Page 127 - tmp

Barnet, Enfield and Haringey NHS
Mental Health NHS Trust IN
PATIENT PRESCRIPTION CHART
INSTRUCTIONS FOR USE OF CHART Notes for

Prescriber

1. Write dearly in BLOCK CAPITALS using BLACK
indelible ink
2. Use APPROVED NAME and METRIC UNITS
3.
Sign your name with FULL signature and date for
prescription to be valid __ __ ___

4. Discontinue drugs thus: RISPERIDONE
and draw a similar line through
recording panels
No prescription should be altered. A new prescription must be
written.
When all sections have been completed, start a new prescription
chart and file the completed chart in -patient's notes.
All current prescriptions should be entered on the new chart, so
For Section Patients Only (Please tick If complete)
that only one chart is in use. Form T2 Attached [ ]
Prescriptions are valid for FOUR WEEKS ONLY and Form T3 Attached [ ]
8. MUST BE REWRITTEN BY A
All prescribers circle administration times.

Notes for NursingStaff on Administration
Please see key below.
1. Check entry’sinevery section to avoid omissions
2. Patient identity matches prescription chart.
3. A Registered Nurse ShouldInitial each administration in the
ADMINISTRATION TIMES appropriate box.
Mom (Morning) 8:00am -9:30am
4. In the event of non-administration, record ail missed doses and
Lunch (Lunch Time) 12:00pm -1:30pm % indicate reasons using the appropriate code:

* Clarify in patient’s note. Codes must be circled
Patient away from ward 1
Drug not available* 2
Patient ref used drug 3
Drug Omitted* 4
Patient self-medicating 5
Other* 6

ONCE ONLY AND PREMEDICATION DRUGS
DATE
PRESCRIBED DRUG DOSE ROUTE SIGNATURE GIVEN BY TIME PHARM,

HYHA597 8/13 (01842) 754984
Page 1 of 6
13