By London Deanery | September 26, 2018
PRESCRIBE MEDICATION SAFELY, INCLUDING RAPID TRANQUILISATION
To assess this clinical skill you will be asked to fill in a drug chart for a patient. Trust audits highlight that a significant number of patient prescription charts have been filled incorrectly. In particular the prescribing of tranquillisation of disturbed or agitated patients has been identified as an area of concern.
You will be asked to write up rapid tranquillisation medication on the “as required” (PRN) on one of your own trust prescription/medication charts.
You may also be asked to prescribe some further medication (you will be given the name, dose and frequency) and need to complete the chart accordingly.
NB! THIS COMPETENCY ASSESSMENT MAY BE SIGNED OFF BY A WARD OR TRUST PHARMACIST, YOU CAN SCHEDULE THIS YOURSELF OR IT MAY BE SCHEDULED INTO PART OF A PHARMACY TRUST INDUCTION.
THIS CLINICAL SKILL REQUIRES ALL THE PRINCIPLES OF GOOD PRESCRIBING IN ANY CLINICAL SPECIALTY:
- Have clear and legible handwriting. Upper case preferable. Most trusts require the use of black ink.
- Always check personal details
- Fill in allergy box even if to state there are no allergies
- Prescribe the drugs with the generic name and dosage (both number and units)
- All medications prescribed should be signed and dated
- With PRN medication ensure frequency, reason for use and maximum in 24 hours are clearly stated
- You also need to be aware of your trust’s rapid tranquillisation protocols and algorithm and prescribe accordingly. This may be covered in your Trust Induction but it may be sensible to speak to your trainer or ward pharmacist about this at the start of the post prior to assessment.
Note: for Children and Adolescents and also with the elderly, the medications and doses use vary. Your trust can provide you with their guidance on this.
Below is the NICE guidelines algorithm. However it is also suggested you familiarise yourself with the following NICE guidelines documents available electronically:
- Violence: The short-term management of disturbed/violent behaviour in psychiatric in-patient settings and emergency departments:
- Medications: Summary of Product Characteristics:
Form to sign off the Competency
Note: You can either fill this PDF form on a computer (preferably together with your assessor) and print it out for the assessor to sign, or you can just print the page and fill it out by hand together with the assessor. In any case after the form is signed, you will need to scan it to upload to your portfolio, just like you would with any paper-based evidence form. If you fill the form on your computer you need to SAVE it with a different name - so that the text you typed into the form gets preserved. A form filled on a computer probably, will be easier to read.
If the form opens directly in your browser you probably will not be able to type in the form fields - for that you need to open the form with your system PDF viewer - which likely will be Adobe Reader.