This audit cycle aimed to identify deficiencies in medicines management in an adult psychiatric hospital. The original audit in 2009 highlighted that a number of improvements were needed to enhance prescribing standards. Following implementation of these recommendations, two reaudits were performed to assess both the improvements in medicines management along with evaluating the newly introduced drug prescription chart.

Local, national and international guidelines on medicines management were reviewed in 2009, following which an audit tool was designed. Recommendations from the original audit were taken on board with the introduction of a new medication chart. This chart incorporated many of the recommendations from the original audit into it. Two reaudits were then performed, each over 1 day by four assessors and included all inpatient wards.

The initial audit in 2009 outlined a number of recommendations, namely the introduction of an appropriate ‘fit for purpose’ medication chart, the need for regular postgraduate prescribing education and training and the consideration of a prescribing formulary and/or Drugs & Therapeutics Committee. Results from the reaudits revealed that considerable improvement was made in areas such as patient demographics, pharmacist involvement, generic prescribing, BLOCK capitals, inclusion of Medical Council Registration Number, PRN prescribing and discontinuation procedures.

Although significant improvement was noted, further improvement is required with regards to the need for a review date for PRN medication; the need for improved documentation of allergies, height and weight; and the importance of a working group to assess community medicines management and the need for further reaudits to assess continued improvement in all deficient areas.