[log in to unmask],Net writes:
>From: Jel Coward <[log in to unmask]>
>I have been horrified to discover what has been happening in our
>practice with some repeats.
>The staff (receptionists) were horrified 'What are we going to do with
>people who have run out of repeats?' My suggestion that this was a
>doctors responisbility was met by derisory laughter.
Yes. Ours were used to writing by hand prescriptions from patients
telephoning, which were signed in a batch with no indication of which
was off a repeat card, and which was either another issue of something
the patient had had before, or just a best guess at what the patient
had said they would like, without a doctor being involved at all.
It improved when we computerised, because they were spelled correctly.
And then there was quite a ruction when the third copy of a
prescription for Quinidine _didn't_ get translated by the Pharmacist
into Quinine.
Mind you, the first one was by a doctor, not me, somebody else.
>I feel that my ass is very exposed here (not a pretty sight).
a. yes. b. no opinion.
>1. Does anyone beleive that it can be right to allow staff to
>reauthorise meds without documented Dr approval?
I would prfer to build the automatic reauthorisation under firm rules
in some cases into the program. Unsupervised staff, absolutely not.
>2. Does anyone beleive it is fair to expose your partners to such risk
>by asking them to sign repeats that you have not authorised and
>documented (and perhaps not seen the patient for 3 years)?
Isn't it a rather pointless activity signing somebody elses' patients'
repeats? You have almost no chance of spotting anything untoward
anyway, and since repeats are rarely urgent it should be easy for
everyone to sign their own.
>3. Does anyone do this - come on, be honest - I have been.
No.
I have a list of nursy preparations, dressings etc, each of which has a
quick code for a suitable prescription of, and the district nurses have
the A4 lists and use these to ask for exact matches, whereupon the
staff generate the acute prescription, but it is clear from the presnce
of the A4 sheet that these are exceptional FP10s.
>5. Does anyone think that it is not negligence to allow your staff to
>prescribe?
No.
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