Journal Mobile

SRJ Maxwell, K Wilkinson
Journal Issue: 
Volume 37: Issue 4: 2007




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.

This  brief  review  highlights  important  principles  and  rules  that  support  safe  and effective  prescribing  in  hospitals.  It  was  first  published  as  part  of  this  College’s CME online module on Clinical Pharmacology.