While e-prescribing is increasingly making handwritten prescriptions a thing of the past, you will likely have to manually prescribe medications at some point in your career. You should also specify the date the prescription was written. Prescription Writing 101 (with Example Prescriptions). Prescription Refills: The prescription label must indicate how many refills you have remaining. If you are unsure whether you should use an abbreviation, spend the extra few seconds to write out your directions completely. A physician may prescribe 1 pack of an oral contraceptive with 11 refills, which would last the patient a full year. You could also just write “1 (one)” as the pharmacist would know what you mean. If you do not want to prescribe any refills, write “zero refills.” For our hypothetical acetaminophen example, if you are prescribing one refill, you would write “1 (one) refill.”. Even though I don’t think I caused any major harm to any of my patients with prescription errors, I wish I had read something like this when I first started writing prescriptions in my 3rd year of medical school. Main part of the prescription; name of the drug, dosage form, and strength. In this post, I’m going to break down all the different parts of a prescription, how to write each section, and what to look out for. I probably killed a whole tree tearing up prescriptions that were wrong. Now let’s look at each part of this individually. In that case, your instructions would read, “Take 1 tablet by mouth every six hours as needed for a headache” or “1 tab PO q6h PRN headache.”, Next comes the dispensing instructions, which let the pharmacist know how much medication you would like your patient to receive. My significant other is a pharmacist, and he always stresses the importance of CLEAR prescription information from the physician. For example, if you would like your patient to take one 650 mg tablet of acetaminophen every six hours, you would write “Take 1 tablet by mouth every six hours” or, using abbreviations, “1 tab PO q6h.”For as-needed or pro re nata (PRN) prescriptions, you should indicate that the prescription is PRN and describe the conditions under which your patient can take the prescribed medication. We’ll be going into the details of each step below. According to the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) national patient safety goals, at least two patient identifiers should be used in various clinical situations. Patient's name and address, the date, and the symbol Rx. So if you choose to use abbreviations in your prescriptions, be sure only to use well-known ones (some commonly used medical abbreviations can be found here). Please check your email for further instructions. Always be cautious when using abbreviations. In learning to write a prescription properly, it is worth discussing two common sources of prescription errors. Classes of Prescription Orders: Effective July 1, 2013, a written prescription must be on a tamper-resistant form consistent with federal requirements for Medicaid. But first, let’s look at why it’s so important to get this skill right. You need to write which one you want. The recipe should include the medication being prescribed, its dose, and its dosage form. It consists of a minimum number of drugs, written in English, employs metric system and may use several abbreviations. As you can see, the abbreviations are either from Latin roots like PO (“per os”) or just common combination of letters from the English word. Below are each of these sections in detail. If there are 800,000 physicians in the United States, each physician accounts for $221,250! Subscription Directions for the pharmacist; size of each dose, amount to be dispensed, and the form of the drug ordered (tablets, capsules, or some other form) Liquids come in specific strengths per amount of liquid. I worried so much about prescription writing in my 3rd year of medical school. Then we have the medication and strength, the amount to be taken, the route by which it is to be taken, and the frequency. Learning to write a prescription? This is important and should be checked by the patient. Great overview of prescriptions. We are dispensing “1 (one) bottle”. Let’s say that you would like your patient to be able to take one 650 mg tablet of acetaminophen every six hours when he or she has a headache. How Do I Know if Medicine is Right for Me? You can follow him on Twitter @sindhu_kunal. Sometimes age or weight is also added, though rarely. how many refills they can get. The “one tab” is the amount of the specific medication and strength to take. For “as needed” medications, there is a symptom included for when it is to be taken. Prescriber information: The doctor's name, address and phone number should be clearly written (or preprinted) on the top of the prescription … As I hinted above, here is the basic format of a prescription: First, we have the patient’s name and another patient identifier, usually the date of birth. When the patient complains of nausea, the nurse can give this medication because it has been prescribed. Sometimes the patient’s home address will be found here, as well. In fact, prescription errors account for 70% of medication errors that result in harm. Writing your prescription as a PRN order essentially gives the patient the option to take the medication when they need it. This is known as “PRN,” from the Latin pro re nata, meaning “as circumstances may require.” For example, you may write for ibuprofen every 4 hours “as needed.”. Premed Q&A Deep Dive and Big Announcement, Ideal MCAT Date, Religion and Medicine & Potential Red Flags. Prescription writing was not covered very well at my medical school. The two most common patient identifiers are their full name and date of birth. This can be anywhere from once a day, once a night, twice a day, or even once every other week. On the prescription pad, there is a small box which can be checked to indicate “brand name only” or “no generics.”. The last instruction on the prescription informs the pharmacist how many times the patient can use the same exact prescription, i.e. Poorly written prescriptions may be one of the main reasons there are so many medication errors today. A prescription is an order that is written by you, the physician (or future physician), to tell the pharmacist what medication you want your patient to take. Kunal Sindhu is a resident physician in New York City. Watch the video above if that’s a more appealing format to you! This is convenient for both the patient and physician for any medications that will be used long term. It generally consists of the prescribing clinician’s name, office address, and contact information (usually the office’s telephone number). To reduce medication errors, QD and QOD are on the JCAHO 'do not use' list for prescription writing. Note: It is often suggested that to help reduce the number of medication errors, prescription writing should be 100% English, with no Latin abbreviations. That is the basic outline of how to write a prescription. You should also make sure to write out any numbers you use here to minimize the risk of a medication error. Statement of Support for Black Lives Matter, Purposeful Prescribing: A dentist’s role in the opioid epidemic, Four Errors Students Make in their First Semester of Medical School.
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