other urgent care centre staff. This is important, as for quite some time, human resource in emergency care departments has been overstretched;
• Being able to complete the care pathway may increase job satisfaction for the prescribing radiographer and make best use of his/her clinical skills.
The evidence base of practical examples of radiographer prescribing is tiny, but with an eye on the experiences of the almost 40,000 non-medical prescribers already practising in the UK, the potential of prescribing for future radiographer practice becomes obvious
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Currently, when radiologists review imaging requests they decide whether medicines are required as part of the procedure (eg contrast agent). In some instances the radiologist does not see the patient in person when making the prescribing decision. Whilst examining the patient the prescribing radiographer could interview the patient prior to the examination and prescribe at that point, or decide part way through the examination. In this context a radiographer who has prescribing competence offers the following benefits:
• Seeing and consulting with the patient in person is safer practice and increases adherence to the medicines regimen2,5
;
• Additional human resource is not required in the decision making. This reduces the burden placed on the radiologist and allows the responsibility for prescribing this medicine to be managed at the most cost effective level6
.
Sometimes there is need for a change of medicine during a radiotherapy procedure. Even if a radiographer is a supplementary prescriber, this is a situation where they may need to refer the patient back to a medical practitioner (oncologist). Clinical management plans required for supplementary prescribing must list the medicines or class of medicine that the radiographer can prescribe for the patient; if the patient requires a different medicine it may be outside the parameters of the clinical management plan. Independent prescribing would enable responsive change of treatment, if within the competence of the radiographer. In this situation the benefits could be:
• The patient gets prompt appropriate treatment for his condition; • A further appointment with the patient’s medical practitioner is saved – a financial saving; • The skills and ability of the radiographer are valued; the benefits of the linkage between the traditional skills of the radiographer and prescribing.
In radiotherapy there can be a need to manage side effects. A patient may decide not to proceed with radiotherapy because of debilitating side effects that could be treated with certain medicines. An initial prescription from the patient’s medical practitioner may be insufficient or the patient’s needs may change during the treatment, requiring additional or alternative medicines to be prescribed. The patient will see the therapeutic radiographer daily, but might not necessarily see their own medical practitioner or any other doctor until treatment is completed. The patient is more likely to complete their treatment with minimised side effects. Similarly, embarrassing side effects may be much more easily disclosed to, and managed by, the therapeutic radiographer who they may see each day and with whom they may have built a relationship.
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