Abstract
Purpose
The aim of this quality improvement project was to look into the hospital prescriptions and to identify and record the type and number of errors, to implement measures to reduce the risk of these errors and then to reaudit to assess the impact of changes implemented.
Methods
The initial audit was conducted prospectively over a eleven-week period. Prescriptions written by doctors of all grades and members of the staff, such as optometrists and nurses, were analysed. A glaucoma prescription guide along with more training at prescribing for doctors was introduced with a view to reducing these errors. A reaudit later demonstrated a significant reduction in these errors.
Results
After the introduction of a glaucoma prescription guide and more training for all grades of staff members, prescription errors reduced to 73/2342 (3.1%). Reaudit showed a reduction in both prescription writing errors 50/73(68.4%) and drug-related errors 23/73(31.6%).
Conclusion
Prescription errors are avoidable. This audit demonstrated that providing an accessible, easy to read and understand glaucoma prescription guide in the outpatient department along with targeted training for medical staff in prescribing can help in minimising these errors and can lead to safer practice.
Similar content being viewed by others
References
Jeffrey K (2009) Aronson. Medication errors: definitions and classification Br J Clin Pharmacol. 67(6):599–604
Cousins D, Crompton A, Gell J et al (2019) The top ten prescribing errors in practice and how to avoid them. The Pharmaceutical Journal. 302:7922
Donaldson L (2002) An organisation with a memory. Clin. Med. 2:452–457
Utman SA, Atkinson PL, Baig HM. Methods to reduce prescription errors in ophthalmic medication. Saudi J Ophthalmol. 2013 Oct;27(4):267-9. doi: https://doi.org/10.1016/j.sjopt.2013.09.003. Epub 2013 Sep 25. PMID: 24371422; PMCID: PMC3841255.
Al-Khani S, Moharram A, Aljadhey H. Factors contributing to the identification and prevention of incorrect drug prescribing errors in outpatient setting. Saudi Pharm J. 2014 Nov;22(5):429-32. doi: https://doi.org/10.1016/j.jsps.2013.11.003. Epub 2013 Nov 19. PMID: 25473331; PMCID: PMC4246412.
GMC (2013) 'Good Medical Practice; Available at https://www.gmc-uk.org/Prescribing_guidance.pdf_59055247.pdf
Mandal K, Fraser SG (2005) The incidence of prescribing errors in an eye hospital. BMC Ophthalmology. 5:4
Leape LL, Bates DW, Cullen DJ et al (1995) Systems analysis of adverse events. JAMA. 274:35–43. https://doi.org/10.1001/jama.274.1.35
Bates DW, Cullen DJ, Laird N et al (1995) Incidence of adverse events and potential adverse drug events: Implications for prevention. JAMA. 274:29–34. https://doi.org/10.1001/jama.274.1.29
Pekdemir M, Yanturali S, Karakus G (2005) More than just an ocular solution. Emerg Med J. 22:753–4
Potter WS, Nelson LB, Raber IM (1990) Corneal graft rejection in a child and inadvertent substitution of Tobrex for Tobra Dex. Ophthalmic Surg. 21:671–2
Holland R, Desborough J, Goodyear L, Hall S, Wright D, Loke YK (2007) Does pharmacist-led medication review help to reduce hospital admission and death in older people? A systematic review and meta-analysis. Br J Clin Pharmacol. 65:303–16
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical approval
This article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Changulani, T., Mustafa, M.Z., Ahuja, S. et al. Minimising prescription errors—a quality improvement project in the ophthalmology department in a tertiary referral hospital. Int Ophthalmol 41, 3041–3046 (2021). https://doi.org/10.1007/s10792-021-01866-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10792-021-01866-2