Safer prescribing and prescribing errors Flashcards
What are the 6 steps to prescribing
Rational prescribing
1 Diagnosis
2 Prognosis
3 Treatment goals
4 Choosing a treatment
5 Prescribing
6 Follow up
6 can revert to 4 in some cases and treatment is reviewed
What are common issues when prescribing goes wrong
Poor prescribing decision
Lack of follow up
Administration errors
Patient doesn’t understand the treatment and medication is not taken as required
When prescribing goes wrong who are most at risk
The very young and the very old.
Patient with multiple pathologies
Patients on a range of hazardous medications
Patients who are seriously unwell
Patient who are ambivalent or do not understand their medication regime
How can prescribing be made safer
familiarity with the drugs you prescribe
Follow the evidence base (protocols etc)
Know what you patient is currently taking
Involve the patient
Keep treatment simple
Stop medication that is not working
Don’t prescribe from some one else recommendation unless you are competent and confident
What are the two types of non adherence
Intentional non adherence A person is choosing not to take a medication.
Unintentional non adherence the patient is will to take the medication but cant.
What is accountability
it is an obligation of one party to provide justification for there action or omissions
What are the three components of accountability
Individuals accountability for the quality of his own work
Accountability of the health professional with in the organisation
Accountability (with others) as senior staff for the organisation and performance of an institution
What is the role of a professional body
To protect the public
Make sure that the professionals are adhering
to legislation
Monitor and manage conduct with in standards set down by the Professional body
What are the 4 areas of accountability
Civil, criminal, employment and professional
How many types of Tort are there
There are 3 types
1 Intentional tort the act of intending harm
2 Negligence tort a failure to act that breached duty of care
3 Strict liability Torts this hold the party liable with out the plaintiff having to prove fault
For negligence to be proved which 3 elements must be present
The accused is expect to behave in a prescribed manner
The plaintiff must prove he deviated from this
The plaintiff then must prove injury
To gain compensation what 5 conditions must be met
The Plaintiff was owed a duty of care
The defendant breached that duty of care
From that breach the defendant suffered harm
Harm was foreseeable as a result of the incident
The harm suffered is recognisable to the court
What are the two elements for a criminal case to be proved
Actus rea The accused acted or omitted which led to the commission of an offense
Men rea The accused intended to cause harm and was negligent or careless to the consequences
What is duty of care
The minimum standard expected from a similar qualified person
What is objective standard
Would a reasonable person of ordinary prudence done the same
