Evaluation of Medication Errors by Prescription Audit at a Tertiary Care Teaching Hospital

Kaushal P. Navadia, Chetna R. Patel, Jeenal M. Patel, Sajal K. Pandya
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Abstract

Objective: The prescription errors and prescribing fault analysis was assessed, the rationality of the prescriptions was checked, and the medication error was categorized according to the NCC MERP Index. Methods: A cross-sectional, observational study was designed as per STROBE guidelines and conducted for 2 months in the pharmacy stores after approval of the Institutional Review Board. Patients’ written informed consent was taken before getting their prescriptions, and each of the prescriptions procured in this way was photographed for record. The completeness of 320 prescriptions of outpatients of all age groups regarding the details about the doctor and the patient and clinical diagnosis/indication was analyzed. The rationality of prescription was based on WHO core drug use indicators. Descriptive analysis was done by using Microsoft Excel. Results: A total of 320 prescriptions were analyzed from eight departments. Information about patients and prescribers was mentioned in 100% of prescriptions. The diagnosis (40%), an indication was written in 195 prescriptions. Instructions for dispensing drugs (89%), instructions to patients (90%), duration of treatment (100%), follow-up visits (19%), and non-pharmacological instructions (13%) were mentioned. In total, 82% of prescriptions were legible. In a total of 1004 drugs, 92% of drugs were prescribed with a generic name, 100% from the essential drug list. The route and frequency of drug administration were mentioned for all drugs. According to NCCMERP, the category of medication errors falls under category B. Conclusion: To reduce medication errors, we can implement an electronic system, involve clinical pharmacologists, utilize prescription charts, and organize nationwide workshops on rational prescription writing. We should encourage regular prescription audits and reporting to improve the healthcare system in the country.
一家三级医疗教学医院通过处方审计评估用药错误
目的评估处方错误和处方过错分析,检查处方的合理性,并根据 NCC MERP 指数对用药错误进行分类。方法:横断面观察研究根据 STROBE 指南设计了一项横断面观察研究,经机构审查委员会批准后,在药店进行了为期 2 个月的研究。在获取处方前,先征得患者的书面知情同意,并对以这种方式获取的每张处方拍照存档。对各年龄组门诊患者的 320 份处方中有关医生和患者的详细信息以及临床诊断/适应症的完整性进行了分析。处方的合理性基于世界卫生组织的核心用药指标。使用 Microsoft Excel 进行了描述性分析。结果共分析了来自八个科室的 320 份处方。100%的处方都提到了患者和处方者的信息。195 份处方中写有诊断(40%)和适应症。处方中提到了配药说明(89%)、患者须知(90%)、治疗时间(100%)、复诊(19%)和非药物治疗说明(13%)。总共有 82% 的处方是可读的。在总共 1004 种药物中,92% 的处方药有通用名称,100% 来自基本药物目录。所有药物都注明了给药途径和频率。根据 NCCMERP,用药错误属于 B 类:为了减少用药错误,我们可以实施电子系统,让临床药理学家参与进来,利用处方图表,并在全国范围内组织关于合理处方书写的研讨会。我们应鼓励定期进行处方审计和报告,以改善国家的医疗保健系统。
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