Student Success in the Prescribing Safety Assessment (PSA)

369 Pages·2013·7.948 MB·\369

by  Vilius Savickas (Author)

Student Success in
the Prescribing Safety
Assessment (PSA)
VILIUS SAVICKAS
MPharm, MRPharmS, CertGPP
Senior Clinical Pharmacist
Surrey and Sussex Healthcare NHS Trust
and
REEM KAYYALI
PhD, MSc, BPharm, MRPharmS
Principal Lecturer, School of Pharmacy and Chemistry
Kingston University
Edited by
DR NEEL SHARMA
BSc (Hons), MBChB, MSc, MRCP (UK)
National University Hospital
Singapore
Radcliffe Publishing Ltd
St Mark’s House
Shepherdess Walk
London N1 7BQ
United Kingdom
www.radcliffehealth.com
_____________________________________
© 2014 Vilius Savickas and Reem Kayyali
Vilius Savickas and Reem Kayyali have asserted their right under the Copyright, Designs and
Patents Act 1988 to be identifi ed as the authors of this work.
Every effort has been made to ensure that the information in this book is accurate. This does
not diminish the requirement to exercise clinical judgement, and neither the publisher nor the
authors can accept any responsibility for its use in practice.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system
or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording
or otherwise, without the prior permission of the copyright owner.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
ISBN- 13: 978 184619 978 3
The paper used for the text pages of this book
is FSC® certifi ed. FSC (The Forest Stewardship
Council®) is an international network to promote
responsible management of the world’s forests.
Typeset by Darkriver Design, Auckland, New Zealand
Contents
About the Authors v
Introduction 1
The Prescribing Safety Assessment 1
Aims and Structure of this Book 3
Chapter 1 9
Prescribing 9
Questions 1–48 11
Chapter 2 65
Prescription Review 65
Questions 1–24 66
Chapter 3 109
Planning Management 109
Questions 1–13 110
Chapter 4 129
Communicating Information 129
Questions 1–13 130
Chapter 5 147
Calculation Skills 147
Questions 1–13 148
Contents
Chapter 6 157
Adverse Drug Reactions 157
Questions 1–13 158
Chapter 7 173
Drug Monitoring 173
Questions 1–13 174
Chapter 8 191
Data Interpretation 191
Questions 1–13 192
Answers 213
Chapter 1: Prescribing 213
Chapter 2: Prescription Review 250
Chapter 3: Planning Management 265
Chapter 4: Communicating Information 273
Chapter 5: Calculation Skills 280
Chapter 6: Adverse Drug Reactions 285
Chapter 7: Drug Monitoring 292
Chapter 8: Data Interpretation 299
Appendix 1: Templates of the Prescriptions to be used
for Questions in Chapter 1 309
Appendix 2: List of Common Abbreviations 315
Appendix 3: Introduction to Prescribing and
Pharmaceutical Care 321
Appendix 4: The Guide to Using and Revising the
British National Formulary 327
iv
About the Authors
Vilius Savickas, MPharm, MRPharmS, CertGPP
Vilius is a Senior Clinical Pharmacist at Surrey and Sussex Healthcare NHS
Trust. He is a former Future Pharmacist Editor, Educational Development
Offi cer and Honorary Life Member of the British Pharmaceutical Students’
Association (BPSA). Vilius continues to support BPSA by coordinating the
Facebook Group ‘Professional Development Matters!’ for students and pre-
registration trainees. He has also recently initiated the ‘Buddy Scheme’ and
the Foundation Pharmacist Forum for postgraduate pharmacists in Kent,
Surrey and Sussex regions.
Dr Reem Kayyali, PhD, MSc, BPharm, MRPharmS
Reem graduated from Nottingham University with a bachelor degree in
pharmacy. She then undertook a Master of Science in Biopharmacy at King’s
College London and then a PhD related to the use of iron chelators in the
management of thalassaemia. She was then awarded the Mapplethorpe
Fellowship for 2 years at King’s College London to conduct research related
to redox activity and apoptosis by iron chelators. After that, she worked as a
research fellow at University College London Medical School. The reforms
that the pharmacy profession has witnessed in the last decade were the driver
for her to make a career transition from pure scientifi c research to an aca-
demic post focusing on pharmacy practice and clinical pharmacy. In 2006,
she joined the School of Pharmacy and Chemistry at Kingston University as
a senior lecturer working within the clinical and pharmacy practice team. In
2010, she was promoted to Principal Lecturer, acting as part of her role as
the pharmacy practice/clinical pharmacy subject area lead. She is a registered
pharmacist with the General Pharmaceutical Council and is a member of the
Royal Pharmaceutical Society.
Neel Sharma (Editor)
Neel Sharma graduated from The University of Manchester with bach-
elor degrees in pharmacology and medicine. He also holds a Master of
v
About the Authors
Science in Gastroenterology from Barts and The London School of Medicine
and Dentistry. Neel undertook his foundation and core medical training
in London and maintains a strong interest in medical education. He was
appointed Clinical Lecturer at the Centre for Medical Education at Barts in
2011, and he previously held the position of Tutor at the Institute of Medical
and Health Sciences Education, Li Ka Shing Faculty of Medicine, The
University of Hong Kong, from 2012 to 2013. He is also a member of the
Curriculum Development Team for the newly established Lee Kong Chian
School of Medicine in Singapore.
vi
I would like to dedicate this book to all my colleagues at East
Surrey Hospital, particularly those within the pharmacy
department. Thank you very much for all your help and support
over the last two years. I feel honoured having been a part of
such an incredible team.
VS
I would like to dedicate this book to my lovely children; Hala and
Sammy, my mum, Samira and my husband, Khaled. Thank
you for your continuous love and support all through the years.
RK
I would like to dedicate this book to my parents, Ravi and Anita,
and my sister Ravnita. Without their continued support and
encouragement none of this would have truly been possible.
NS

Introduction
THE PRESCRIBING SAFETY ASSESSMENT
Medical students are subject to robust training in a variety of disciplines rang-
ing from anatomy and pathophysiology to law and psychology. However, it is
widely recognised that current medical degrees in the UK incorporate a lim-
ited amount of training in clinical pharmacy/pharmacology and prescribing,1
yet junior doctors are often responsible for the majority of routine prescribing
practice.
Junior house offi cers’ prescribing has been associated with more than half of
all the prescribing errors among the medical practitioners of different grades
in hospitals, as opposed to only 2% by medical consultants.2 Furthermore,
the EQUIP study, ‘An in depth investigation into causes of prescribing errors
by foundation trainees in relation to their medical education’ carried out by
the General Medical Council (GMC) in 2009, demonstrated that prescrib-
ing errors were twice as common among the Foundation Year 1 (FY1) and
Foundation Year 2 (FY2) doctors as compared to consultants. It was obvious
that junior doctors may not have been capable of meeting the prescribing-
related expectations fully from day one of their independent practice.
The GMC responded with Tomorrow’s Doctors (2009), outlining a number
of competencies for medical graduates that should be achieved before they
qualify.3 The document included eight competencies relating to good practice
in prescribing, to ensure that graduates are able to prescribe drugs ‘safely,
effectively and economically’.3 There is no formal prescribing assessment
across the UK to ensure that all graduates are at the same level of competence
required to enter their prescribing practice. As a result, the Prescribing Safety
Assessment (PSA) was proposed by the Medical Schools Council (MSC) and
the British Pharmacological Society (BPS) to help medical graduates achieve
these learning outcomes before they are released into the real world.4
The PSA has been defi ned as the ‘pass/fail, summative examination of the
skills, judgment and supporting knowledge related to prescribing medicines in
the NHS’.4 The content of the assessment maps into prescribing competencies