Secondary Care

New algorithm at UHB supports prescribing

A new algorithm developed by staff at University Hospitals Birmingham NHS Foundation Trust (UHB) is automatically providing the correct doses for doctors to treat a patient after an overdose.

The trust said the electronic prescription tool has reduced the number of errors when prescribing a drug for paracetamol overdoses to zero. The tool, recognised nationally by Health Data Research UK, sees the correct prescription automatically provided when NAC is typed into the Prescribing Information and Communications System (PICS) and the patient’s weight is entered.

The algorithm then automatically provides the correct doses for doctors to treat patients after an overdose.

Adam Seccombe, Acute Medicine Consultant, said “The drug used to treat paracetamol overdose, NAC, is a complex drug to prescribe. It requires three bags of the drug to be given, with each bag having a different weight, volume of fluid, and delivery speed. As a result, we found there was a 25% chance of error when it was prescribed.”

“If NAC is prescribed too quickly or the doses are excessive, patients are more likely to experience adverse effects which might stop the treatment working, but if it’s prescribed too slowly or the doses are too low, then it increases the risk of further liver damage.”

“We were delighted to find that our tool reduced the number of prescription errors to zero, significantly improving care for patients coming in with paracetamol overdoses.”

“I would like to thank everyone involved with the project, in particular Adam McCulloch, a gastroenterology consultant who had the initial idea for the project and led data collection and analysis. I would also like to thank junior doctor colleagues Tom Bate, Qamar Sharif and Patrick McDowell, pharmacist Asif Sarwar, and Dave Thompson in the Prescribing Information Communication System (PICS) team.”

A report on the tool, which was introduced in the QEHB emergency department in July 2018, shows that similar tools could be used for other complex drug prescriptions, potentially transforming the way drugs are prescribed across the NHS.