Safe Prescribing Flashcards
What factors can increase the rate of medication errors?
More rapid throughput of patients
New drug developments and extending medicines into new areas
Increasing complexity of medical care
Increased specialisation
General increased use of medicines
Sicker and older patients who are more vulnerable to ADRs
Problems with shift work and reduced hours?
Less teaching Working alone more often Less ward teaching and feedback Poorer morale Lack of continuity of care
What are the primary components in Reason’s model of error causation?
Latent conditions - processes inherent to an organisation or management decisions
Error producing conditions - poor environment or lack of communication
Active failures - occur individually, can be errors or violations
What is the system approach for accident causation?
Errors are seen as consequences
Unable to change human condition
Countermeasures are centred on barriers and safeguards
What is a violation?
Where an individual intentionally goes against others’ judgement or clinical guidelines
What are the different types of errors?
Mistakes - knowledge or rule-based
Slips - erroneous performance (intend to do the right thing, carry it out wrong)
Lapse - erroneous memory
What are some examples of defences in the system?
Senior reviews
Pharmacy reviews
Nurse’s review
Electronic system review
What must be confirmed before prescribing a drug?
Name of drug Dose Strength Frequency Duration of treatment Allergies/adverse effects Indications Adherence
What are the legal requirements of prescriptions?
Must be written in indelible ink Patient ID with name and address DOB if under 12 Signed Dated Name and address of practitioner
In the yellow card scheme, what should be reported?
Black triangle drugs - all suspected reactions
Established products and vaccines - all serious reactions
All paed reactions
Why are some drugs black triangle drugs?
Being intensively monitored
- newly released
- changed indications
- changed formulation
- combination product
What can bad prescribing lead to?
Deaths
Complications
Under-estimation of ADRs
Cost
