Issue Date: 01/01/2017

FH/MOM / Doc no 05
Issue No.: 02
Revision Date: -
Prescription Of Medication Prescription policy 3-/12/16
Revision No.: 02
Effective Date:
Reference NABH standard 4th Edition:
01/01/2017

Service Name :
Prescription of Medication Policy

Director
Approved By : Name : Dr. Manish Kumar

Responsibility of Updating :
Quality Manager
Name : Mr . Rahul shukla

Prepared by Approved by

Quality Manager Director

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 Issue Date: 01/01/2017
FH/MOM / Doc no 05
Issue No.: 02
Revision Date: -
Prescription Of Medication Prescription policy 3-/12/16
Revision No.: 02
Effective Date:
Reference NABH standard 4th Edition:
01/01/2017

PRESCRIPTION OF MEDICATION POLICY

1.0 POLICY:

No medicines shall be dispensed from pharmacy store without a written prescription

order, except in emergency cases, where prescription can be sent after the patient is
stabilized.

Drugs can be prescribed to the patients only by treating consultant except in case of
emergency situations where in house doctor can prescribe.

All orders for medication shall be written in medical records of the patient and shall be in
appropriate location. These orders shall be crosschecked by treating consultant and shall
be signed, named, timed and dated.

Prescription shall be written and signed by the treating doctor and shall be clear, legible,
dated, timed, named and signed.

For verbal orders of medications, refer the document ‘Verbal orders for medication ’

Special care shall be taken while prescribing high-risk medication. Refer document ‘list of
high risk medications’ for List of high-risk medication

2.0 PURPOSE:

To develop and maintain processes for prescription ordering by the physician and
House Staff within the Hospital.

3.0 SCOPE:
Prepared by Approved by

Quality Manager Director

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 Issue Date: 01/01/2017
FH/MOM / Doc no 05
Issue No.: 02
Revision Date: -
Prescription Of Medication Prescription policy 3-/12/16
Revision No.: 02
Effective Date:
Reference NABH standard 4th Edition:
01/01/2017

The policy applies to all the clinical specialties, including ICU’s, Inpatient area and Out-
patient Department.

4.0 RESPONSIBILITY:

Physicians

5.0 DISTRIBUTION:

Doctors and Nurses

6.0 PROCESS DETAILS:

6.1 DESCRIPTION OF THE PROCESS

Physician Orders:

 Only Physicians authorized by Fortune Hospital can prescribe medications.

 Physicians are authorized to use only those drugs listed in the Formulary except in
specific instances.
 All medication orders to be written on Hospital Prescription Form/Letterhead or
the Case Sheets labeled/verified with Patient’s name and Registration number.
 Use of Hospital Information System: Use of Hospital Information System for
reducing prescribing errors is desirable to reduce prescription errors.
 Orders are to be written in a uniform location in the medical records.
 History for drug allergies to be documented in red ink.
 Abbreviations for drug names are not to be written.
 All medication orders to specify the drug name, dosage or dosage range, the route
of administration, the frequency and duration of administration.
 High Risk medications need to be verified by treating Consultant prior to
administration.
 Medication orders are to be clear, legible, dated, named and signed.
 Doses:
Prepared by Approved by

Quality Manager Director

Page 3 of 6
 Issue Date: 01/01/2017
FH/MOM / Doc no 05
Issue No.: 02
Revision Date: -
Prescription Of Medication Prescription policy 3-/12/16
Revision No.: 02
Effective Date:
Reference NABH standard 4th Edition:
01/01/2017

a. For pediatric age group patient shall be based on age, weight etc.
b. All orders for a drug dose less than one shall have a zero preceding the
decimal amount. E.g. write 0.25mg instead of .25 mg.
c. Do not use decimal points or trailing zeros. e.g. Write 2 mg instead of 2.0
mg.
d. Microgram amounts shall be clearly written as “microgram” to clearly
distinguish form milligrams (mg).
e. All orders for units shall be clearly written in “units”.
f. Orders calculated in either milligrams or micrograms doses shall be left in
the units in which the calculation was made.
 If more than one physician is prescribing medications for one patient, each
individual medication order must be written separately and each medication order
must be signed.
 To change any of the medication orders, physician must cease the original order
and write a new order.
 To cease a medication order physician must draw a line across the area of the chart
where administration is recorded (after the last entry) and sign and date adjacent
to this line.
 The original order must not be obliterated.
 If a drug is not to be given on certain days, cross out those days on the medication
chart, in order to prevent the drug being administered in error on those days.
 There shall be an automatic cancellation of drug orders when a patient changes
service, when a patient is moved into or out of an intensive care unit, or when a
patient is sent to the operating room or delivery room.
 All the medications prescribed at the time of discharge should be included in the
discharge summary, whether or not it is to be supplied by the hospital pharmacy.

Patient and Family Education

 Patient and family are to be educated about safe and effective use of medication.
 Patient and family are to be educated about food-drug interactions.

Prepared by Approved by

Quality Manager Director

Page 4 of 6
 Issue Date: 01/01/2017
FH/MOM / Doc no 05
Issue No.: 02
Revision Date: -
Prescription Of Medication Prescription policy 3-/12/16
Revision No.: 02
Effective Date:
Reference NABH standard 4th Edition:
01/01/2017

SPECIFIC SITUATIONS:

1. Drops: specify which orifice (ear, eye, oral) and the number of drops to be
given. Do not use Latin abbreviations such as AU for both ears, AS for left
ear, AD for right ear.
2. Skin creams: specify the area of skin on which application is required and
the amount to be applied on a given occasion.
3. Infusions: specify as subcutaneous, intravenous, epidural or intrathecal. For
intravenous infusions----specify via regular drip set, micro drip set or
syringe pump; peripheral vs. central access, mode of preparation of infusion
, rate, duration, titrating orders for nursing staff (e.g.—as per BP level, as
per HR, as per glucometer reading, etc)
4. Insulin and insulin syringes : specify 40 Unit/ml or 100 Units/ml
5. Oxygen: specify as --- litre/min via nasal cannula/venturi mask/ventilator
6. Vaccines: patient leaflet to accompany each vaccine. Batch number to be
indicated on patent’s immunization card.
7. Pediatrics: dose --- mg/kg/day in 3 divided doses is better written as

--- Mg thrice-a-day factoring in the patient’s weight. Avoid leaving that

responsibility on the nurse/pharmacist.

8. Narcotics: Requires narcotic prescribing license number

9. Emergencies: write “ STAT” next to the prescribed item
10. IUCD/peccary: specify when next to be changed
11. Surgical / miscellaneous items: specify number of items needed and their
size (e.g.: 16 gauge or small/medium/large/X large)
12. The Physician is to notify the nursing staff when “Stat” orders are written.
“Stat” orders must be transcribed immediately and followed.
13. “Hold” means discontinue the medication.

6.2 ACTIVITIES AND RESPONSIBILITY:

Prepared by Approved by

Quality Manager Director

Page 5 of 6
 Issue Date: 01/01/2017
FH/MOM / Doc no 05
Issue No.: 02
Revision Date: -
Prescription Of Medication Prescription policy 3-/12/16
Revision No.: 02
Effective Date:
Reference NABH standard 4th Edition:
01/01/2017

S. No. Procedural steps Responsibility

Drugs shall be prescribed in writing in medical Treating consultant/

1.
records of the patient. Attending Doctor

The prescription shall be entered in the Medicine

2. Nurse on Duty
Sheet.

3. This should be checked and signed by the duty doctor Duty Doctor

Prescription comes in pharmacy only in case of IPD

4. Nurse In charge/M.O
patients and for ambulatory care patients.

Medicines are issued only in case of proper

5. Pharmacist
prescription.

Pharmacist checks date, patients name, medicines

name, strength/dosing, the route of administration
6. Pharmacist.
and the prescribing doctor’s info, if written properly
then only the medicines are dispensed.

If there is any error in the prescription, pharmacist

will personally contact Medical Officer, confirm
7. Pharmacist
necessary information on the prescription, and
dispense medication thereafter only.

Prepared by Approved by

Quality Manager Director

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