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Improving prescription quality in an in-patient mental health unit

^*University College Hospital Galway and National University of Ireland Galway, Ireland, email: brian.hallahan{at}nuigalway.ie

Ivan Murray, Research Registrar and Colm McDonald, Professor of Psychiatry

University College Hospital Galway and National University of Ireland Galway, Ireland

We read with interest the evaluation of prescription quality on an in-patient mental health unit by Ved & Coupe (Psychiatric Bulletin, August 2007, 31, 293-294). We have recently completed an audit of prescription quality of ‘as required’ medication on our acute psychiatric in-patient ward. All prescription charts (n=90) over a 1-month period were audited, incorporating 282 prescriptions. Similar results were noted to those in the first cycle of the clinical audit by Ved & Coupe (2007). However, we had lower rates of generic prescribing (43 v. 96%) and the reason for prescribing ‘as required’ medications was stated less frequently (17 v. 52%). There is a culture of non-generic prescribing in Ireland compared with the UK, most probably fuelled by differing legislation with regard to prescribing liability and dispensing of medications (McGettigan et al, 1997). We had higher rates of cancelling medications correctly (78 v. 40%).

Unlike Ved & Coupe (2007) we assessed whether nursing staff recorded administering ‘as required’ medications to patients in the nursing notes after signing for them in the prescription chart and found that they did in 57% of cases. In 90% of these cases an explanation was documented. Nurses were far more likely to record administering psychotropic than non-psychotropic medication (70 v. 22%, P<0.0001).

Both our study and that of Ved & Coupe (2007) demonstrate that the quality of prescribing can be improved and we agree that continuous quality assurance requires ongoing data collection, review of those data and action. The greatest deficits in prescription quality in our acute in-patient unit were in prescribing medications generically and stating a reason for prescribing ‘as required’ medication.

References

McGETTIGAN, P., McMANUS, J., O’SHEA, B., et al (1997) Low rate of generic prescribing in the Republic of Ireland compared to England and Northern Ireland: prescribers’ concerns. Irish Medical Journal, 90, 146 -147.[Medline]

Related articles in PB:

Improving prescription quality in an in-patient mental health unit: three cycles of clinical audit

Priti Ved and Tim Coupe
PB 2007 31: 293-294. [Abstract] [Full Text]  

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Related articles in PB Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Hallahan, B. Articles by McDonald, C. Search for Related Content PubMed Articles by Hallahan, B. Articles by McDonald, C.