Prescription audit in outpatient department of multispecialty hospital in western India: an observational study.

Studying the prescribing audit is that part of the medical audit which seeks to monitor, evaluate and if necessary, suggest modifications in the prescribing practices of medical practitioners. Our objective was to study the Prescription Audit in Out Patient Department of in Multispecialty Hospital in western India. Methods: An Observational study was carried out during the period of 2012-2013. Total 150 prescriptions of Out-patient department were collected, scrutinized and statistically analyzed with Reporting procedures to pharmacy and quality department. We have also considered Statistical Process control (SPC) to provide the guidance on how the process may be improved by reducing variation & to assess the performance of a process. Results: Total 150 patients were evaluated for Prescription Audit, out of which 60% were Male & 40% were Female cases. In the same mainly 13 parameter were assessed according to the checklist provided by the Hospital with total 1950 (150*13) counts; from this 1126 Counts were under compliance, 74 Counts were non-compliance & 750 Counts were not applicable. 50 cases were analyzed for 3 months, showed better compliance rate of prescription audit parameters in February 2013 compared to December 2012, while non-compliance rate in prescription audit was reduced as time progresses. Conclusions: A definite role of clinical pharmacist, in the process control by utilizing SPC during prescription audit. The members of the hospital and Quality committee need to focus on findings of it, which help them during accreditation by regulatory authority.

Root cause analysis of medication errors at a multi-specialty hospital in Western India.

Background: Medication use is a complex process in a medical setting, it starts with physician prescribing, followed by nurse transcribing, pharmacist dispensing, medication administration, and patient monitoring. There is a definite role of clinical pharmacists in reduction of Medication errors by examining and evaluating its causes and communicate the results to physicians and caregivers. The aim of the present study was study of medication errors for the safety & the health benefit of the patient visiting multi specialty hospital. Methods: The Observational study was carried out at in-patient appointments at multi specialty hospital during the period of June 2012 to April 2013 at Baroda. Results: Total of 300 patients were observed out of which medication error has occurred in 117 (39%) cases considering 62% were males & 38% female patients. Out of 117 cases 28% of transcription errors, 62% of prescription errors, 11% of dispensing errors & 16 % Administration errors. 51% of medication errors were occurring in the age group of 40-60. Root cause analysis showed that prescription error was due to Illegible handwriting, No dosage form prescribed, the Wrong Brand name prescribed; transcription error due to Wrong drug is transcribed; administrative error due to Wrong dose is administered, Drug administered through wrong route, Wrong drug is administered while dispensing error due to Urgent dispensation not done within 10 to 15 minutes, Wrong dose dispensed. Conclusion: Most common medication errors were Prescription error & Transcription error which accounts for almost 77% of the total error, which is according to Pareto 80:20 Principle.