Prescribing and monitoring of oral supplements
Aims
Electrolyte abnormalities are common in inpatients. There are problems noted at ward level regarding the prescription and use of oral supplements. The aim of this audit is to highlight this to staff and to promote better prescriptions and more appropriate use of supplements. In addition, the audit aimed to record the monitoring of electrolyte levels in those patient groups and whether or not this was in keeping with the trust guidelines.
Methods
Over a 1-month period, a random selection of drug kardexes were audited from both medical and surgical wards. The sample size was 39 patients. Measured variables:
evidence of a start date and stop date on the drug kardex
supplement prescribed and the dose
baseline electrolyte level
duration of treatment
electrolyte monitoring during the prescription period.
Results
61% of prescriptions were without stop dates or start dates
the most commonly replaced electrolyte is potassium
56% of phosphate prescriptions and 80% of magnesium prescriptions were in cases of mild electrolyte deficiency
46% of cases had an appropriate duration of treatment
55% of cases did not have regular daily monitoring of electrolyte levels.
Proposed action
The intervention of this audit is education. This has been implemented and there is a plan to reaudit within the coming months.
Conclusions
The majority of oral supplements are not prescribed or monitored appropriately within inpatients. Medical staff need to be aware of the local guidelines relating to oral supplements to ensure knowledge of when to prescribe and how often to monitor their effects.
Conclusions
Conflict of interest statement
Electrolyte deficiencies can be lethal. Inappropriate supplement prescribing and inadequate monitoring of the electrolyte can be lethal too!
- © Royal College of Physicians 2016. All rights reserved.
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