Drug calculation Consists of five drug calculation questions and a 100% pass mark is required in order to be successful. Thirty minutes is allocated for this task. CASE STUDIES Four case studies will be written, each of which will comprise a brief outline of the prescribing scenario using the Seven Principles of Prescribing. These can be in the form of short / briefing notes. ASSIGNMENTS 19 Four 2000 word assignments will be written, arising from the four case studies. Each assignment will take one issue arising from the reflection section in one of the case studies and develop an academic discussion based on a critical evaluation of the literature and its application to clinical practice. (N.B. if you work with children then at least one case study should focus on prescribing for a child). The assignments will be assessed using the University of Sheffield marking criteria (pertinent to the level undertaken i.e. degree or masters) which can be found in the “General Student Handbook”. CLINICAL COMPETENCE The competencies for assessment of practice are based upon the National Prescribing Centre “Maintaining Competency in the Prescribing Framework” (National Prescribing Centre, 2003) You will be supervised and assessed in practice by a Designated Medical Practitioner and the outcomes recorded in the “Assessment of Practice Record” Assessment of competence will utilise any one of the following methods: Direct observation by the assessor or other designated medical practitioner Question and answer to assess underpinning knowledge Reflective discussions between the assessor and the student Simulation (only if an opportunity to demonstrate a performance outcome has not been available) Whilst the designated medical practitioner is the named supervisor / assessor it is important that co-mentorship and support is provided by a non medical prescriber from your own area, wherever possible. In addition a diary/log of the required 90 supervised practice hours should be completed, with some detail of the activities undertaken during each practice session. 20 In order for the assessment of practice to progress, the academic mentor will undertake a placement audit prior to the beginning of the course, if an audit has not been undertaken within the last two years. He/she will meet with you and the designated medical practitioner and nurse / midwife prescriber co-mentor for discussion. Assessment of Competence This is assessed on a pass/fail basis. When the assessor is satisfied that you have achieved each performance outcome safely, effectively and consistently to the required standard it will be signed off as competent. The intermediate formal preview of progress will conducted on a tripartite basis, with your academic mentor present. This will need to be arranged at a mutually convenient date and time. The academic mentor will also sign the assessment record once it has been completed. In addition, a final report on your conduct, attitude and motivation as a potential nurse/midwife prescriber will also be completed by your designated medical practitioner. N.B. Where you are in a professional position to prescribe for children this should be identified and assessed by a medical supervisor who is competent to prescribe for children. If for any reason there is a lack of opportunity to demonstrate performance then the course leader should be informed and strategies agreed to address this. In some circumstances it may be necessary to seek an extension. PORTFOLIO A portfolio of learning and evidence of achievement of the stated learning outcomes will be developed throughout the programme. A range and combination of evidence will be provided as evidence of application of theory to practice, through critical analysis and reflection on personal prescribing practice. Therefore, each student’s portfolio will be different, as it will be individual and 21 personal. However, it will contain a number of essential elements, which should be cross referenced to the NMC learning outcomes and include the following: A contents page and an organisational grid cross matching the contents to the NMC learning outcomes. A brief introduction to your professional role and justification for becoming an Independent / Supplementary Nurse Prescriber. A diary/log sheet showing how the 90 hours in supervised practice was spent. If prescribing for children, this should be indicated. Four case studies. Four 2000 word assignment that reflect wider issues concerning professional ethical or legal aspects of prescribing. Evidence of numeracy skills, writing prescriptions and prescribing in a range of scenarios. Reflective accounts. A Clinical Management Plan (Supplementary Prescribers only) Care should be taken to avoid plagiarism and ensure that the confidentiality of clients / patients, colleagues and organisations is maintained throughout. See Plagiarism packages and notes given on day 1 and seek guidance from your academic supervisor in case of doubt about exactly what this means. The portfolio must be submitted in a soft binder (not a ring binder or lever arch file) on the last day of the programme, together with the open learning DVD and an electronic copy of the four assignments. Portfolio Marking Criteria The assignments in the portfolio will be marked using the School of Nursing and Midwifery Marking Criteria. Assessment Calendar Assessment Date Publication of results Seen OSCE Examination 24.5.2012 Ratified 30.7.2012 Seen OSCE Examination Re-sit 28.8.2012 Ratified 29.10.2012 22 Unseen Examination 2.8.2012 Ratified 24.9.2012 Unseen Examination Re-sit 22.10.2012 Ratified 26.11.2012 Portfolio Submission 16.8.2012 Ratified 29.10.2012 Portfolio Resubmission 23.1.2013 Ratified 25.2.2013 NB Further important information Further important information about the rules, regulations, policies and procedures of this University course can be found in the “General Student Handbook” which should be read in conjunction with this Independent/Supplementary Nurse/Midwife Prescribing Programme Handbook. It includes the following topics. Receipt and collection of course work Publication of results Marking criteria Grievances procedures Course Evaluation Plagiarism Confidentiality Failure to meet standards Attendance Extensions Harvard referencing system Welfare and support Changes in personal details Car parking Catering Resources The School of Nursing and Midwifery general handbook can be found at http://www.shef.ac.uk/snm/current/undergrad_cpd The programme will reflect the University of Sheffield rules and regulations. A copy of these can be found at: http://www.shef.ac.uk/ssid/atoz.html#R 23 Student Support You will be allocated an academic mentor from within the programme teaching team, who will support you in the production of the written assignments and with your progress generally. The Designated Medical Practitioner will support you in practice. Your academic mentor will meet with you and your DMP in clinical practice for your intermediate assessment and will monitor your progress. You are advised to identify an experienced independent / supplementary prescriber who can assist you in the application of the programme principles and content to the role of independent / supplementary prescriber. You will be invited by email to join MOLE2 where you will find all the documentation for the course, a discussion page, and links to other important internet sites. Student Representation The University places great value on the opinions of its students; and there are numerous opportunities for you to get involved at both departmental and faculty level on a variety of committees. This gives you the opportunity to have your voice heard and also to represent the views of other students. Please see your programme/unit lead if you wish to be a student representative. These opportunities are supplemented by a range of surveys and evaluations which you will be invited to participate in. If you do not wish to be involved in student representation but would like to comment on your experience or make a contribution to programme/school governance then you are encouraged to visit the following website where you can comment on issues that will contribute to discussion at the Staff Student Committee, Board of Studies and Teaching and Learning Committee. Key Texts 24 Courtenay M and Griffiths M (eds) (2010) Independent and Supplementary Prescribing: An Essential Guide. Second edition. Cambridge, Cambridge University Press Courtenay M and Griffiths M (eds) (2010) Medication Safety: An Essential Guide. Cambridge, Cambridge University Press Lymn J, Bowskill D, Bath-Hextall F, Knaggs R (eds) (2010) The New Prescriber. Chichester, Wiley Blackwell Nursing and Midwifery Council (2006) Standards of Proficiency for Nurse and Midwife Prescribers. London, NMC Nursing and Midwifery Council (2008) The Code of Professional Conduct, Performance and Ethics. London, NMC Nursing and Midwifery Council (2010) Standards for Medicines Management. London, NMC Nuttall d and Rutt-Howard J (eds) (2011) The Textbook of Non-Medical Prescribing. Chichester, Wiley Blackwell Volans G and Wiseman H (2012) Drugs Handbook 2012-2013. Basingstoke, Palgrave MacMillan Wright K (2011) Drug Calculations for Nurses: Context for Practice. Basingstoke, Palgrave MacMillan Key Journal Journal of Nurse Prescribing (available as an eJournal on the University Library site) Key Websites: British Medical Association http://.bma.org.uk British National Formulary http://www.bnf.org Clinical Governance Research http://www.le.ac.uk/cgrdu/ & Development Unit Department of Health http://www.doh.uk./nurseprescribing 25 Guild of Healthcare Pharmacists http://www.ghp.org.uk National Pharmaceutical Association http://www.npa.co.uk/ National Prescribing Centre http://npc.co.uk Nurse prescriber www.nurse-prescriber.co.uk Patient Group Directions http://www.groupprotocols.org.uk Pharmaceutical Services Negotiating Committee Prescription Pricing Authority Royal Pharmaceutical Society Of Great Britain http://www.psnc.org.uk http://www.ppa.org.uk http://www.rpsgb.org.uk 26 Appendix A THE UNIVERSITY OF SHEFFIELD SCHOOL OF NURSING & MIDWIFERY ASSIGNMENT FEEDBACK SHEET Agreed Mark Assignment Student Number : Assignment : Attempt : 1st Programme Code : NURU140 Submission Date : Cohort Unit Code : SNM3223 Dist Level : Pass Campus: MARKER : PRINT NAME The reason you have been awarded the above mark is: 27 Fail Turnitin Similarity : Action : Signature : Date: MODERATOR : PRINT NAME The marker has: Agree Disagree Appropriately interpreted the assessment criteria Appropriately applied the marking criteria Comments : Signature : Date EXTERNAL EXAMINER: PRINT NAME Signature Date: Appendix B SCHOOL OF NURSING AND MIDWIFERY NON MEDICAL PESCRIBING PROGRAMME NURU 213 SNM 3223/624 28 [Cohort] [University U Card number] [Total word count] [Submission date] 29