Objectives Timely and correct prescription of patients’ regular medications on admission to neurosurgical unit is noticed not to be fully compliant with set standards. This audit aims to review the practice of medication prescription by junior doctors during patient admission to a national neurosurgical unit, and to identify areas of improvement for prompt and accurate prescription.

Design Prospective clinical audit.

Subjects 130 patients admitted to the neurosurgical unit in 2 weeks.

Methods Prescription of patient’s regular medications on admission was audited. The prescription practice was compared against the set standards, and between different settings (in-hour vs. out-of-hour, emergency vs. elective, experienced vs. new SHOs).

Results 18% of patients had no regular medications prescribed by clerking doctors, the majority of which were elective admissions during in-hour clerking and performed by experienced SHOs. Of the patients who had their regular medications prescribed on admission, 29% were prescribed inaccurately, and 16% in wrong doses. Total percentage of missed and error prescription was 46%, in which only 18% were corrected within 24 hours and 21% corrected up to 48 hours after admission.

Conclusions Areas of improvement identified: prescription practice of experienced SHOs during elective admissions, medication and dose check on prescription in both elective and emergency settings, medication reconciliation within 24 hours and thereafter. Changes (e.g. an alert system) are being implemented and re-audit is in plan.