Publication:

Assessment of medication errors and prescribing patterns in orthopaedic inpatients at a tertiary care hospital

Background The objectives of the study were to assess medication errors and prescribing patterns among orthopaedic inpatients at a tertiary care hospital and evaluate compliance with National Accreditation Board for Hospitals (NABH) medication safety standards across prescribing, transcribing, dispensing, and administration processes.

Methods A cross-sectional observational study was conducted over six months in the Orthopaedic Department of a tertiary care teaching hospital. A total of 110 case records were reviewed. Medication errors were identified using NABH standards, including prescription, transcription, dispensing, and administration errors. Errors were further classified based on severity using the NCC MERP index. Data were analyzed using appropriate statistical methods.

Results Among 21,312 medication-use opportunities evaluated, 750 medication errors were identified (overall error rate 3.52%). Prescription errors were most frequent (599;7.78%), followed by transcription (122;6.87%), dispensing (23;0.55%), and administration errors (6; 0.08%). Common prescribing errors included non-use of generic names (51.6%), omission of dosage (13.5%), and inappropriate capitalization (8.0%). Most errors were of minor to moderate severity and unlikely to cause direct patient harm. Antibiotics and non-steroidal anti-inflammatory drugs were the most commonly implicated drug classes.

Conclusion Medication errors were predominantly related to prescribing practices. Strengthening prescription protocols, encouraging generic prescribing, and implementing regular pharmacist-led audits can enhance medication safety and improve compliance with NABH standards.