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Improving prescribing

In partnership with Health Education England, the Dudley Group NHS Foundation Trust aimed to improve prescribing and patient safety through simulated training sessions where pre-registration pharmacists and foundation doctors learn and work together.


Related themes

  • Multi-professional team

Background

The ‘promoting practical prescribing course’ project was multi-professional and focused on improving prescribing (from the point of view of foundation doctors) and improving the understanding of the clinical context of prescribing (from the point of view of young pharmacists). The idea was to get pre-registration pharmacists and foundation doctors learning together and developing closer working relationships on the wards as a result.

How they did it

The project team developed a training course on safe prescribing and assessed the impact of this learning against length of stay, drug prescribing in the elderly, accuracy of completed To Take Out forms (TTOs) (forms which are used by practitioners to record discharge medicines required by the patient), antibiotic/ insulin prescribing audits, and trainee feedback. The sessions were aligned with the foundation year curricula and supported by resources from the SCRIPT e-learning system, which includes e-learning modules on prescribing that all doctors in the  West Midlands are required to complete.

Outcomes

  • The confidence and skills of trainees were enhanced, along with a noticeable increase in efficiency and productivity
  • Adherence to national guidelines increased from 40% to between 55% and 60% for respiratory and elderly care wards respectively
  • An improvement in completion of prescription charts and the insulin audit results showed an increase from 79% to 100% in the recording of insulin devices on charts.
  • Trainees were found to be more safety aware when prescribing
  • Trainers were able to share the risks of prescribing in their speciality with the trainees and raise awareness. This improved prescribing in protected time, away from the ward environment
  • Feedback from trainees helped them to improve their teaching technique, and tailor each teaching session to enable trainees to get the most out of the session
  • There was an improvement in prescribing that would lead to an improvement in administration, reduction in incidents, and also better, safer care for the patients
  • Working relationships between pharmacists and trainees, and communication and understanding of each other’s roles was greatly improved by the implementation of the pilot.

What they’ve said

“The project helps to build professional relationships with the trainers which makes it feel easier to approach them on the wards… it’s very useful to have a ward-based pharmacist” Trainee

“I feel I have more confidence in explaining why I’ve done things” Trainee

“I feel I am more aware of the potential pitfalls of prescribing and therefore am more aware to double check something before prescribing” Trainee

Toolkit

Please look at the toolkit materials in the document section below. The top tips and business cases have been developed by the BTBC team to support organisations to implement these changes and the case studies and project resources have been developed and approved by the project teams.

The top tips include lessons learnt that have been identified throughout the project. The business case will guide you through the management principles and communications and engagement activities. The case studies provide a detailed overview of the project. Feel free to adapt these resources to suit your projects. Your organisation may have its own materials and templates that you can use or you may find the NHS Improving Quality (NHS IQ) learning handbook useful too.

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