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Assignment 1 Prescription Analysis

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There were numerous reasons why a prescription was inadequate (Table 2), the most common being the wrong / lack of which eye the prescription was for followed by the wrong / lack of frequency specified.
At the end of the clerking proforma, the doctor completing the admission clerking for the patient is requested to document their designation and grade. We found that majority of the doctors did not complete this section; therefore to compare the prescribing quality of different grades of doctors we used the first 30 prescriptions chronologically completed by Foundation Year 1, Senior House Officer and Senior Doctors each. The highest error rates were amongst the Senior House Officers, followed by Foundation Year 1s and finally Senior doctors …show more content…

O or IU; 1 prescription specified a dose of 10mls to be administered, which was the size of the bottle rather than the dose; numerous glaucoma medications were prescribed as pro re nata rather than regularly; 1 prescription was illegible and not corrected even following pharmacists’ or nurses’ written prompts. The majority of prescription errors however were due to the wrong or lack of eye specified. The main reason for incorrect prescription of ophthalmic medications is probably unfamiliarity with the preparations in terms of the frequency of prescription and the different concentrations available. It can be hypothesized that eye drops are often not considered as medication, not only amongst patients but also amongst junior doctors. GP records do not specify which eye the ophthalmic medication is for and simply states ‘on affected eye’, which can be a concern for patients unable to communicate. Some doctors did not know that glaucoma can exist in one eye and therefore drops are supposed to be prescribed only for one eye. There was 1 case where a patient was seen in the outpatient ophthalmology clinic, found to have glaucoma and was started on regular Azopt and Ganfort. Within 3 days he was admitted with a urinary tract infection and by this time, his GP summary had not been updated with the new regular eye drops and therefore he was not prescribed these. This not only shows a failure in communication between GP and hospital prescribers, but also between doctors within the same hospital, especially when treatment is started by a different

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