WHAT IS A PRESCRIPTION?

Stems from the Latin term praescriptus meaning to write before

Ancient prescriptions were noted for their multiple ingredients and complexity of
preparation
Need for complete understanding and accuracy universal and standard
language be used
Present day prescriptions are written in English, doses given in the metric system
A prescription is a written order for compounding, dispensing and administering
drugs to a specific client or patient
Once signed by the physician, it becomes a legal document.
It is an official written document from a physician to signify that an order of a
specific drug and its proper dosage is authorized by a legal physician.
Most prescriptions are given to the pharmacy by patient to receive the prescribed
drug or medication.

WHAT IS A PRESCRIPTION?
Instructions on the prescription should include a reminder of the intended
purpose of the drug
Learn the units of the quantities and apothecary symbols which can easily be
misread or misunderstood

PARTS OF A PRESCRIPTION
These are the essential parts of a drug order or prescription written by
physicians.

-full name of the client
-date and time the order is written
-name of the drug to be administered
-dosage of the drug
-frequency of administration
-route of administration
-signature of the person wrting the order

PARTS OF A PRESCRIPTION
TYPES OF DRUG ORDERS
1. STAT ORDER - indicates that the medication to be given immediately and only once (e.g.,
Demerol 100 mg IM stat)

2. SINGLE ORDER or One-Time Order - is for medication to be given once at a specified
time (e.g., Seconal 100 mg hs before surgery)

3. STANDING ORDER - may or may have a termination date. may be carried out indefinitely
(multivitamins) until an order is written to cancel it, or it may be carried out for a specified
number of days (Demerol 100 mg IM q4h x 5 days). In some agencies, standing orders
are automatically canceled after a specified number of days and must be reordered.

4. PRN ORDER - permits the nurse to give a medication when, in the nurse's judgement, the
client requires it. (Amphojel 15 mL prn). The nurse must use good judgement about when
the medication is needed and when can it be safely administered.

ERRORS IN PRESCRIPTION
1. Inadequate knowledge of the patient
Wrong diagnosis
2. Inadequate knowledge of the drug
3. Calculation error
Dose error
4. Illegible handwriting
5. Drug name confusion
6. Poor history taking

ERRORS IN PRESCRIPTION
7. Abbreviations


Abbreviation Intended Meaning Misinterpretation
g microgram Mistaken as mg
BT Bedtime Mistaken as
BID(twicedaily)
cc Cubic centimeters Mistaken as u units
IU International unit Mistaken as IV OR 10
o.d. or OD Once daily Mistaken asright
eye(OD-oculusdexter)
q.d. or QD Everyday Mistaken as q.i.d.,
qhs Nightly at bedtime

Mistaken as qhr or
every hour
qn Nightly or at bedtime Mistaken as qh (every
hour)
q.o.d. or QOD Every other day Mistaken as q.d.
(daily) or q.i.d. (four
times daily)
Drug Abbreviations

Abbreviation Intended Meaning Misinterpretation
APAP acetaminophen Not recognized as acetaminophen
ARAA vidarabine Mistaken as cytarabine(ARAC)
AZT zidovudine Mistaken as azathioprine or
aztreonam
CPZ Compazine(prochlorperazine) Mistaken as chlorpromazine
DPT Demerol-Phenergan-Thorazine Mistaken as diphtheria-pertussis-
tetanus (vaccine)
HCl Hydrochloricacidor
Hydrochloride
Mistaken as potassium chloride
HCT Hydrocortisone Mistaken as hydrochlorothiazide
HCTZ Hydrochlorothiazide Mistaken as hydrocortisone
MgSO4 Magnesium sulfate Mistaken as morphinesulfate
MS, MSO4 Morphines ulfate Mistaken as magnesium sulfate
MTX Methotrexate Mistaken as mitoxantrone
PCA Procainamide Mistaken as patient controlled
analgesia
PTU Propylthiouracil Mistaken as mercaptopurine
TAC triamcinolone Mistaken as tetracaine, Adrenalin,
cocaine
ZnSO4 Zinc sulfate Mistaken as morphine sulfate

Symbols
Abbreviation Intended Meaning Misinterpretation
/ (slashmark) Separates two doses or
Indicates per

Mistaken as the number 1
@ At Mistaken as 2
& And Mistaken as 2
+ Plus or and Mistaken as 4

WHAT DO PHARMACISTS LOOK FOR?
1. Legal, legible and complete
2. No duplication of pharmacologically similar drugs
3. No identified significant ADRs (including allergies)
4. No significant drug / disease interactions
5. No significant drug / drug interactions
6. The dosage, dosage interval and duration of treatment are reasonable
7. The dosage form and route of administration are appropriate.
8. No formulation / pharmaceutics problems; incompatibilities, stability, rate of
infusion

SAFE PRACTICE RECOMMENDATIONS
1. Lower case letters or mixed case letters
2. Block printing on lightly lined forms
3. Symbolic differentiation
4. Space between the drug name and dose
5. Drug and dose make sense

PGH DOCUMENTATION OF PRESCRIPTION
ERRORS IF INCURRED BY A NURSE
Nurse writes an IR then submits it to the charge-nurse
Charge-nurse forwards IR to Head Nurse of ward
Head Nurse forwards the IR to the Chief Nurse of the ward
The Chief Nurse notes the IR then forwards it to the Department of
Nursing Services in PGH






Source: Verbal interview with Kristine Basinang, RN, Nurse-II, RCB2 4
th

Floor
REFERENCES
http://www.mapharm.com/prescr_parts.htm
http://www.mapharm.com/prescription_writing.htm
http://www.yorksandhumberdeanery.nhs.uk/medicine/cmt/documents/SaferPr
escribingv4Oct2009.pdf
http://www.slu.edu/Documents/nursing/LavinPrescribingErrors.pdf