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• W4247943732 abstract "Bryony Dean and colleagues1Dean B Schachter M Vincent C Barber N Causes of prescribing errors in hospital inpatients: a prospective study.Lancet. 2002; 359: 1373-1378Summary Full Text Full Text PDF PubMed Scopus (479) Google Scholar suggest training of junior doctors in the principles of drug dosing before they start prescribing, and enforcement of good practice in documentation to reduce prescribing errors in hospitals.Higgins and Tully2Higgins MP, Tully MP. Hospital doctors and ‘appropriate’ prescribing decisions: a schema theory perspective. 8th Health Services Research and Pharmacy Practice Conference, Leeds, April 11-12, 2002: 19 (abstr).Google Scholar reported variation in approach to prescribing between consultants and senior house officers. They interviewed the clinicians for their views on their role as doctors, their approach to prescribing, and to the appropriateness of and factors affecting prescribing. With use of the schema theory perspective, data were analysed in the context of psychological constructs that inform the prescribing decision-making process.Consultants had complex schemas and placed emphasis on a wider, holistic approach to patients' care, whereas house officers generally worked to address discrete functions within the care-delivery package, with the patient as a passive receptor. A possible suggested hypothesis was that house officers would progress towards more complex schemas with training, time, and experience.How can consultant teams ensure a high standard of prescribing decisionmaking and care delivery to patients, despite the training phase that junior medical staff need to go through?We identified and addressed this question in 1996, by implementation of a structured on-site training programme for junior medical staff rotating through the menopause clinic. Staff grade and specialist registrars were also able to join these sessions. The main objective was to deliver appropriate prescribing training for menopause and hormone replacement therapy (HRT) before the house officers saw patients during the weekly outpatient clinics. Secondary objectives included quick familiarisation with the multidisciplinary approach to patients' care (our team consists of a consultant, a family physician associate specialist, a medical research fellow, nurse specialists, research nurses, a counsellor, and a specialist pharmacist), and ensuring awareness of the importance of the holistic approach to menopause care. We use forms for menopause history taking for new and follow-up patients to ensure standard and comprehensive case assessment. Junior medical staff report improved awareness of multidisciplinary working, competency, risk management, and HRT prescribing decision-making.Currently being piloted in our district general hospital are formalised, pharmacist-led, menopause and osteoporosis medication management clinics.3Tanna N Pitkin J Frank A Tellez M Medication management clinics in the secondary care sector.http://www.bmj.com/cgi/eletters/323/7325/1340#18708Google Scholar The consultation forms, with minor modifications, are used by the pharmacist for medication history taking. There is close, geographically facilitated, liaison with the consultantled menopause and bone metabolic teams.We suggest that this model of medication management clinics could provide the appropriate setting for training of junior medical staff, with a resultant effect on reduction of prescribing errors. This would be in line with the recommendations of the UK Government's 2001 Audit Commission Report,4Audit commission report (2001): a spoonful of sugar—medicines management in NHS Hospitals. Stationery Office, London2002Google Scholar which advises integration of the pharmacist within clinical teams to manage medicines more effectively and use of multidisciplinary working to improve the quality of patients' care. Bryony Dean and colleagues1Dean B Schachter M Vincent C Barber N Causes of prescribing errors in hospital inpatients: a prospective study.Lancet. 2002; 359: 1373-1378Summary Full Text Full Text PDF PubMed Scopus (479) Google Scholar suggest training of junior doctors in the principles of drug dosing before they start prescribing, and enforcement of good practice in documentation to reduce prescribing errors in hospitals. Higgins and Tully2Higgins MP, Tully MP. Hospital doctors and ‘appropriate’ prescribing decisions: a schema theory perspective. 8th Health Services Research and Pharmacy Practice Conference, Leeds, April 11-12, 2002: 19 (abstr).Google Scholar reported variation in approach to prescribing between consultants and senior house officers. They interviewed the clinicians for their views on their role as doctors, their approach to prescribing, and to the appropriateness of and factors affecting prescribing. With use of the schema theory perspective, data were analysed in the context of psychological constructs that inform the prescribing decision-making process. Consultants had complex schemas and placed emphasis on a wider, holistic approach to patients' care, whereas house officers generally worked to address discrete functions within the care-delivery package, with the patient as a passive receptor. A possible suggested hypothesis was that house officers would progress towards more complex schemas with training, time, and experience. How can consultant teams ensure a high standard of prescribing decisionmaking and care delivery to patients, despite the training phase that junior medical staff need to go through? We identified and addressed this question in 1996, by implementation of a structured on-site training programme for junior medical staff rotating through the menopause clinic. Staff grade and specialist registrars were also able to join these sessions. The main objective was to deliver appropriate prescribing training for menopause and hormone replacement therapy (HRT) before the house officers saw patients during the weekly outpatient clinics. Secondary objectives included quick familiarisation with the multidisciplinary approach to patients' care (our team consists of a consultant, a family physician associate specialist, a medical research fellow, nurse specialists, research nurses, a counsellor, and a specialist pharmacist), and ensuring awareness of the importance of the holistic approach to menopause care. We use forms for menopause history taking for new and follow-up patients to ensure standard and comprehensive case assessment. Junior medical staff report improved awareness of multidisciplinary working, competency, risk management, and HRT prescribing decision-making. Currently being piloted in our district general hospital are formalised, pharmacist-led, menopause and osteoporosis medication management clinics.3Tanna N Pitkin J Frank A Tellez M Medication management clinics in the secondary care sector.http://www.bmj.com/cgi/eletters/323/7325/1340#18708Google Scholar The consultation forms, with minor modifications, are used by the pharmacist for medication history taking. There is close, geographically facilitated, liaison with the consultantled menopause and bone metabolic teams. We suggest that this model of medication management clinics could provide the appropriate setting for training of junior medical staff, with a resultant effect on reduction of prescribing errors. This would be in line with the recommendations of the UK Government's 2001 Audit Commission Report,4Audit commission report (2001): a spoonful of sugar—medicines management in NHS Hospitals. Stationery Office, London2002Google Scholar which advises integration of the pharmacist within clinical teams to manage medicines more effectively and use of multidisciplinary working to improve the quality of patients' care." @default.
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• W4247943732 title "Prescribing errors" @default.
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