1 / 18

Audit of drug prescribing in RHSC

Audit of drug prescribing in RHSC. Catherine McDougall Camilla Stockley, Phui Yee Wong May 2010. Background. Limited evidence suggests medication errors & corresponding harm could be higher in children than adults Prescribing errors are common in paediatric inpatients in UK

aulii
Download Presentation

Audit of drug prescribing in RHSC

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Audit of drug prescribing in RHSC Catherine McDougall Camilla Stockley, Phui Yee Wong May 2010

  2. Background • Limited evidence suggests medication errors & corresponding harm could be higher in children than adults • Prescribing errors are common in paediatric inpatients in UK • 13.2% medication orders contained error Ghaleb et al, Arch Dis Child 2010 • Previous prescribing audits at RHSC 2007/8

  3. Objective • To improve safety in drug prescribing by all clinical staff

  4. Methods • All drug charts in use on hospital wards on 23.3.10 assessed using proforma • Allergies confirmed by referring to medical notes or asking parents • Kardex “failed” if any one drug failed on any point • NHS Lothian Medicine Policy (“Golden Rules”) used as audit standard

  5. Patient details BLOCK CAPITALS Black pen Documentation of drug allergies Kardex number if applicable (1 of 2, 2 of 2 etc)

  6. Name & DOB on each page Oxygen prescription Drug name in capitals Units in full, except mg/g/ml Stopping drugs: Vertical + double diagonal lines Sign, print, date Signature + printed name

  7. Minimum time interval between doses, maximum daily dose

  8. Results • 80 drug charts audited • Medical (wards 1,2,6,7): n=34 • Surgical (wards 3,4,5): n=34 • Critical care (PICU,HDU,NNU): n=12

  9. Personal details • Multiple charts appropriately labelled in 8/10 cases (1 of 2, 2 of 2 etc)

  10. Documentation of allergies • Of 29 charts with incomplete allergy information, 5 (17%) children had drug allergies • No identified cases of documented allergy info being incorrect

  11. Drug prescriptions

  12. All drugs prescribed correctly Only 33% drug charts

  13. Discontinuing drugs • Overall, drugs discontinued correctly on 5/51 (10%) drug charts

  14. Prescription of oxygen • 11 patients received oxygen • Only prescribed in 2 cases (18%) • 1/4 medical, 1/7 critical care

  15. Conclusions • Only one third of drug charts were completed according to Medicines Policy • Main problem areas • Use of capitals • Documentation of allergies • Prescriber’s name printed • Minimum interval for ‘as required’ drugs • Discontinuation of drugs • Prescription of oxygen

  16. Completing audit cycle • Dissemination of audit results + raising awareness of prescribing guidelines • “Golden rules” for paediatric prescription writing now issued in induction pack • Prescribing quiz with kardex question • ?alterations to drug kardex • Repeat audit on regular basis

  17. Comments on new RHSC kardex? • Separate section for iv drugs • Minimum interval/indication for PRN drugs • Fewer time slots catherine.mcdougall@luht.scot.nhs.uk

More Related