When prescription medication is taken exactly as it should, it can massively improve a person’s medical condition, way of life, and future health. But when mistakes are made and prescription drugs aren’t taken correctly, there’s a serious risk of harm.
While some errors with medication may be relatively harmless, some could be much more serious or even fatal. Here we’ve looked at some of the common mistakes that are easy to make in prescribing:
1. Medication has been delayed or omitted
This is when a patient has already received care, for example undergone an operation, but their follow-up medication either isn't forthcoming or is delayed/inaccurate. Prescribers must communicate with other healthcare professionals as well as the patient and their carers to allow for urgent prescription writing, dispensing and administration. A regular review of medication and what the next steps should be are also critical so that vulnerable patients don’t miss out on medication they need.
2. Anticoagulants
When prescribing anticoagulants, practitioners must include a review of weight, age, medication/medical history and previous blood tests/interactions. Procedures must clarify the healthcare professional responsible for counselling patients on newly prescribed anticoagulant therapy in individual clinical areas. As local anticoagulant procedures can differ across the country, and warfarin for example may be offered either in only one strength or multiple-strength tablets, the total dose and the number of tablets of each strength to self-administer must be explained thoroughly to the patient.
3. Opioid analgesics
In primary healthcare settings, the dosing and use of opioids should be thoroughly explained to patients and their carers, especially if they are vulnerable.
4. Insulin
Diabetic patients should be regularly reviewed. There should also be discussions happening periodically about any changes in their insulin treatment. If the patient requests a medication change, this should be done in conjunction with the diabetes clinic. Any new medication should be discussed with the patient, including how to use it and what the likelihood is of side effects.
5. Nonsteroidal anti-inflammatory drugs
When the use of NSAIDs cannot be avoided, they should be prescribed at the lowest effective dose for the shortest time possible. Their use should be avoided in older people if it can be.
6. Drugs that necessitate regular blood test monitoring
When a drug is first prescribed, a drug-monitoring plan should be put in place. Regular blood tests should make up part of the plan, with results reviewed and prescriptions modified as needed.
7. Patient allergies to medicine, including antibiotics
It needs to be ascertained if a patient has any allergies before a new medicine is prescribed, dispensed or administered by healthcare professionals. Allergy status should also be regularly reviewed across the course of their treatment.
8. Drug interactions
Drug interactions can make a drug less effective, or increase the changes of unpleasant side effects. In some cases, drug interactions can even be fatal. Pharmacists and healthcare professionals should therefore be fully clear about which drugs patients are currently using, and in what dose, before prescribing more.
9. Loading doses
Loading doses are not easy to prescribe as they require multiple-step calculations using patient information about their medicine, their dosage and whether there has been any recent changes. Loading doses can easily be miscalculated, additional doses given by mistake, and errors made in maintenance doses. Again this is where communication with patients is vital.
10. Oxygen
Oxygen should be thought of as a drug, just like any other. It is prescribed for hypoxaemic patients to increase alveolar oxygen tension and ease their difficulty in breathing. The concentration of oxygen required depends on what illness the patient has; too much or too little oxygen can bring about serious or even fatal consequences.
Is your V300 up to date?
If you’re a non-medical prescriber (NMP) it’s essential that you demonstrate ongoing CPD by updating your qualification annually.
Our scheduled Annual NMP V300 update course is a one-day programme offering 8 hours of CPD. It’s an interactive generic course, aimed specifically at all non-medical prescribers (NMP) with a recorded prescribing qualification (V300) who work within the NMP role. Completion of the course fulfils your CPD obligations.
Course dates are the 22nd April and the 7th July 2020, and it’s held at Hamilton House in London. All course material, evaluations, certificate and refreshments are provided but space is limited so book up early!
Misty Jhones