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CORA FLYNN RANP RNP RGN MSC EPILEPSY Opportunities + Challenges in Nurse Prescribing
C O R A F L Y N N
R A N P R N P R G N M S C E P I L E P S Y
Opportunities + Challenges in Nurse Prescribing
Pathway to Nurse Prescribing Epilepsy
Commission On Nursing NCNM NMBI
S/N CNS CANP RANP
Epileptologist Nurse Prescribing Msc Epilepsy
HRB Grant EPR
National Clinical Care ProgrammesModel Of Care: Right Person Place Right Time Sharing Information
Delivering Patient Centred Care
Nursing Network
MSc Epilepsy RCSI
2003 2009
2005-2016
2000
Quality Safety STEEEPSeizure Presentations
SafetyAEDs given EDStatus TxVetting TestsReconcile
TimelyAccess to: OPDMRIEEG
EffectiveStandardsVariance
Competence
EfficientLOS
Reductions
EquitableLTI GMS
Patient Centred
Busy Lives Drug Regimes
DrivingWork
Opportunities
Patient Centred Medications
Response /Outcomes
Timely response to adverse effects
Building relationships with community (GP, Pharmacists, psychiatry)
Quality Safety
Information
Challenges
Roles Responsibilities Governance
Bypassing Primary Care
Adherence
Drug Drug Interactions
Medication Resistance
Unlicensed medications
X Minimum Data Set
Nurse Prescribing
Patient Centred Approach23yr College Female with JME High BMI Hx low mood
Juvenile Myoclonic EpilepsyGeneralised Epilepsy (Imaging Normal EEG Poly spike and wave)Cause: GeneticSeizure Type: GTC, Absence, MyoclonusAge Onset: AdolescenceTreatment: AED LifelongOutcome: 90% Seizure Free
Challenges
Valproate a first line drug in JME historically
Valproate birth defects and developmental disorders
Prescription little use in the absence of Lifestyle advice
Levetiracetam broad spectrum (10-20% adverse mood effects)
Epilepsy + Fertility (PCOS Endocrine disorders)
Bone Health
Opportunities
Clinical History Clinical Diagnosis
Prescribing opens up discussions
Pre Pregnancy Counselling
Health Promotion (Mental Health, Sensible attitude to alcohol)
Minimising psychosocial difficulties/Driving
Disclosure
HEALTH CARE PROFESSIONAL GUIDE
CHECKLIST FOR PATIENTS
Patient Information Booklet
Status Epilepticus
Timely use of Benzodiazepine V Tolerance
When to administer V Overuse
Which Seizure Type V Major Minor
Clinical Judgement
Need for CPD Seizures
Epilepsy Programme Nursing NetworkRGN RNP CANPs…..MSc RANP
Together wE Achieve More
16 years
M O R E O P P O R T U N I T Y C H A L L E N G E S O V E R C O M E W I T H T E A M A P P R O A C H
H O L I S T I C C A R E L O C A L L Y T O P W E
C O N T I N U O U S P R O F E S S I O N A L D E V E L O P M E N T
Summary
