Drug charts in Unity

February 4, 2019

By Dominic LeGros, Informatics Nurse

I’m back to talk Unity again. This week, I’m going to focus on one of the most critical bits of paper (or cardboard) we currently use; the drug chart.

Handwritten drug charts are one of the single biggest concentrations of potential errors, or they have a habit of going into hiding when it’s time for a drug round (it’s not always in pharmacy!).

Let’s look at potential sources of error; the first, and most concerning, is inappropriate abbreviations. The best example of this is “units”, if a hastily written “u” is used in its place, the consequences can be severe – insulin errors are a never event…

Another paper pitfall comes from drugs with similar names, especially when brand names get involved; consider Parvolex and Pabrinex (n-acetylcysteine and vitamin B/C high potency), I have seen one prescribed in place of the other on more than one occasion.

Dosages can get muddled up, is that a 125, or 12.5? Was it milligrams or micrograms? Easily confused, especially once the drug chart is wearing a cup of coffee (or two).

So, how will Unity help?

Legibility is an obvious gain, no dodgy handwriting, no smudged ink – just easy to read text.

Abbreviations can only be used in prescribing if they are allowed within Unity, most parts of a prescription that tend to get abbreviated are replaced with drop-down lists in Unity so that correct terms are used.

Our EPMA (electronic prescribing and medication administration) team have configured Unity to accept only generic drug names for the vast majority of drugs (there are select drugs where prescribing by brand name is good practice – this is reflected in Unity) as generic names are usually less likely to be mixed up. In addition, Unity uses a system called “tall man” letters to help identify drugs with names that may get mixed up e.g. cefoTAXime vs cefTRIAXone.

Dosing errors will be reduced by something called “order sentences”, these include all of the information required for common prescriptions of a given drug, such as “paracetamol, 1g tablets by mouth, four times a day PRN, for pain” rather than having to select each element of the prescription. Unity will also (where available) offer age appropriate order sentences.

Finally, the incredible disappearing drug chart will be a thing of the past. A major advantage of electronic records is the ability to access them from anywhere meaning that a chart can be reviewed without needing to physically remove it from the clinical area and interrupting a drug round.

#HellomynameisDom, and I am one of your informatics Nurses

#Unityiscoming