title: Development and evaluation of a pocket card to support prescribing by junior doctors in an English hospital.
abstract: BACKGROUND
  Junior doctors do most inpatient prescribing, with a relatively high error rate, and locally had reported finding prescribing very stressful.
  
  
  OBJECTIVE
  To develop an intervention to improve Foundation Year 1 (FY1) doctors' experience of prescribing, and evaluate their satisfaction with the intervention and perceptions of its impact.
  
  
  METHODS
  Based on findings of a focus group and questionnaire, we developed a pocket Dose Reference Card ("Dr-Card") for use at the point of prescribing. This summarised common drugs and dosing schedules and was distributed to all new FY1 doctors in a London teaching trust. A post-intervention questionnaire explored satisfaction and perceived impact.
  
  
  RESULTS
  Focus group participants (n = 12) described feeling anxious and time pressured when prescribing; a quick reference resource for commonly prescribed drug doses was suggested. Responses to the exploratory questionnaire reinforced these findings. Following Dr-Card distribution, the post-intervention questionnaire revealed that 29/38 (76 %) doctors were still using it 2 months after distribution and 38/38 (100%) would recommend ongoing production.
  
  
  CONCLUSIONS
  FY1 doctors reported feeling stressed and time pressured when prescribing; this was perceived to contribute to error. A pocket card presenting common drugs and doses was well-received, perceived to be useful, and recommended for on-going use.
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust and UCL School of Pharmacy, London, UK. matthew.reynolds@nhs.net.
authors.forename: Matthew
authors.initials: M
authors.lastname: Reynolds
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust and UCL School of Pharmacy, London, UK.
authors.forename: Elina
authors.initials: E
authors.lastname: Larsson
authors.affiliation: North West Thames Foundation School, London, UK.|Department of Medicine, Imperial College London, London, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Hewitt
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust and UCL School of Pharmacy, London, UK.
authors.forename: Sara
authors.initials: S
authors.lastname: Garfield
authors.affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust and UCL School of Pharmacy, London, UK.
authors.forename: Bryony Dean
authors.initials: BD
authors.lastname: Franklin
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D011307:Drug Prescriptions; D004739:England; D005260:Female; D017144:Focus Groups; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D008508:Medication Errors / Q000517:prevention & control*
keywords: Errors; Junior doctor; Medication; Prescribing; Reference source; Safety; United Kingdom