DART - on target for safe prescribing Karin Purshouse Judith Bailey Jane Hough Triss Clark.

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Presentation transcript:

DART - on target for safe prescribing Karin Purshouse Judith Bailey Jane Hough Triss Clark

Today  Prescribing errors  What is DART?  Group work

Prescribing errors  Nationally  1 in 10 patients = adverse event  15% of these are medication related

Case  75 year old lady with advanced cancer, brain and bone metastasis  Admitted with general malaise, vague neurological symptoms  Attended with sister and bag of medications  Stated she had forgotten her morphine, but normally took 100mg MST.

Case continued  SHO prescribed 100mg MST and asked sister to check medication at home.  Next day…  Medicine reconciliation by pharmacist, found patient actually took 20mg MST BD.  Sister had called the ward and message hadn’t been handed on.  Patient was completely well, slightly drowsy.

Case learning points  Near miss  Prompted this Quality Improvement Project on prescribing.  Prescribing errors can happen to everyone  Any examples?

Evaluation of prescribing in EAU and medical wards – Dec/Jan 2013/14  1 in 5 prescriptions had an error  Nearly HALF were due to drug omissions on admission  Nearly a THIRD were dose-related (mostly over-dosing)  10% were due to incorrect/absent drug timings  Of high-risk drugs, antibiotic and insulin prescribing was least accurate

You are agents for change!

D DOCUMENTATION - Complete the prescription CLEARLY in full so it can BE GIVEN SAFELY. Clearly document changes to medicines in the medical notes. A ALLERGIES - Is the patient allergic to the drug? Have I checked and documented this? R REGULAR MEDICATIONS - Do I know the patients' regular medications? - Find out via OxCS. Check the pharmacy box in the drug chart. T TIME CRITICAL MEDICINES- Does this medication need to be given STAT? Tell the nursing staff!

Oxfordshire Care Summary 1) Search ‘Oxfordshire Care Summary’ 2) Complete training 3)Use when clerking!

For those in AGM/Medicine: Prescribing simulation sessions  Multidisciplinary (Nurses, doctors, pharmacists)  Dates:  Friday 11 th April 2-3pm, pm AGM seminar room  Wednesday 16 th April 2-3pm, pm GPEC seminar room 2B  One hour, coffee+cake and certificate for your e- portfolio  Consultants will be looking for your participation.

Groups  Cases from actual scenarios found in the study  Discuss the cases and amend the prescriptions  Take a DART card for your badge holders