Correct Prescription Basis, a Pillar in Medication Management in Nursing Homes

The prescription basis is an original document. Many serious errors have occurred when nurses have copied a prescription basis or when the basis is unclear. A misplaced comma can mean that the individual receives a dose of the drug ten times too strong.

In nursing homes, correct medication management is of decisive importance for the elderly's health and safety. A central component in this process is to have correct prescription bases. Prescription bases are the documents and information used to administer medicines to the residents.

Normally, it is always doctors who prescribe and prescribe drugs. Some drugs can also be prescribed by a district nurse with prescribing rights. In addition, there are often "General directives" where the nurse can prescribe based on their own assessment. It could be about giving Paracetamol for headaches and similar prescriptions.

Prescription bases should be current. When initiating or discontinuing medication, the basis should be updated. Many care recipients have pre-packaged dose pouches. When changes are made, it is important that the nurse replaces the old basis. This should then be done both in connection with the staff's signing list and in the care recipient's paper journal. If the care recipient is not registered in Pascal, the health center should provide new prescription bases. Pascal is a digital portal that has information about all dose drugs.

When delivering doses, the dose pouches should be checked by a nurse so that what is in the packages corresponds to what is prescribed and that any changes are included.

The routines also need to work to get in temporary prescriptions that can come by phone from the doctor.

What is a prescription basis?
A prescription basis includes all information that the healthcare staff need to administer medicines in a safe and correct way. It includes the doctor's prescription, the elderly's medical history, medicine lists, dosage instructions and any special instructions.

The importance of correct prescription bases

Safety Correct prescription bases are crucial for ensuring that the right medicine is given to the right person in the right dose. Incorrect prescriptions or inadequate documentation can lead to serious medical mistakes and complications.
Efficiency With correct prescription bases, healthcare staff can effectively manage and follow up drug treatment. It saves time and reduces the risk of double work or overlooking important doses.
Communication Prescription bases serve as an important communication link between healthcare professionals, including doctors and nurses. Clear and complete documentation facilitates understanding and cooperation around medication.

Examples of consequences of incorrect prescription bases and inadequate documentation of drug treatment

Incorrect dosing If the dosing instructions are incorrect or unclear, the patient may get too much or too little of the medicine, which can lead to ineffective treatment or side effects.
Double medication Inadequate documentation can result in a patient receiving the same medicine from several different caregivers, increasing the risk of overdose and side effects.
Missed doses If the prescription basis is not updated with changes in medication, it can result in important medicine doses being missed.
Allergic reactions If the elderly's medical history is not correctly documented, it can lead to the patient receiving medicines that they are allergic to.
Communication failures Inadequate documentation can result in misunderstandings or lack of communication between healthcare staff, which can have serious consequences for the patient's care.

To ensure correct prescription bases and thereby prevent accidents and complications, it is crucial to have clear and uniform routines for documentation of medication management. It requires accuracy, attention and continuous updating of the information. Investing time and resources in training and the right technology for managing prescription bases is an investment in the well-being and safety of the elderly in nursing homes.

Reflection questions - prescription basis
Care staff:
- Do you always check against the prescription basis before giving medication?
- Does it happen that the bases do not match?
- What are the routines when one of the residents needs medication as needed?

Manager, nurse, occupational therapist and physiotherapist:
- Is the collaboration with the doctor working well?
- Do you have current prescription bases for all residents where you are responsible for medication management?
- How does it work with prescription bases for prescriptions on call?
- Are the routines for "as needed medication" working well?

Residents and relatives:
- Are you informed when medication prescriptions are changed?

Erland Olsson
Specialist nurse
Sofrosyne - Better care every day