Writing a Prescription
This is a fairly common OSCE station, often with a BNF supplied. Many medical errors occur as a result of prescription errors- ensure you have all the correct elements for an accurate and safe prescription. Even when writing up a previous prescription, check each section carefully- does the patient really need this drug?
- Indications- Is this the correct indication for this drug?
- Contraindications- Are there any reasons that this patient should not receive this drug? (including allergies).
- Route- Is this the most appropriate route to administer the drug? Nil by mouth patients can't receive oral medications, for instance.
- Interactions- Is the patient taking any other medications that could interact? You can check these in the back of the BNF.
- The patient's details
- NHS/Hospital number
- Your details & signature
Additionally, there may be space for the consultant name, and the number of charts in use.
- Use the generic drug name, not branded names. This allows the use of cheaper alternatives and different preparations.
- Supply drug dose while minimising use of decimal points. Grams > Milligrams > Micrograms > Nanograms
- If using micrograms, nanograms or units, do not abbreviate
- Drug schedules should be written in full, but latin abbreviations are fine
- Add the duration of treatment/ review date
|tds||Three Times per Day|
|qds||Four Times per Day|
|on||One at Night|
|om||One in morning|
- Written in indellible ink
- Ensure further drugs cannot be added to your signature. On a cardex, this is not possible (one drug per line), but on a pad, ensure the pad is scribbled across.
- Should be dated, including a review date- 48 hours by default for Antibiotics
- If a drug is written in error, or changed, cross out the drug completely, including the section recording administration, then sign and date the record.
Drugs supplied by the nurse as the patient needs them e.g. to control breakthrough pain. Ensure the above are met, plus:
- A maximum daily dose
- Indication for taking the PRN