Transcribing in the patient’s home with healthcare input

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 the patient's home with healthcare input

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 setting

Teams that deliver healthcare within the patient’s home include:

  • Rapid response team
  • Virtual ward
  • Community nursing team
  • Community IV team

Healthcare setting factors

Conferring risk

  • Patient may have supplies of medicines that have been discontinued.
  • More than one organisation prescribing for the individual, resulting in more than one record of medicines.

Reducing risk

  • Patient has own labelled medicines and only medicines for the household are available, so picking errors may be reduced.

Personnel factors associated with setting

Conferring risk

  • May have limited medical input and limited access to medical notes which increases errors in transcribing.
  • May have little or no 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

  • Patient’s own labelled medicine provides a transcription of the prescription, but this might not reflect any recent changes or have adequate instructions for some medicines (e.g. insulin).

Reducing risk

  • Direction to administer should be in place where staff are required to administer in the absence of a comprehensively labelled dispensed medicine.
  • Administration undertaken by registered staff who should act as layer of defence if error in transcribing.

Medicine factors associated with setting

Conferring risk

  • May have high risk medicines.
  • May have high risk administration methods.