The Pharmaceutical Journal Vol 263 No 7074 p918
December 4, 1999 Forum

Guild of Healthcare Pharmacists

Vaccine storage and prescription legibility

The Guild of Healthcare Pharmacists day conference took place in Oxford on November 26

A competition was held for the best oral presentation and poster at the conference. The Hooper Baxter oral presentation prize was won by Mr DAVID STEAD (Blackpool Victoria hospital NHS trust) and the successful poster was that of Ms JILL McDONALD (Milton Keynes General NHS trust).

Vaccine storage

Mr Stead’s presentation concerned the efficacy of vaccines, which was largely dependent on their being stored at the correct temperature. The final link in the “cold chain” was often the refrigerator in clinics or surgeries, he said.

Award winners: David Stead (left) and Jill McDonald were presented with their awards by Peter Cooke

Little was known about the state of the refrigerators, so he had undertaken a study to investigate storage conditions in clinics. Eleven clinics and 63 practices had been visited, which had had a total of 105 refrigerators between them. Of these, 29 per cent had been operating outside the required 2-8C temperature range. Some had been warmer than recommended by the vaccine manufacturers and some had been colder, which could be more destructive to vaccines than excessive heat.
The refrigerators had ranged from high-tech pharmacy refrigerators to ordinary food appliances but there had been little difference in their performance. In many cases, the correct temperature range had been achieved simply by adjusting the refrigerator controls.
Checking the temperature of the refrigerators was not a difficult exercise and Mr Stead recommended that someone at a clinic should take responsibility for checking the temperature of the refrigerator, otherwise there was no way of ensuring that the vaccine supplies were at their most effective.

Clarity of prescribing

Ms McDonald’s poster described an audit of legibility and adherence to local guidelines on prescribing. Data on legibility and compliance with trust guidelines on prescribing had been collected for 1,632 prescribed items over a two-day period. Of these, 31 per cent had been illegible (despite 62 per cent of all prescriptions being written in block capitals). In only 35 per cent had drug allergies been recorded and only 58 per cent had had the frequency of administration clearly marked. It was of concern that so many prescriptions were unclear or illegible and the study results had been circulated to all prescribers, she said. Trust guidelines on prescribing had been reissued, a summary of which was stuck on the front of all newly issued BNFs, and junior doctors were introduced to these guidelines during their induction programme. However, further measures and a multidisciplinary approach, were needed to achieve real improvement.