Print this page Email this page Users Online: 36 | Click here to view old website
Home About us Editorial Board Search Current Issue Archives Submit Article Author Instructions Contact Us Login 
ENHANCING EDUCATION AND PRACTICE
Year : 2002  |  Volume : 15  |  Issue : 3  |  Page : 315-325

Intern Prescribing Decisions: Few and Far Between


1 Discipline of Clinical Pharmacology, Faculty of Medicine and Health Sciences, University of Newcastle, Australia
2 Health Professional Education, Faculty of Medicine and Health Sciences, University of Newcastle, Australia

Correspondence Address:
Sallie-Anne Pearson
Discipline of Clinical Pharmacology, Faculty of Medicine & Health Sciences, University of Newcastle, Mater Misericordiae Hospital, Edith Street, Waratah 2298
Australia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Objective: To examine the scope of intern prescribing practices by determining: the proportion of prescriptions that interns chart compared with other medical staff; the proportion of intern-charted prescriptions for which interns are sole decision-makers; whether or not intern-initiated prescribing varies with respect to the specialty to which they are attached, the shifts they are working and the types of charts they are using; the types of clinical conditions for which interns initiate prescribing decisions; and the drug classes that interns use for their self-initiated prescribing. Design: Prospective study of a random sample of intern-charted prescriptions. Setting: Two teaching hospitals of the Hunter Area Health Service, Newcastle, Australia. The study was conducted from the .fth to the eighth month of the intern training year. Main Outcome Measures: The proportion of prescriptions charted by interns that resulted from their own decision-making, the circumstances relating to this, clinical conditions for which they prescribe and drugs prescribed. Results: A total of 17,895 prescriptions were examined-3437 (19%) were interncharted. Interns reported they were the sole decision-makers for 19% (95% CI: 14 - 24%) of prescriptions they had charted. Interns were more likely to initiate decisions in accident and emergency (OR=7.5, 95% CI: 2.2 - 25.2) and obstetric and gynaecology (OR=2.3, 95% CI: 1.6 - 3.2) rotations than in medicine and were more likely to initiate decisions on night (OR=7.3, 95% CI: 3.4 - 15.5) and weekend (OR=1.7, 95% CI: 1.0 - 3.2) shifts than during the day. They were also more likely to prescribe on the ''as required'' (OR=36.6, 95% CI: 20.6 - 65.0), ''statim'' (OR=26.1, 95% CI: 17.0 - 40.1) and ''intravenous'' (OR=7.2, 95% CI: 4.3 - 12.3) charts compared with ''regular'' charts. A total of 52% of intern-initiated prescriptions were for symptom relief; pain, insomnia and nausea; and 75% of the drugs for which interns made independent decisions were analgesics, antithrombotic agents, psycholeptics, antispasmodics, laxatives and anti-asthmatic agents. Conclusion: Interns have a limited role with respect to independent prescribing and take the sole responsibility for only one-.fth of the prescriptions they chart. This limited, albeit safe, approach to prescribing may impact signi.cantly on an intern's opportunity to acquire the skills necessary to become an independent, rational prescriber.


[PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed380    
    Printed27    
    Emailed0    
    PDF Downloaded59    
    Comments [Add]    

Recommend this journal