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

Abstract

Objectives: 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.Materials and 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 nonpharmacological 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.

Keywords: Medication error; prescription audit; WHO core drug use indicator; NCCMERP; prescribing error