Prescribing in Practice Part 1 (e) Good practice in prescription writing The following lead lectures within this OER are referred to it this presentation and may be useful to review Prescribing Triangle, Accountability, Concordance and Team Working

Legal requirements Name and address of patient Signature in ink by the prescriber The practice address/address of prescriber The date it was written or date intended Information on who the prescriber is (Dr, dentist, IP, SP) The age of the patient if under 12 years of age There are additional requirements for writing CDs (see BNF) Prescriptions for controlled drugs must be handwritten. In certain situations the signature can be generated by a computer e.g. electronic generated prescription Community prescriptions: Prescription pad (FP10) will have the nurses’s name and NMC PIN printed on it. Electronic prescriptions can be set up with prescriber’s names, number Address even if private Valid for 6 months from date Hospital Prescriptions: For hospital nurses name, registration number may be put on a stamp to be able to use on his/her prescription. Alternatively the details should be handwritten on the prescription to show the qualification. Private prescriptions should show also that the practitioner is qualified to prescribe.

Validity Valid for 6 months from the date of prescription Prescriptions for CDs in schedule 2 & 3 are valid for 13 weeks/28 days

Good Clinical Practice Written legibly DOB included Dosage instructions clear Frequency Formulation Quantity The route (N.B.) Facilitator’s note: The route of the drug is commonly omitted so needs to be stressed to the audience. Possible question: What is the implication of not stating the route of administration?

Must dos See BNF for legal and good practice in prescription writing BNF gives you very clear directions to be followed Facilitator’s note: What is and what is not a law requirement Distraction is the biggest cause of prescription errors proven by evidence (See National Prescribing Centre) Possible question: ask audience the challenges they might face e.g. phone ringing, the patient talking about their condition

Can do Cautionary and advisory labels…last page of BNF Label 29 & 30…’Do not take more than 2 at a time and more than 8 in 24 hours’, ‘Do not take with any other paracetamol products’ Good practice to prescribe generically except if a clinical reason, elderly, durogesic, smoking sessation

Accountability Vicarious liability Professional accountability If you work in the NHS or other large organisations you will be covered by vicarious liability by your employer in case of civil action so as long as you work within your scope and local policies, formularies, standards you will be covered for compensation to be met by the NHS , if you depart from these standards you may be held accountable personally duloxetine example. If prescribing privately you need to have adequate professional indemnity.

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