Safe Prescription for Junior Doctors in Accordance with All Wales Prescribing Standards
Safe Prescription in Accordance with All Wales Prescribing Standards
DOI:
https://doi.org/10.37978/tijfs.v5i2.316Keywords:
Drug administration, Drug Prescription, Health professions education, Prescribing errorsAbstract
Background: Prescribing errors are quite common and according to one estimate out of 100 patients admitted into UK hospitals 15 will have some form of prescribing error in their records. It is a general understanding that most of the time these errors are made due to lack of awareness. Severity of these errors can range from minor to major mistakes that can lead to fatal results.
Materials and Methods: A simplified anonymous approach of identifying these errors and then using a step wise approach to educate the prescribers’ especially junior doctors can be quite fruitful in reducing these errors. Unfortunately there are not many studies or projects available to back our proposal however these seems a logical way forward and is exactly what we have shown in our study.
Results: We performed a prospective snapshot study involving 100 inpatients to get baseline measurements. The errors and mistakes were identified and fed back to the junior doctors in an anonymous manner. Clear & legible writing, frequency of use, responsible consultant name, allergy box filled, VTE assessment, oxygen prescribing and labeling of medication discontinuation were the most common negligence identified. At the same time junior doctors were reminded of local prescription standards and guidelines which usually don’t form part of induction.
Conclusion: Multiple deficient areas were identified during this audit like legible writing, dosage frequency, VTE prophylaxis and oxygen prescription. It was highlighted to junior doctors how important are these components as they play a key role in patient getting better after medical review. Above mentioned steps did improve prescription errors to an extent, but aim should be to achieve 100% results. Repeated reminders are important in this case as that helps to improve practice and avoid clinical accidents.
Downloads
References
Brennan TA, Leape LL, Hebert L, Localio AR, Lawthers AG, Newhouse JP, et al. Incidence of Adverse Events and Negligence in Hospitalized Patients. N Engl J Med. 1991;324(6):370-6. doi: 10.1056/NEJM199102073240604.
Pham JC, Aswani MS, Rosen M, Lee H, Huddle M, Weeks K, et al. Reducing Medical Errors and Adverse Events. Annu Rev Med [Internet]. 2012;63(1):447–63. Available from: http://www.annualreviews.org/doi/10.1146/annurev-med-061410-121352
Dean B. Prescribing errors in hospital inpatients: their incidence and clinical significance. QualSaf Health Care. 2002;11(4):340–4. Available from: https://qualitysafety.bmj.com/lookup/doi/10.1136/qhc.11.4.340
Classen DC, Pestotnik L, Evans RS, Lloyd JF, Burke JP. Adverse Drug Events in Hospitalized patients. Excess Length of Stay, Extra Costs, and Attributable Mortality. JAMA. 1997;227(4):301-6. doi:10.1001/jama.1997.03540280039031
Sandars J, Esmail A. The frequency and nature of medical error in primary care: understanding the diversity across studies. Family Pract. 2003;20(3):231–6. Available from: https://academic.oup.com/fampra/article-lookup/doi/10.1093/fampra/cmg301
The association of British Pharmaceutical Industry. Our Ethics. Appropriate Prescribing. Available from: https://www.abpi.org.uk/our-ethics/appropriate-prescribing/ [Accessed 15th November 2019]
M, Jheeta S, Benn J, Sanghera I, Jacklin A, Ingle D, et al. Improving feedback on junior doctors’ prescribing errors: mixed-methods evaluation of a quality improvement project. BMJ QualSaf. 2017;26(3):240–7. Available from: https://qualitysafety.bmj.com/lookup/doi/10.1136/bmjqs-2015-004717
All Wales Prescription Writing Standards. Quality and Safety group of Welsh Chief Pharmacists Committee January. 2014. https://awmsg.nhs.wales/files/medication-charts-and-records/all-wales-prescription-writing-standards-2014-pdf/
General Medical Council. Good Practice in Prescribing and Managing Medicines and Devices. Available from: https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/prescribing-and-managing-medicines-and-devices [Accessed 10th November 2019.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 The International Journal of Frontier Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.