Refining patient care: Evaluating prescription practices of medical residents and interns in a teaching hospital through an audit

Abstract

Objective: Hospitals in India use the National Accreditation Board for Hospitals and Healthcare Providers guidelines as criteria to ensure safe prescribing practices. This audit was conducted to provide insight into in-patient prescription of drugs to (1) evaluate the quality of prescriptions (2) reduce prescription and medication errors (3) improve the quality of care in terms of prescriptions that the hospital provides to the patient.

Methods: The cross-sectional study was conducted in an in-patient department of a tertiary care teaching hospital in Chennai where 153 paper-based prescriptions were continuously collected from the internal medicine department over 1 month. The prescriptions were evaluated on 13 parameters that is, patient details (including name, age, sex and Hospital unique ID), height and weight, allergies, capital letters, legibility, date and time of prescription, medicine prescribed by generic name, brand name or both, dosage, route of administration, frequency, relation with food, stop order and signature of the doctor. The data obtained was summarised and analysed using Google Sheets.

Results: A total of 153 prescriptions from the in-patient department of a tertiary care teaching hospital were audited. Out of the 153 prescriptions and 13 parameters assessed, patient details (including name, age, sex and Hospital unique ID), legibility, route of administration and frequency were found in all of the prescriptions. On further analysis, we found that only 12.26% of the prescriptions were compliant with the components of the stop order. The majority of the prescriptions (69.28%) contained both generic and trade names.

Conclusion: Prescriptions are the most common areas of errors. This study shows the form of errors that can arise while prescribing medications. Doctors must be adequately trained to write prescriptions and follow the standards set by the National Accreditation Board for Hospitals and Healthcare Providers. Audits need to be conducted regularly to ensure and improve the quality of prescriptions.

Keywords: Prescription audit; clinical audit; health care quality; interns; medical audit; medication safety; prescription safety; quality improvement.

Figure 1.

Bar graph illustrating the percentage of compliance for each parameter of in-patient prescriptions.