{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T08:04:06Z","timestamp":1785398646706,"version":"3.56.0"},"reference-count":15,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prescribing violations\u2014deliberate deviations from prescribing rules or guidelines\u2014are a recognized subtype of error but have received limited attention in clinical practice research. Although prescribing errors are common, violations are often under\u2010reported and may be normalized in busy hospital environments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore how Foundation Year 2 (FY2) doctors perceive prescribing violations in everyday clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twelve FY2 doctors from multiple UK hospitals participated in semi\u2010structured interviews. Two real prescribing\u2010violation scenarios, presented on example drug charts, were used to prompt discussion. Interviews were audio\u2010recorded, transcribed verbatim and analysed thematically using a deductive framework based on Reason's taxonomy (routine, situational, optimizing violations) alongside inductive constant comparison to identify additional themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants described routine and situational violations as common, normalized and often necessary responses to workload, time pressure and organizational constraints. Optimizing violations were not identified. Key influences included diffusion of responsibility (reliance on pharmacists and nurses to detect errors), hierarchical pressures, informal categorization of drugs as \u2018safe\u2019 or \u2018dangerous\u2019 and limited feedback about prescribing errors. Participants perceived many violations as low\u2010risk and viewed safety nets as compensating for shortcuts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FY2 doctors in this study perceived prescribing violations as an embedded and often unavoidable part of practice. These perceptions highlight the need for organizations to design workable prescribing systems, clarify responsibility for prescription accuracy, improve feedback mechanisms and support junior clinicians in challenging unsafe norms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bcp.70696","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:46:28Z","timestamp":1785397588000},"source":"Crossref","is-referenced-by-count":0,"title":["Perceptions of prescribing violations by doctors: A qualitative study using semi\u2010structured interviews"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0960-2609","authenticated-orcid":false,"given":"Deborah","family":"Kirkham","sequence":"first","affiliation":[{"name":"Mortimer Market Centre Central and North West London NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary P.","family":"Tully","sequence":"additional","affiliation":[{"name":"The University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"DornanT AshcroftD HeathfieldH et al.An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. General Medical Council Manchester;2009."},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9781139062367","volume-title":"Human Error","author":"Reason J","year":"1990"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1136\/bmjqs-2012-001175","article-title":"Perceived causes of prescribing errors by junior doctors in hospital inpatients: a study from the PROTECT programme","volume":"22","author":"Ross S","year":"2023","journal-title":"BMJ Qual Saf"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102012\u2010001009"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/AMEP.S40487"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7237.781"},{"key":"e_1_2_11_8_1","unstructured":"Health and Safety Executive.Improving compliance with safety procedures \u2010 reducing industrial violations.1995."},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeq131"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7237.768"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2010.108423"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","unstructured":"AshcroftDM LewisPJ TullyMP et al.Prevalence nature severity and risk factors for prescribing errors in hospital inpatients: prospective study in 20 UK hospitals.2015.","DOI":"10.1007\/s40264-015-0320-x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102015\u2010004717"},{"key":"e_1_2_11_14_1","unstructured":"General Medical Council.Outcomes for graduates summary; outcomes 2 \u2010 professional skills.2018. [Online]. Available:https:\/\/www.gmc\u2010uk.org\/education\/standards\u2010guidance\u2010and\u2010curricula\/standards\u2010and\u2010outcomes\/outcomes\u2010for\u2010graduates\/outcomes\u2010for\u2010graduates\/outcomes\u20102\u2010\u2010\u2010professional\u2010skills#prescribing\u2010medicines\u2010safely\u2010169BA813BBF3461788E28D941623D8F7. 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