Background
Prescribing errors occur in up to 15% of UK inpatient medication orders. However, junior doctors report insufficient feedback on errors. A barrier
preventing feedback is that individual prescribers often cannot be clearly
identified on prescribing documentation.
Aim
To reduce prescribing errors in a UK hospital by improving feedback on prescribing errors.
Interventions
We developed three linked interventions using plan*do*study*act cycles: (1)
name*stamps for junior doctors who were encouraged to stamp or write their
name clearly when prescribing; (2) principles of effective feedback to support
pharmacists to feed back to doctors on individual prescribing errors; (3)
fortnightly prescribing advice emails that addressed a common and/or serious
error. Implementation and evaluation
Interventions were introduced at one hospital site in August 2013 with a
second acting as control. Process measures included the percentage of
inpatient medication orders for which junior doctor s stated their name.
Outcome measures were junior doctors’ and pharmacists’ perceptions of
current feedback provision (evaluated using quantitative pre*post
questionnaires and qualitative focus groups), and the prevalence of erroneous
medication orders written by junior doctors between August and December
2013.