Retrospective analysis of completeness and legibility of prescription orders at a tertiary care hospital

Abstract

Background: Medication errors contribute significantly to adverse drug events. These errors can occur at any step from prescribing to administering drug. While most of the prescribing errors can be prevented, administering errors seldom can be intercepted. Aims & Objective: Prime objective was to analyze the quality of prescription writing, as a part of a continuous quality improvement program with emphasis on Completeness & legibility of prescriptions. Materials and Methods: A retrospective cross-sectional study was conducted including 225 prescriptions. All prescriptions were evaluated for doctors' information: Name, address, specialty and signature, patient information: name, sex, weight, age, date and medication details: strength, quantity, frequency, dosage form and instructions for use. Results: Doctors Name, specialty, sign were present in 17.77%, 90.22%, 91.11% prescriptions respectively. The symbol Rx was present in 99% while the patient's name and age was present in 100% cases. No prescription contained the patient's address while Sex and weight mentioned only in 42.66% and 3.11% respectively. Date was mentioned in 100% cases. Generic names were used in 58.49% cases. Strength, frequency of administration and quantity were present on 59.37%, 99.55% and 88.15% respectively. Instructions were mentioned in 8.44% of prescriptions. Conclusion: There is a need to address the legibility of prescription, correct spelling with the correct strength and frequency, authorized abbreviations as well as all other information on a prescription concerned with patient, prescriber and drugs to minimize the occurrence of medication errors.

Evaluation of hands on training on prescription writing skills among medical students in a tertiary care teaching hospital

“…In the prescriber information, (Figure 1) the prescriber name and signature was missing in 56% of the prescriptions, which is more than that reported by Mahato et al 22%, Patel et al 30%, but were lesser than that reported by Khan et al 77% and Dharmadikari et al 82% [18][19][20][21] The prescriber registration number was missing in 58% of the prescriptions, which is lesser as compared to the studies where it was not written in 85% and 77% of the prescriptions. [18,20] The use of personalized stamps bearing the prescribers name and registration number was found to be a useful and inexpensive method to improve the quality of the prescriptions.…”

“…[18,21,24] In this study, the students were able to select appropriate drugs for the given case scenarios, as the cases chosen were based on problems that the students had studied as part of their curriculum. The students only wrote the generic names of the drug.…”

“…19% [24] and Dharmadikari et al 26%. [21] The importance of legible handwriting and the completeness of the prescriptions was explained in detail by showing them examples of illegible prescriptions and medication errors which occurred due to the lapses in prescription writing. Post session there were only 10% of illegible prescriptions.…”

“…In one study, the address was missing in all the prescriptions. [21] The presence of name and address is useful in locating the patient in case of any prescribing or dispensing errors. Age and gender of the patient were missing in 52% and 59% of the prescriptions, respectively.…”

Adherence to prescription-writing guidelines for outpatients in Southern Gauteng district hospitals

“…28 , 31 , 32 Legibility has been assessed using different methods including optical computer software and subjective scales, with the legibility of letter words (such as drug names) being worse than that of numbers (such as frequency of dosage). 33 , 34 , 35 A validated tool, the Prescription Quality Index (PQI), provides indicators to measure legibility in chronic diseases using a three-point Likert scale, with scores of 0 for ‘illegible’, 1 for ‘barely legible’ and 2 for ‘legible’. 36 …”