Prescribing

Question 1

Good prescribing

Answer 1

Max effectiveness
Min cost
Min risk
Respect patient choice

Question 2

Sources of error

Answer 2

Pt factors- age/preg/polypharmacy
Health prof factors-knowledge/tired/stress/communication skills
System factors- workload/culture

Question 3

Swiss cheese model

Answer 3

Info not passed on, error less likely reported

Admitting team->MDT->prescribing doc->pharmacist->nursing team

Question 4

Types of error

Answer 4

Mistakes: error in planning actions

Skill-based errors: error executing planned actions

Question 5

Error in planning actions

Answer 5

Knowledge based errors

Rule based errors- good rules not applied/misapplied

Question 6

Skill based errors

Answer 6

Action based errors-technical

Memory based errors

Question 7

Adherence and concordance

Answer 7

How many p take a given prescribed drug

Increase non concordance with increase no. drugs given

Question 8

Minimise risk

Answer 8

Recognise high risk activity
Focus on task
Check: med history, allergies,drug dose/freq/duration/route
Interactions and SE
local/national guidance/policies
Shared decision making
Pt- check prescription and drugs dispensed
Double check

Question 9

Shared decision making

Answer 9

Involve pt- capacity to make decision/communication/understand or perspective
Provide info-use pt. decision aids- medication review, support adherence,self management plans,medicines reconciliation