4 Ways to Eliminate Prescription Errors

How to Eliminate Prescription Errors

Simple things you can do right now to eliminate prescription errors.

As practicing doctors, you may be aware that medical errors are extremely common in hospitals and clinical practices. These errors could either occur during the writing of the prescriptions or due to unintentional and inaccurate medical decisions, ultimately harming the patients.

A few years ago, the Supreme Court of India ruled against a large hospital,passing a verdict with the highest penalty till date on them. One of the points that was held against the hospital was a prescription error caused by the treating doctor.The ruling held the hospital management responsible for the error, basically communicating that what a doctor does to the patient in hospital premises is responsibility of the hospital.

The point of bringing up this incident is basically to bring to light a couple of important points:

  • Prescription errors can be extremely damaging to both hospital and patients
  • The management of a hospital is also held responsible if it happens in their premises

Faults in dose determination, omitted transcription, poor handwriting & misinterpretation are common sources of prescription errors, and they occur more commonly than you think.

Here are 4 process changes you can do immediately to contain prescription errors right away.

1. Include Drug Allergies and Reactions in Pre-Assessment

Pre-Assessment is the first documented point of interaction between a doctor and a patient. Make sure both your OPD assessment sheets as well as the IPD pre-assessment sheets have a section on drug allergies and reactions.

Make it a mandatory SOP that residents should obtain this information from the patients/attendants and ensure this is logged in the patients’electronic medical record

2. Include Medication Sheet as an IPD Record

Assess your IPD record sheets and include Medication Sheet as a mandatory part of IPD records. A Medication Sheet is a log dedicated to drugs – prescription, administration, monitoring and documentation. Make sure that the Medication Sheet has a prominent field for mentioning drug allergies and reactions and make it mandatory to fill up this information. The sheet should contain drug name, dose, frequency, special instructions, drug administration confirmation and reactions to drugs.

However, using an electronic information management system can completely eliminate the chance of an error at this stage. A central log for medicines on the hospital or practice management system will give the doctor a complete picture of the drug history including the current medication and allergies or reactions. This will help the doctor foresee some drug interactions and a possible prescription error can be prevented.

3. Maintain an updated High Risk Medication List

Get a high risk medication list made by your Pharmaco-Theraphatic Committee and make sure that it is updated from time to time. Make this list available to all your doctors and at all nursing stations. Also ensure this is easily accessible in your practice management system.

Doctors can consult this list in case of any doubt about the risky nature of any drug and the possible reactions or interactions it will have within the body. Till the list is developed, get your doctors to use www.epocrates.com to counter check any drug that they are doubtful of prescribing.

4. Track Medication Errors

Make tracking medication errors, on a monthly basis, compulsory. When the management starts taking medication errors seriously and investigating them, the prescribing errors will automatically start coming down. Medical audit around prescriptions will also help. Emphasize the importance of medical audit around prescriptions among your doctors.

Using electronic medical record system and automating your practice with an intelligent information management solution will not only make your operations more efficient, they will also reduce prescription related errors and other human errors dramatically.

Start implementing these and watch your system transform. To know more about how you could reduce prescription errors in your practice, click here.

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