A Pharmacist’s 4 Top Tips for Safe Prescribing

• ISMP has a list of dangerous abbreviations you can download and print for your office
• Prioritize eliminating abbreviations associated with the highest risk medications in your practice (eg, insulin, anticoagulants, opioids, drugs in pregnancy)
• Make a goal of stopping use of one abbreviation at a time, over a set period, until they have been eliminated

Focusing on one abbreviation at a time will help ensure that the new habit sticks. I did that with “QD” in pharmacy school (I actually write out quite a few prescriptions too when I take them as verbal orders) and got in the habit of writing “Qday;” it quickly became second nature.

• There are numerous drug interaction checkers, including apps – they are all your friends!
• When the pharmacist calls you about a drug interaction, the best practice is to personally take the call
• Be sure to include medications that other providers have written when checking interactions

Three popular online databases to check interactions that I recommend are: Facts and Comparisons® eAnswers, Lexi-Comp, and MicroMedex. All provide information on drug uses, dosing, administration, warnings and precautions, interactions, pharmacodynamics and pharmacokinetics, and other essential features and characteristics. The services provide a suite of tools including a drug interaction checker. Enter a list of a patient’s medications and it will screen and cross screen for potential interactions.

• Never write the dose out in tablespoon or teaspoon-always write both the volume (in mL) and dose (in mg or other appropriate unit) on the prescription
• Write the child’s weight on the face of the prescription so we can double-check the dose
• For antibiotics especially, it helps us if you write the indication

• E-prescribing eliminates many sources of errors, but also introduces opportunities for new errors
• Drug product mix-ups are particularly common
• Be careful with units when assigning a quantity