REPEAT PRESCRIBING AUDIT PROFORMA

Transcription

1 REPEAT PRESCRIBING AUDIT PROFORMA Practice Name: Practice Number : Date Completed: Completed by: Aim: to audit the entire repeat prescribing process within the practice and to allow identification of areas where further work is required, if necessary, to ensure that the practice is maintaining a quality repeat prescribing protocol. Grading System size A = Standard fully achieved B = Standard broadly achieved C = Considerable scope for improvement D = Deficiency with potential for wastage or adverse events A random sample of a minimum of twenty prescriptions should be used with at least 3 repeat items. Forty-fifty will be needed for larger practice

2 1. Existing Repeat Prescribing Protocol 1.1 Does the practice have a policy governing repeat prescribing? 1.2 Is the policy written and accessible to all members of staff? 1.3 Are all staff trained regularly and aware of the policy? 1.4 Is the policy included as part of your induction for new members of staff? 2. Ordering Prescriptions 2.1 Is there a clear method for ordering repeats with an explicit timescale for issue? 2.2 What is the timescale? hrs 2.3 What information does the practice require when taking requests? Name Drug Name Address Drug Dose DOB Pharmacy 2.4 Is this timescale for notice generally enforced? 2.5 How are patients made aware of these arrangements? 2

3 3. Records Assess sample of repeat prescriptions 3.1 Do all prescriptions have full, clear directions for use? i.e have a dose and frequency stated 3.2 Is there a standard number of days supply for a patients medication? 3.3 Are patients checked for overuse/underuse at time of ordering? 3.4 How does the practice deal with these early/ late requests? Assess sample of repeat prescriptions 3.5 How far in advance of the due date is the practice happy to accept requests for further repeats? days 3.6 Does the practice have a policy for dealing with requests for changes to repeat by GP or patient? i.e. holidays 4. Initiating Repeats 4.1 What system has the practice in place for authorisation of new repeat medication? 4.2 Are repeat prescribing screens regularly tidied? i.e. drugs not issued in the past year removed (note exclusions Appendix 1) 4.3 Is there an Indication in patient for any new repeats initiated after April 2004? Computer scripts and check 3

4 5. Hospital Letters 5.1 Are all hospital letters given directly to a GP for action? 5.2 Does the GP carry out all the necessary actions? i.e. adding and removing the appropriate drugs 5.3 Does the practice adhere to the timescale for repeats when producing scripts from hospital letters? 6. Prescription Collection 6.1 Does the practice have a policy regarding who can collect prescriptions and how identity is checked? 6.2 Is there a procedure for patients under 16 years collecting prescriptions? 6.3 Is there a record of prescriptions staff collected by pharmacies? 6.4 Does the practice have a policy regarding missing scripts? i.e. do they check with the chemist, reprint 6.5 Are there any problems for the practice with pharmacy collection services? 6.6 Are uncollected prescriptions destroyed? 6.7 Are uncollected prescriptions removed from patients medication screen? 4

5 7. Recording of Prescriptions 7.1 How are prescriptions for home visits recorded? 7.2 How are prescriptions that are issued Out of Hours recorded? staff Records 7.3 How are prescriptions issued by any nurse prescribers in the practice recorded? 8. Specialist Drugs 8.1 Is there a system in place to deal with Consultant only prescribed drugs? eg Roaccutane 8.2 If yes, what is the procedure for patients initiated on a Consultant only medicine? 8.3 Are these recorded on the repeat prescribing screen? 8.4 Does the practice have a system in place for drugs that need require monitoring? E.g. Methotrexate, Statins etc 9. Medication Review 9.1 Is there a record of most recent review? 9.2 How does the practice know when a medication review is due? i.e review date 9.3 How does a patient know that their review is due? 9.4 What action is taken if the patient does not attend for review? 5

6 9. Medication Review (continued) 9.5 Who is responsible for deleting inactive repeats? 9.6 On review, are all medications checked for concordance and action taken for under/over use? 9.7 Where necessary, what action is taken? 10. Computer Security 10.1 Does each member of staff have their own password? 10.2 Does each staff member log off if leaving the terminal? 11. Prescription Security 11.1 Is there a procedure for recording serial numbers of prescriptions? 11.2 Are blank forms kept in a locked cupboard? 11.3 Is there a procedure for the issue of blank prescriptions? i.e. Locums 11.4 Are there appropriate storage facilities for signed prescriptions awaiting collection? 6

7 12. Audit 12.1 Does the practice have a system in place to allow regular audit of the repeat prescribing system? i.e hospital letters, prescription security Acknowledgement NHS D&G s Prescribing Support Team would like to thank our colleagues in Ayrshire & Arran for developing this document and for allowing us to use it. 7