Prescription Audit towards Quality Indicators at a Tertiary Care Teaching Hospital in South India

Introduction: The World Health Organization has laid down guidelines for rational prescriptions. Adherence to those guidelines is an important aspect of medication safety. In India, such adherence is mandatory towards National Accreditation Board for Hospitals and Health-care Providers (NABH) accreditation of health-care facilities. The audition of the prescriptions is therefore a quality improvement process that indirectly benefits the health-care stakeholders. Such an audit is part of the NABH Management of Medication and is monitored by the Pharmacy and Therapeutics (P&T) committee in most hospitals. Materials and Methods: This prospective study was conducted between December 2018 and November 2019. An audit was carried out using 4800 case sheets from different in-patient departments of Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, India. The data were recorded in a predefined audit form. Results: Out of 4800 prescriptions, 71% (n=3408) of the audited orders had drugs written down in the capital; moreover, 97% (n=4656) and 47% (n=2256) of the prescriptions were legible and were written in generics, respectively. Furthermore, 97% (n=4656) of the orders had a physician’s signature, and 70% (3360) of them had a clinical review. It should be noted that only 1% (n=48) of the orders had drug-drug and drug-food documented interactions. Conclusion: According to the results of this study, physicians did not document suggestions regarding drug-drug and drug-food interactions. Moreover, there were fewer numbers of prescriptions written in generics. In addition, the majority of the medication orders were legible and adhered to standards in the 12th month. This may be due to sharing the monthly audit reports with various departments and the continuous feedback process involving the P&T committee.

Keywords:

Medication order , NABH , Management of medication , Prescription audit