Safe Prescribing

Question 1

What are the ethical principles involved in prescribing

Answer 1

Beneficence

Non-maleficence

Autonomy

Justice - cost effectiveness

Question 2

What goals are used for good prescribing

Answer 2

Barber’s goals:

Maximise effectiveness

Respect patient choice

Minimise cost

Minimise risk

Question 3

Name some sources of error in prescribing

Answer 3

Patient factors - elderly, weight, polypharmacy, palliative care, pregnancy, breast feeding, hepatic or renal impairment

Systems factors - workload, hierarchy, culture, ethos, team and inter-professional working

Health professional factors - communication skills, technical skills, distracted, tired, stressed, knowledge

Question 4

What model is used to describe how errors in prescribing can slip through the mutliple checks done by health care professionals

Answer 4

Swiss Cheese Model

Question 5

What types of errors are there

Answer 5

Mistakes and errors in planning actions - knowledge-based and rule-based errors

Skill-based errors

Errors in exectuing correctly planned actions - action based and memory-based errors

Question 6

How can risks assocaited with prescribing be minimised

Answer 6

Recognising prescribing is a high risk activity

Aiming to give the task the attention and focus it requires

Asking for help

Considering non-prescription alternatives

Checking factors and guidlines

Sharing decision making

Double checking

Question 7

What factors shoudl be checked when prescribing

Answer 7

Medication history and allergies

Drug/dose/route/frequency/duration

Interactions and side effects

Correct instructions and monitoring

Local/national guidance and policies