Prescribing

Question 1

What is underprescribing

Answer 1

Not giving medication that the patient would benefit from

Not giving a sufficient dose to have an impact

Question 2

What are some of the environmental factors that result in prescribing errors

Answer 2

Surrounding noise
Lighting
Disorganised work space

Mood
Time/peer pressure from colleagues
Blame culture and whistle blowing
Interruptions

Question 3

What are some of the team factors that result in prescribing errors?

Answer 3

External pressures from seniors that you don’t agree with

Over dependence on nurses or seniors even though you’re the one signing the prescription

Question 4

What are some system based issues that may result in prescribing errors

Answer 4

Lack of core training in IT systems
Different guideline for each trust
Lack of standardised systems
Glitches in the system with paper copies

Question 5

How may distractions affect the likelihood of prescribing errors

Answer 5

Interruptions
Life events
Knowledge is not sufficient or up to date 
Time/peer pressure
Want to go home, hungry, tired

Question 6

How would you prescribe safely?

Answer 6

Protected time for prescriptions
Don’t be afraid to ask for help
Have all the info on the drug, patient and past reactions
Take the patient’s opinions into consideration

7 rights

Review repeat prescriptions for amounts

Question 7

What is the WHO pain ladder?

Describe the steps on it

Answer 7

Start from the bottom and move up the pain ladder to stronger forms

Non opioids

• aspirin
• ibuprofen
• naproxen

Weak opioids

• codeine
• co codamol
• tramadol
• dihydrocodeine
• pethidine

Strong opioids

• PO morphine
• IV/IM morphine
• diamorphine
• methadone
• buprenorphine
• fentanyl