The quality of written inpatient prescriptions

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Abstract
The aim of this study was to determine the quality of inpatient prescription writing. Prescriptions from a teaching hospital and a district general hospital were assessed against prescription writing standards drawn from the British National Formulary and local procedures. The prescription charts were from a stratified sample of inpatients discharged between July, 1989, and July, 1990. Over 400 inpatients' charts, containing 4,536 prescriptions, were examined. Depending on the type of prescription, between 12 per cent and 32 per cent failed to use the approved name of the drug and 4 to 10 per cent were illegible or ambiguous. The dose was written incorrectly in 11 to 26 per cent of cases. Failures were particularly common in “as required” prescriptions, with 21 per cent potentially allowing an overdose of a drug to be given and 5 per cent indicating more than one route of administration. Three per cent of fluid additive prescriptions had not had the type of fluid defined. The standard of inpatient prescription writing needs to be improved. This paper offers objective standards which could be used to start a regular audit process.

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