Who makes prescribing decisions in hospital inpatients? An observational study.

Postgraduate Medical Journal
Sarah RossChristine Bond

Abstract

Errors involving drug prescriptions are a key target for patient safety initiatives. Recent studies have focused on error rates across different grades of doctors in order to target interventions. However, many prescriptions are not instigated by the doctor who writes them. It is important to clarify how often this occurs in order to interpret these studies and create interventions. This study aimed to provisionally quantify and describe prescriptions where the identity of the decision maker and prescription writer differed. Observational data was collected in six wards, 2 weeks per ward, at a single large UK teaching hospital over a 12-week period from January to April 2011. In 112/183 (61%) cases where a new medicine was prescribed, the decision maker was not the prescription writer. Decision making and the writing of prescriptions are generally not undertaken by the same doctor. Moreover, communication about prescriptions is poor. Further research in a larger sample of hospitals is required to confirm generalisability of the results, and to inform educational interventions to reduce error rates.

Citations

Jul 31, 2014·Journal of the American Medical Informatics Association : JAMIA·Jamie J ColemanRobin E Ferner
Apr 5, 2014·The Journal of Antimicrobial Chemotherapy·Karen MattickCharlotte Rees
Aug 21, 2015·British Journal of Clinical Pharmacology·Effie DeardenJeni Harden
Jun 28, 2015·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Darren M AshcroftTim Dornan
Apr 23, 2014·British Journal of Clinical Pharmacology·Sarah RossRhona Flin
Dec 27, 2019·The International Journal of Pharmacy Practice·Cassandra WoitTheresa L Charrois
Oct 28, 2017·International Journal of Clinical Pharmacy·Pamela Ruth MillsDerek Stewart
Apr 3, 2018·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Nice M O SilvaFernanda G Surita
Nov 10, 2020·International Journal of Clinical Pharmacy·Fahad AlshahraniAnthony R Cox

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