Evaluation of the use of a handheld prescribing card in supporting Foundation year one doctors in End of Life (EOL) prescribing.

Abstract

This article was migrated. The article was marked as recommended. Background Literature reports disquiet in junior doctors' abilities in palliative care prescribing; including distress and low confidence ( Charlton and Smith, 2000). We confirmed similar findings following local research thus identifying a development need. This led to the design and implementation of a hand-held prescribing card. Objective Usefulness of the prescribing card in supporting foundation year one doctors was evaluated. We hypothesised this intervention would help improve End of Life (EOL) care. Methods A mixed methods approach was employed using a specially designed questionnaire, distributed to 39 foundation year one doctors (doctors in their first year of practice after graduating from medical school). Focused questions were on utilisation, levels of prescribing confidence and exploring further interventions that might help, as well as feedback on card design. Results 25 doctors completed questionnaires; a response rate 86%. Almost half routinely used the card. 40% were not yet prescribing for EOL situations at the time of the study because of their specific job rotation (e.g. ophthalmology). The commonest motivator was accessibility. All doctors reported increased confidence in prescribing and approximately three quarters said it enhanced practice. "Usefulness" was the commonest free-response descriptor. Feelings included it being a good reference and preventing errors. A development idea included an electronic version. Conclusion Results highlight that a simple hand-held prescribing card is useful. To our knowledge, this is the first UK study of its kind employing an educational intervention in palliative care in a hospital setting. It is important to implement this educational intervention early to support doctors.