Writing safe and effective prescriptions in a hospital kardex

Abstract

Several thousand prescriptions will be dispensed each day in a typical National Health Service hospital in the UK. The success of each normally depends on a communication between one healthcare professional (usually a doctor), who has made a diagnosis and formulated a treatment plan, and a second professional (usually a nurse), who will deliver the medicine to the patient. This critical communication, or prescription, should convey all the necessary information about the dispensing of the medicine: which medicine and formulation, who it should be given to, how much, which route, how often, and for how long. Sometimes the prescription will provide discretion to the dispenser about the amount and timing, e.g. for as-required medicines. Confusion surrounding the information conveyed in the prescription accounts for many of the 40,000 serious hospital medication errors reported to the National Patient Safety Agency each year, some of which are fatal. Evidence of poor prescription writing has been documented in numerous studies of hospital prescription charts. Although most prescription errors in hospital are made by junior medical staff (because they write the majority of the prescriptions), more senior staff are also implicated, and importantly have an opportunity to lead by example. Not surprisingly, the Department of Health in the UK is taking the issue of safety related to medicines very seriously.