Background University Hospitals Bristol (UHBristol) have standards for safe and professional prescribing [1]. The standards include prescriber accountability and informed clinical decision making by awareness of drug chart(s) in use and any medicine(s) not given. In 2011 the Medical, Pharmaceutical and Nursing Colleges produced standards for hospital in-patient prescription charts aimed to help eliminate prescribing errors and improve patient outcomes [2]. The standards correlate with the UHBristol standards.

Timeline Initial audit February 2010. New prescription chart was released in July 2010 and re-audited in September 2010. Revised chart was released July 2011 and re-audited in January 2012.

Directing Change The audit results and the NHS Institute for Innovation and Improvement Plan, Do, Study, Act (PDSA) [3] tool informed each chart change. The strategy was co-ordinated by pharmacy, with input from the healthcare team.

Purpose To establish achievement of the prescribing standards below within in-patient medical wards at UHBristol.

Prescriber identity: 100% of prescribers should print their name

Prescriber contact: 100% of prescribers should print their bleep number

Additional chart(s): 100% of additional prescription charts(s) will be documented on main prescription chart

Missed doses: 100% of medicines that are not given will have a documented reason

Materials and Methods Data collection proforma was designed, piloted and used for each audit cycle. Ten in-patient prescription charts from each ward were reviewed.

Results The table states the achievement of the standards with each cycle. The last column indicates the change between the first and last audit.

Conclusions Each revision of the prescription chart produced improvements in achievement of the standards. The audit cycle, PDSA and multidisciplinary approach informed changes and enhanced the charts’ fitness for purpose.

References

1. UHBristol Medicines Governance Group.Medicines code.2009.

2. http://www.rpharms.com/what-s-happening-/news_show.asp?id=275

3. http://www.ihi.org/knowledge/Pages/Tools/PlanDoStudy ActWorksheet.aspx

No conflict of interest.