An evaluation of pharmacist-written hospital discharge prescriptions on general surgical wards

Abstract

Objective To evaluate the quality of pharmacist‐written hospital discharge prescriptions (DPs) in comparison to those written by doctors. Method The study was carried out in two, week‐long phases on the general surgical wards in one UK hospital. In phase 1, doctors wrote the DPs, which were then checked by the ward pharmacist. In phase 2, ward pharmacists wrote the DPs which were then checked by the patient's junior doctor. In both phases, the clinical dispensary pharmacist made their routine check of the prescription prior to dispensing. All interventions were recorded on a pre‐piloted data collection form. Key findings In phase 1, doctors wrote 128 DPs; in phase 2, pharmacists wrote 133 DPs. There were 755 interventions recorded during phase 1 in comparison to 76 during phase 2. In phase 1, transcription errors accounted for 118 interventions, 149 were due to ambiguity/illegibility; 488 amendments were to facilitate the dispensing process e.g. clarification of patient, medical and drug details, and dosage form discrepancies. In phase 2, transcription errors accounted for one intervention, 50 interventions were due to ambiguities or illegibility; 25 amendments were to facilitate the dispensing process. During phase 2, doctors made 10 minor alterations to pharmacist‐written DPs. On 52 occasions during phase 2, the ward pharmacist had to clarify, prior to writing the DP, either the dose of a drug, or, whether a drug should be continued on discharge, and if so, for what duration. Conclusion Pharmacist‐written DPs contained considerably fewer errors, omissions and unclear information in comparison to doctor‐written DPs. Doctors recorded no significant alterations when validating pharmacist‐written DPs.

Slick scripts: impact on patient flow targets of pharmacists preparing discharge prescriptions in a hospital with an electronic prescribing system

“…earlier patient discharge, reduction in medical and nursing time, reduction in time taken for the WP to amend prescriptions) outweigh the costs. It may be argued that employing an additional doctor could have been another approach to speeding up the discharge process; however, the cost may be higher and many studies have shown that pharmacist‐prepared prescriptions have fewer errors .…”

Pharmacist contributions to ensuring safe and accurate transfer of written medicines-related discharge information: lessons from a collaborative audit and service evaluation involving 45 hospitals in England

“…A small study found that using a pharmacist to transcribe discharge medication did reduce the time between the decision to discharge and actual discharge and increase cost savings from reuse of the patient's own medicines; however, pharmacist errors were still identified by the dispensing pharmacy team 24. In a second study comparing discharge prescriptions written by pharmacists and doctors, those written by pharmacists were deemed to contain fewer errors and omissions 25. However, the legal position around pharmacist transcribing has been described as unclear 26.…”

Comparison of pharmacy technicians’ and doctors’ medication transcribing errors at hospital discharge

“…While the incidence of pharmacist discharge transcribing error rates have been reported,13 14 there are no known studies describing the impact of pharmacy technicians in undertaking this role and their impact on discharge transcribing error rates, severity of error or error type.…”