1 The General Medical Council’s EQUIP Study, involving 19 Trusts in North-West England, found 11,077 errors from 124,260 medication orders (8.9% prescribing error rate).2 The error rate varied according to prescriber: 8.4% Foundation Year 1 doctors, 10.3% Foundation Year
2 doctors, consultants 5.9%, nurses 6.1% and pharmacists 0%.2 It is well recognised that involving pharmacists in the prescribing pathway reduces the risk of an error reaching the patient. What is less well understood is the actual error rate of pharmacist prescribers. This study aimed to quantify prescribing selleck compound by pharmacists and determine the error rate. The study was undertaken across three district general hospitals. Part one assessed prevalence of prescribing by pharmacists and part
two assessed the prevalence of prescribing errors made by pharmacists. In part one, prevalence of prescribing by pharmacists was assessed by counting the number of items prescribed by a pharmacist compared with all items prescribed. click here Data were collected for all patients on the ward, one ward at a time from September to October 2012. In part two, a clinical check of prescribing by pharmacists was undertaken by other pharmacists, recording errors as categorised by the EQUIP study.2 EQUIP used clinical pharmacists to clinically assess prescribing by doctors; 29 error categories (e.g. missing signature, interaction) were defined and these categories were used to identify errors in this study. Data for part two were collected over two consecutive weeks in November 2012, across three hospitals. Advice
on Ethical Approval was sought from the Trust’s Research Development Unit. A total of 457 patients (on 26 wards) were included in part one of the study with the pharmacist prescribing for 182 (39.8%) of patients. Pharmacists prescribed 12.9% of all items (680 from 5274 items). Pharmacists prescribed a wide variety of medication from 12 out of the 15 BNF categories (no prescribing of drugs used in malignancy, immunology and anaesthetics). The majority of prescribing was for central nervous system, cardiovascular and respiratory medicines. In part two, pharmacists prescribed for 155 patients on 31 wards Chloroambucil across three hospitals. 1,413 pharmacist prescribed items were clinically checked, with 4 errors (0.3%) noted. Two errors were interactions, the wrong analgesic was prescribed in one instance and one prescribing entry was not signed. This study has shown that two fifths of patients admitted to three district general hospitals were prescribed a medicine by a pharmacist, with one in eight of all items being prescribed by pharmacists. This study also shows that pharmacists are not focusing on a limited formulary of medicines but are prescribing from all but three sections of the BNF. This study has shown a low error rate associated with pharmacist prescribing of 0.3% compared with 8.