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Nurses spot doctors' prescribing mistakes to prevent lethal errors, says research

  • 21 Comments

Nurses, senior medics and pharmacists are regularly correcting doctors’ mistakes with medicines, according to research.

The study, commissioned by the General Medical Council, found that “doctors relied heavily on pharmacists and nurses to identify and correct errors”.

The report said some of the junior doctors interviewed thought these “safety nets” were so efficient they did not need to worry too much about their errors reaching patients.

The GMC called for a standardised prescription chart - the type that sits at the end of a patient’s hospital bed - to be introduced across England to cut down the number of errors.

Research involved 19 hospital trusts in North West England. Errors, which occur in around one in 10 hospital medication orders, are sometimes caused by what the report calls “a lack of safety culture” in the NHS.

The study said: “A ‘safety culture’ was conspicuous by its absence from respondents’ discourses of their prescribing errors, the reported culture of their working environments and the reported actions of other doctors.

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  • 21 Comments

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Readers' comments (21)

  • I don't find these results in the least surprising. I remember having to correct junior doctor errors as a newly qualified staff nurse! Although I had trained for 3 years as opposed to their 5 years!

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  • Michael Sandiford

    I agree with Victoria, this isn't suprising at all! I remember when I first qualified and began working on a cardiac cath. unit. I was asked on many occasions by junior doctors, what and how much of a drug should be prescribed! Only slightly worrying!

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  • Doctors are taught very little about medicines when in Uni. So it is unfare to expect a perfect prescriber when they leave and take up work.
    Prescribing is complicated and to be fair I would rather they ask about something rather than presume before they prescribe.

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  • Michael Sandiford

    To James Davidson: Fair point, its good to ask rather than just blindly prescribe! But if thats the case, doctors education needs to be addressed if they are put in this situation.
    Nurses aren't taught a great deal about medication during their training. Junior doctors need to be better supported by their seniors.

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  • I don't understand why anyone is surprised by any of this. Medical students don't really get taught anything about pharmacology. They are taught by doctors who are in training themselves ( where I lecture the pharmacology course is run by a registrar as part of his/her training- trainees teaching trainees will always be a recipe for disaster). Medical students only get taught, if they are lucky, about the mechanism of action of medication- if that.
    Doctors are unable to teach. I have seen a well seasoned old school consultants inappropriately prescribe anticonvulsant medication, antibiotics and all sorts. Believe me doctors unable to prescribe is the tip of the iceberg- you would be amazed at how many can't examine a patient, interpret investigations etc!

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  • James Davidson | 3-Dec-2009 3:26 pm

    Doctors are taught very little about medicines when in Uni. So it is unfare to expect a perfect prescriber when they leave and take up work.
    Prescribing is complicated and to be fair I would rather they ask about something rather than presume before they prescribe.
    -------------------------------
    I totally disagree with this comment. A doctor before prescribing the medication, should know everything about it, if not do what everyone else does and go read about it in the bnf ect.. to accept that education is to blame and thus not thier fault is evidence of the root of the problem. Nurses face reassessment for drug errors, why should this be ANY different for doctors ?? Who protects the nurse when administering ??

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  • It's good for doctors to ask when they do not know rather than putting patient's lives at risk.I do not have an idea of the content of their training but as a registered nurse when I started working in the ward I used to ask the HCA's the management of patiens.That helped me,if we have issues with this problem we know our lines of communication and it will help the patients and our hospitals.

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  • Prescribing errors by doctors? Hardly surprising is it? Look at the amount of medications they have elderly patients taking. This can't be any good for patients and often contributes to them ending up in hospital- interactions with warfarin, falls in the elderly etc. I think the answer should be for a prescribing apprenticeship in hospital as part of their training. This way junior doctors should not prescribe anything more than simple analgesia unless supervised by a skilled doctor or nurse in the area. I bet there are no junior doctors that would resist this notion- the majority would be very grateful I should imagine.

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  • Hardly surprising news, and as Anonymous has said, it is just the tip of the iceberg. I have had a doctor calling out my name with some urgency, whilst trying to take bloods ( to check if it was a vein and not an artery!! ). We all have to learn, but it has to be done in a safe environment.

    I would much rather work with a doctor who will ask and seek guidance, knowing their limitation, than not.

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  • Why have we allowed a sytem that is so unsafe and unsatisfactory exist for so long? If everyone did the 6 month prescribing course that you have to do to be a non medical prescriber the healthcare world would be much safer and much more economical. Its not ehtically or morally right to expect junior doctors to prescribe drugs that they don't understand, and "learn" on vulnerable patients. Having more experienced professionals such as nurses and pharmacists prescirbe is safer, and gives patients a much better quality, faster, holistic and seamless access to drugs, with much better continuity of care.

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