Ethical and juridical base of nurse prescribing (5cr)

Evaluation scale

Pass/Fail

Content scheduling

In January, lecture 1, skills assessment and learning diary 1.
In March, lecture 2.
In May, lecture 3.
In June, learning diary 2.
In September, workshop and submission of written assignment.
In December, learning diary 3.

Objective

The aim is that after completing the course, you will be familiar with the regulations regarding prescribing medications and be able to adhere to them in your practice. You will recognize the limits of your own professional competence and responsibilities, as well as the requirements for patient safety in limited prescribing.

Competencies of the Course
Clinical Expert Competence

Learning Objectives
You will apply laws, and regulations related to patient care and prescribing medications, as well as professional ethical principles, to your own professional work.

You will recognize your scope of practice, boundaries of competence and responsibility related to prescribing medications and you will consult other professionals when necessary.

You will operate ethically at a high level in assessing care needs, prescribing medications, and providing patient guidance.

You will be able to evaluate your own competence and regularly update your knowledge and skills related to diagnostics and new drugs in your area of responsibility.

You will identify and anticipate problems and risks related to medication therapy, and you will record and report deviations.

Content

Regulations, ordinances, and legislation governing the prescribing of medication
Professional values, ethics, and responsibility
The nurse's area of responsibility and expertise in prescribing medication
Safe implementation of medication therapy and risk management in medication therapy
Quality assurance in medication therapy
Social responsibility and sustainable development related to the prescribing of medications and the promotion of public health
Interprofessional collaboration in prescribing medication

Materials

The following are up to date (note the changes):
Laki potilaan asemasta ja oikeuksista (785/1992)
Laki sähköisestä lääkemääräyksestä (61/2007)
Asetus sähköisestä lääkemääräyksestä (485/2008),
Laki terveydenhuollon ammattihenkilöistä annetun lain muuttamisesta (433/2010)
Potilasvakuutuslaki (948/2019) § 1-2
Sairausvakuutuslaki (1224/2004): 2. part 2. 1 § ja 5. 1 9 §
Sosiaali ja terveysministeriön asetus lääkevaihdosta (210/2003)
Sosiaali ja terveysministeriön asetus potilasasiakirjoista (298/2009)
Sosiaali ja terveysministeriön asetus laadunhallinnasta ja potilasturvallisuussuunnitelman
täytäntöönpanosta (341/2011)
STM Asetus lääkkeen määräämisestä (1088/2010)
Valtioneuvoston asetus lääkkeen määräämisen edellyttämästä koulutuksesta (1089/2010)
Terveydenhuoltolaki (1326/2010): 2 §, 8 §, 9§
Suomen Keskinäinen Lääkevahinkovakuutusyhtiö. Lääkevahinkovakuutusehdot.https://www.laakevahinko.fi/
Lääkealan turvallisuus- ja kehittämiskeskuksen ohje Haittavaikutuksista ilmoittaminen 2022.
https://www.fimea.fi/laaketurvallisuus_ja_tieto/laakkeiden_turvallisuus/haittavaikutuksista_ilmoittaminen
Rokotteiden haittavaikutuksista ilmoittaminen (THL 2017)
https://www.thl.fi/fi/web/rokottaminen/hyodyt-ja-haitat/haittavaikutukset/haitoista-ilmoittaminen
Gielen, SC., Dekker, J., Francke, AL., Mistiaen, P & Kroezen, M. 2014. The effects of nurse
prescribing: A system- atic review. International Journal of Nursing Studies 51(7), 1048–1061.
https://www.sciencedirect.com/sci- ence/article/abs/pii/S0020748913003714?via%3Dihub
Graham-Clarke, E., Rushton, A., Noblet, T., & Marriott, J. 2018. Facilitators and barriers to nonmedical prescrib- ing - A systematic review and thematic synthesis. PLoS One 13(4), e0196471.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5927440/
Koskiniemi S, Sund R, Liukka M & Härkänen M. 2023. Readmissions after appointments with nurse
prescribers: A register based study. Journal of clinical nursing. Issue 18 – 19
https://onlinelibrary.wiley.com/doi/10.1111/jocn.16837
International Council of Nurses (ICN), 2021. GUIDELINES ON PRESCRIPTIVE AUTHORITY FOR
NURSES. https://www.icn.ch/sites/default/files/2023-04/ICN_Nurse_prescribing_guidelines_EN.pdf
Sosiaali- ja terveysministeriö. 2022. Asiakas- ja potilasturvallisuusstrategia ja
toimeenpanosuunnitelma 2022- 2026. https://julkaisut.valtioneuvosto.fi/handle/10024/163858
Laapio-Rapi, E. 2020. Sairaanhoitajien rajatun lääkkeenmääräämistoiminnan tuottavuuden,
tehokkuuden ja kustannusvaikuttavuuden arviointi perusterveydenterveydenhuollon avohoidon
palveluprosessissa. Acta Universitatis Lappeenrantaensis 901 Diss. Lappeenranta-Lahti University
of Technology LUT. https://lutpub.lut.fi/handle/10024/160751
Laukkanen E. & Ruokoniemi P. 2021. Turvallinen lääkehoito - Opas lääkehoitosuunnitelman
laatimiseen. So- siaali- ja terveysministeriön julkaisuja 2021:6.
https://julkaisut.valtioneuvosto.fi/handle/10024/162847
Maier, C. 2019. Nurse Prescribing of medicines in 13 European countries. Human Resources for
Health 17, 95 https://doi.org/10.1186/s12960-019-0429-6
Nuttal, D. 2018. Nurse prescribing in primary care: a metasynthesis of the literature. Primary Health
Care Research & Development 2018; 19: 7–22 doi:10.1017/S1463423617000500
Sairaanhoitajat. 2023. Laajavastuinen hoitotyö – sairaanhoitajan uramalli lähellä ihmistä.
https://sairaanhoitajat.fi/wp-content/uploads/2023/04/APN-raportti-2023_final.pdf
Schepel, L. & Kuitunen, S. 2020. Lääkitysturvallisuus sairaalassa. Lääketieteellinen aikakauskirja
DUODECIM 136(2), 212-22. https://www.duodecimlehti.fi/duo15348
Syyrilä T, Hanslian E, Linden-Lahti C, Hakoinen S & Kuusisto M. 2023. Jotta lääkehoito ei katkeaisi.
Suomen lääkärilehti 8.6.2023. www.laakarilehti.fi (Luettavissa korkeakoulujen tietokantojen kautta)
Wilson, DM., Murphy, J., Nam, MA., Fahy, A., & Tella, S. 2018. Nurse and midwifery prescribing in
Ireland: a scope-of-practice development for worldwide consideration. Nursing and Health Sciences
20, 264–70. https://doi.org/10.1111/ nhs.1240
Weeks, G., George, J., Maclure, C. & Stewart, D. 2016. Non-medical prescribing versus medical
prescribing for acute and chronic disease management in primary and secondary care. Cochrane
Database Systematic Reviews 22;11:CD011227. 32 s.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464275/
STM raportti 2015/49: Työnjakoa uudistamalla nopeammin hoitoon ja joustavuutta palveluihin

Teaching methods

Contact lectures 6 hours (3 x 2 hours)
Workshop 2 hours
Skills self-assessment
Learning diary
Written assignment
Independent study during which the material is studied

Student workload

Lectures 6 hours
Workshop 2 hours
Competence assessment 2 hours
Written assignment 10 hours
Learning diary 10 hours
Reading written material 105 hours

Assessment criteria, approved/failed

The course is considered approved when the student demonstrates the ability to apply legislation related to patient care and prescribing medication, as well as professional ethical principles when prescribing drugs, while recognizing the limits of their own area of responsibility.

The student is able to assess their own competence and its development, identifies and anticipates problems and risks in medication treatment, and develops risk and quality management in their own area of responsibility.