Development of a Prescription Screening System for Outpatients in Chumphon Khet Udomsakdi Hospital

Abstract

Objective: To assess the rate, type, and severity of prescribing errors (PEs) before and after the development of a prescription screening system in the outpatient pharmacy services of Chumphon Khet Udomsakdi Hospital. Methods: This action research was carried out in three phases including planning and determining the prescription screening system for outpatients, implementing the prescription screening process as the first step in the work process of outpatient pharmacy services, and evaluating the outcomes at 6 months before and after system implementation i.e., type of PEs and severity of PEs as assessed by the criteria of the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP). Result: Implementation of prescription screening as the first step in the work process of outpatient pharmacy services significantly increased the detection of PEs from 4.80 times per 1,000 prescriptions to 7.83 times per 1,000 prescriptions (P < 0.001). The top three types of PEs found after system implementation were wrong quantity, overdose and underdose. The severity of PEs before system implementation was in category A-D, while the severity of PEs after system implementation was mostly found in category A-B, i.e., medication errors that did not reach the patients. Conclusion: Implementing the prescription screening process as the first step in the work process of outpatient pharmacy services increases the ability to detect medication errors and helps improve patient safety.