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There are two principle ways in which drugs are prescribed. Drug prescriptions may be recorded on prescription forms to be dispensed by a pharmacist to the patient. Alternatively, a drug may be prescribed on a hospital in‐patient prescription to be administered by a member of staff other than a dispensing pharmacist (Figures 4.1 and 4.2).

Figure 4.1 Example community prescription conforming to the principles outlined in this chapter.

Source: NHS Scotland.

Figure 4.2 Examples of hospital prescription chart prescribing, including some important examples of poor prescribing practice with the potential to lead to error.

Both types of prescription require similar information and you should adhere carefully to the following principles to ensure that your prescription is clear and safe. Drug administration errors often arise because an insufficient amount of attention has been given to making a prescription clear.

1 Ensure that the prescription contains sufficient patient‐identifiable information. The legal requirement is for the name and address of the patient (and the age if under 12) but in practice you should include the date of birth and appropriate identifying numbers, such as the Community Health Index (CHI) number in Scotland.

2 The prescription should be completed in an indelible manner – for example printed or written in ink. All prescriptions should be signed in a manner that allows the prescriber to be identified later.

3 The prescription should include the drug name, dose, route of administration and frequency. Dispensing prescriptions should always include the number of days treatment or the total quantity of drug to be administered.

4 Use the approved generic name of the drug wherever possible. Only prescribe a branded product if it is important that the patient receives that product.

5 Avoid abbreviations unless approved and universally accepted. Abbreviating grams (g), milligrams (mg), millilitres (ml or mL) is acceptable but micrograms, nanograms and units must be written out in full to avoid confusion. Similarly, decimal points should be avoided wherever possible and leading decimal points should never be used (i.e. 0.5 mg rather than 0.5 mg although 500 micrograms would be better).

6 Make sure that the entire prescription is legible and avoid crossing out and correcting mistakes – it is better to rewrite the prescription if a mistake is made.

7 Note that there are specific requirements for writing controlled drug prescriptions:The form of the medicine (i.e. tablets, capsules, etc.) must be stated even if only one form is available.The total quantity of medicine to be dispensed must be stated in both words and figures (i.e. 20 (twenty) 10 mg tablets). It is not necessary to state the dose in words and figures.The prescription can be printed but must have a handwritten signature.While it is not a legal requirement, the supply of a controlled drug should not exceed 30 days except in exceptional circumstances, which should be recorded.