Development of a Prescription Screening System for Reducing Medication Error in an In-patient Department, Sunpasitthiprasong Hospital, Ubon Ratchathani Province

Abstract

Medication errors have been a major cause of death and patient harm worldwide. Medication errors may occur at any stage of the medication management process including prescribing, transcribing, dispensing and administration. Medication errors can be prevented by developing efficient and standardized system design in order to detect such events before reaching the patient. Objectives: 1. To develop a prescription screening system in an In-patient department 2. To assess the rates, types and severity of prescribing errors and the rates and types of pre-dispensing error before and after implementation of the system Materials and methods: The 3 steps of action research were followed; 1. basic information and obstacle analysis 2. prescription screening system development and implementation, and 3. medication erors assessment. Data were analysed using descriptive statistics. Results: A prescription screening system was developed, with the pharmacist serving as the first step in the in-patient care workflow. Result showed that the prescribing error were detected from 0.472/1,000 patient-days at baseline to 1.204/1,000 patient-days after the implementation. Wrong dosage regimen, unclear strength, and wrong strength were the top three of prescribing error. On evaluation of severity prescribing error, there were type B and D category at baseline and only type B category was found at post-system development. The pre-dispensing errors, which in the data entry process, were decreased from 19.94/1,000 patient-days at baseline to 14.36/1,000 patient-days after the implementation. Conclusion: The development of the prescription screening process, which pharmacist has been working at the first step of in-patient care services, could helped detected medication erors and improve patient safety.