Semi-acute settings and transcribing

Tracy Rogers, Director, Medicines Use & Safety, Medicines Use and Safety TeamPublished

Consideration needs to be given to the risk factors particularly associated with transcribing in semi-acute settings

Risk factors

Factors will be considered in terms of those that confer risk, those that reduce risk and those factors that have the potential to influence risk either way, depending on other variables.

Examples of semi-acute setting

Semi-acute care settings include:

  • Community hospital
  • Rehabilitation unit
  • Mental health unit (non-acute)
  • Hospice

Healthcare setting factors

Conferring risk

  • A greater stocklist of medicines in clinical areas presents risk because transcribing errors may result in patient administration, simply due to easy accessibility of the medicine.
  • There is the risk that transcribing may be used as a substitute for prescribing and a clinical review.

Reducing risk

  • Where available, electronic prescribing systems reduce the need for transcribing unless patients moving between different care settings.
  • Administration charts should be designed to reflect average length of stay, which minimises need for transcribing onto new chart.
  • Administration charts should be agreed for use across the health economy in order to facilitate familiarity.

Personnel factors associated with setting

Conferring risk

  • May have limited medical input.
  • May have limited clinical pharmacy involvement.

Variable risk

  • Transcribing may be seen as an administrative task by registered staff.

Reducing risk

  • Registered staff should be familiar with medicines and indications.

Process factors associated with setting

Variable risk

  • Transcribed charts cannot be used as a prescription to supply medicines.

Reducing risk

  • Medicines reconciliation on admission should reduce risk, but may not be available within 24 hours.
  • Administration undertaken by registered staff who should act as layer of defence, if there is transcribing error.

Medicine factors associated with setting

Conferring risk

  • May have high risk medicines, e.g. high strength opiates.
  • May have high risk administration methods, e.g. complex syringe drivers.