Aims FP10s are routinely used for children requiring urgent medication on discharge home from the emergency department. FP10s are legal documents requiring specific patient, prescriber and medication data for dispensing by a pharmacist. There is a cost associated with this, which is not regulated if certain unlicensed concentrations are used; our department had previously incurred a cost of £2000 for liquid ranitidine.
We aim to audit the quality of FP10 prescribing and type of medications prescribed in a South London Children’s ED.
Methods A retrospective analysis of a random selection of 150 FP10s issued over the preceding 6 month period. We used guidance from BNFc and London Deanery as the standard for legal requirements and good practice prescribing.
Results 150 prescriptions were analysed. 39 different medication groups were prescribed; the commonest being antibiotics, asthma medications and analgesics.
All prescriptions were legible and included patient name, DOB and prescriber signature. Patient age, address, date of prescription and name of prescriber were included in at least 97% of our sample. GMC number was included in only 27% of FP10s.
The majority of medications were prescribed by their generic name and a dose provided (87%, 87%). However, only 45% included a route of administration, 61% included the formulation required and 19% included a concentration of a liquid medication. 3% of FP10s specified a weight with no prescriptions indicating a dose/kg. 2 prescriptions gave a dose in micrograms, however both were incorrectly abbreviated to ‘mcg’.
No sugar-free preparations were prescribed.
71% of patients had allergy status appropriately documented.
Conclusion We must ensure that FP10 prescribing is legally correct and cost effective. We have introduced specific FP10 teaching during induction. A poster highlighting required information with ‘model’ FP10s has been placed at point of use. Doctor name stamps are being encouraged. Re-audit following these changes will be performed.
Electronic prescribing would improve FP10 prescribing.
Dispensing costs can be reduced through specific prescribing and pre-pack dispensing of the most commonly prescribed medications. Implementing these changes could potentially save our department up to £10K per year.